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Sample records for acute medical emergencies

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

    PubMed

    Kawahara, M; Takeshita, T; Akita, S

    1986-01-01

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

  2. The Role of Emergency Medical Services in Geriatrics: Bridging the Gap between Primary and Acute Care.

    PubMed

    Goldstein, Judah; McVey, Jennifer; Ackroyd-Stolarz, Stacy

    2016-01-01

    Caring for older adults is a major function of emergency medical services (EMS). Traditional EMS systems were designed to treat single acute conditions; this approach contrasts with best practices for the care of frail older adults. Care might be improved by the early identification of those who are frail and at highest risk for adverse outcomes. Paramedics are well positioned to play an important role via a more thorough evaluation of frailty (or vulnerability). These findings may inform both pre-hospital and subsequent emergency department (ED) based decisions. Innovative programs involving EMS, the ED, and primary care could reduce the workload on EDs while improving patient access to care, and ultimately patient outcomes. Some frail older adults will benefit from the resources and specialized knowledge provided by the ED, while others may be better helped in alternative ways, usually in coordination with primary care. Discerning between these groups is a challenge worthy of further inquiry. In either case, care should be timely, with a focus on identifying emergent or acute care needs, frailty evaluation, mobility assessments, identifying appropriate goals for treatment, promoting functional independence, and striving to have the patient return to their usual place of residence if this can be done safely. Paramedics are uniquely positioned to play a larger role in the care of our aging population. Improving paramedic education as it pertains to geriatrics is a critical next step.

  3. Emergency medical dispatching: rapid identification and treatment of acute myocardial infarction. National Heart Attack Alert Program Coordinating Committee Access to Care Subcommittee.

    PubMed

    1995-01-01

    Emergency medical telephone calls (ie, those made to 9-1-1 or 7-digit emergency numbers) are directed to emergency medical dispatchers (EMDs) who are responsible for quickly obtaining critical pieces of information from the caller, then activating an appropriate level of emergency medical services (EMS) response and providing the caller with patient care instructions until medical help arrives. The impact of well-trained, medically managed EMDs on the early care of potential acute myocardial infarction (AMI) patients is believed to be beneficial. However, standards for emergency medical dispatching vary widely across the nation. To improve emergency medical dispatching for AMI patients in the United States, this article by the Access to Care Subcommittee on behalf of the National Heart Attack Alert Program makes a number of recommendations regarding the use of medical dispatch protocols, provision of dispatch life support, EMD training, EMD certification, and emergency medical dispatch quality control and improvement processes.

  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 expertise evaluation of organization of rendering of acute, emergency and urgent medical care in rural regions of Novosibirsk oblast'].

    PubMed

    Ivaninskiĭ, O I; Sharapov, I V; Sadovoĭ, M A

    2013-01-01

    The most problematic spheres in the resource support of emergency medical care to rural residents are the completeness of staff of physicians in rural medical surgeries, community hospitals and departments of emergency medical care in central district hospitals. The provision of feldsher obstetrics posts with sanitary motor transport and medical equipment is yet another problematic sphere. The main troubles during provision of emergency medical care at feldsher obstetrics posts are related to surgery treatment. The organization of emergency and urgent medical care suffers of many unresolved problems related to informational program support at feldsher obstetrics posts, polyclinics of central district hospitals.

  6. Predictors for Delayed Emergency Department Care in Medical Patients with Acute Infections – An International Prospective Observational Study

    PubMed Central

    Hausfater, Pierre; Amin, Devendra; Amin, Adina; Haubitz, Sebastian; Conca, Antoinette; Reutlinger, Barbara; Canavaggio, Pauline; Sauvin, Gabrielle; Bernard, Maguy; Huber, Andreas; Mueller, Beat; Schuetz, Philipp

    2016-01-01

    Introduction In overcrowded emergency department (ED) care, short time to start effective antibiotic treatment has been evidenced to improve infection-related clinical outcomes. Our objective was to study factors associated with delays in initial ED care within an international prospective medical ED patient population presenting with acute infections. Methods We report data from an international prospective observational cohort study including patients with a main diagnosis of infection from three tertiary care hospitals in Switzerland, France and the United States (US). We studied predictors for delays in starting antibiotic treatment by using multivariate regression analyses. Results Overall, 544 medical ED patients with a main diagnosis of acute infection and antibiotic treatment were included, mainly pneumonia (n = 218; 40.1%), urinary tract (n = 141; 25.9%), and gastrointestinal infections (n = 58; 10.7%). The overall median time to start antibiotic therapy was 214 minutes (95% CI: 199, 228), with a median length of ED stay (ED LOS) of 322 minutes (95% CI: 308, 335). We found large variations of time to start antibiotic treatment depending on hospital centre and type of infection. The diagnosis of a gastrointestinal infection was the most significant predictor for delay in antibiotic treatment (+119 minutes compared to patients with pneumonia; 95% CI: 58, 181; p<0.001). Conclusions We found high variations in hospital ED performance in regard to start antibiotic treatment. The implementation of measures to reduce treatment times has the potential to improve patient care. PMID:27171476

  7. Emergency Medical Technician.

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. Center on Education and Training for Employment.

    This document, which is designed for use in developing a tech prep competency profile for the occupation of emergency medical technician, lists technical competencies and competency builders for 18 units pertinent to the health technologies cluster in general and 4 units specific to the occupation of emergency medical technician. The following…

  8. Alcohol as a trigger for medical emergencies

    PubMed Central

    Borges, Guilherme; Cherpitel, Cheryl J.; Orozco, Ricardo; Macdonald, Scott; Giesbrecht, Norman; Cremonte, Mariana; Moskalewicz, Jacek; Swiatkiewicz, Grazyna

    2013-01-01

    Our goal is to report relative risks of the impact of alcohol consumption six hours prior to medical emergencies presenting in the emergency department for 8,346 patients in seven countries using data from the Emergency Room Collaborative Alcohol Analysis Project. We found that alcohol increased the risk of a medical emergency by 2.17 times (Confidence Interval=1.78–2.65) and those without a regular pattern of heavy drinking and those younger showed greater risk. Acute alcohol is associated not only with injury but also with medical emergencies. More studies are needed on the acute role of alcohol in medical emergencies, preferably with data on type of medical emergencies. PMID:23566204

  9. Alcohol as a trigger for medical emergencies.

    PubMed

    Borges, Guilherme; Cherpitel, Cheryl; Orozco, Ricardo; MacDonald, Scott; Giesbrecht, Norman; Moskalewicz, Jacek; Swiatkiewicz, Grazyna; Cremonte, Mariana

    2013-05-01

    In this paper, our goal is to report relative risks of the impact of alcohol consumption 6 hours prior to medical emergencies presenting in the emergency department for 8,346 patients in seven countries using data from the Emergency Room Collaborative Alcohol Analysis Project. We found that alcohol increased the risk of a medical emergency by 2.17 times (confidence interval: 1.78-2.65), and those without a regular pattern of heavy drinking and those younger showed a greater risk. Acute alcohol is associated not only with injury but also with medical emergencies. More studies are needed on the acute role of alcohol in medical emergencies, preferably with data on the type of medical emergencies.

  10. 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.

  11. Emergency Medical Treatment Needs: Chronic and Acute Exposure to Hazardous Materials.

    DTIC Science & Technology

    1982-06-01

    Written-Material Resources Distribution List I I .tti. --1..... INDEX OF FIGURES 1 ~ Page 1 Sample Posting from RTECS Under Category "Moderate - Eye...Irritation 8 INDEX OF TABLES 1 Chemical Classes Listed in Industrial Hygiene and Toxicology 6 2 Categories Used in the RTECS Data Bank 7 3 Matrix of...readily available, unbiased listing of chemicals in order * to correlate medical guidelines with chemical classification groups. The starting point for

  12. Neighborhood Influences on Emergency Medical Services Use for Acute Stroke – A Population-based Cross Sectional Study

    PubMed Central

    Meurer, William J.; Levine, Deborah A.; Kerber, Kevin A.; Zahuranec, Darin B.; Burke, James; Baek, Jonggyu; Sanchez, Brisa; Smith, Melinda A; Morgenstern, Lewis B.; Lisabeth, Lynda

    2015-01-01

    Objective Delay to hospital arrival limits acute stroke treatment. Use of emergency medical service (EMS) is key in ensuring timely stroke care. We aimed to identify low-EMS utilizing neighborhoods and to evaluate whether neighborhood-level factors were associated with (EMS) use. Methods We conducted a secondary analysis of data from the Brain Attack Surveillance in Corpus Christi (BASIC) project, a population-based stroke surveillance study of ischemic stroke and intracerebral hemorrhage cases presenting to emergency departments in Nueces County, Texas. The primary outcome was arrival by EMS. The primary exposures were neighborhood resident age, poverty, and violent crime. We estimated the association of neighborhood level factors with EMS use using hierarchical logistic regression, controlling for individual factors (stroke severity, ethnicity and age). Results During 2000-2009 there were 4004 identified strokes, with EMS use data available for 3474. Nearly half (49%) of stroke cases arrived by EMS. Adjusted stroke EMS utilization was lower in neighborhoods with higher family income (OR 0.86 95% CI 0.75-0.97) and a larger percentage of older adults (OR 0.70, 95% CI 0.56-0.89). Individual factors associated with stroke EMS use included white race (OR 1.41 95% CI 1.13-1.76) and older age (OR 1.36 per 10-year age increment, 95% CI 1.27-1.46). The proportion of neighborhood stroke cases arriving by EMS ranged from 17% to 71%. The fully adjusted model only explained 0.3% (95% CI 0-1.1%) of neighborhood EMS stroke use variance, indicating that individual factors are more strongly associated with stroke EMS use than neighborhood factors. Conclusions While some neighborhood-level factors were associated with EMS use, patient-level factors explained nearly all variability in stroke EMS use. In this community, strategies to increase EMS use should target individuals rather than specific neighborhoods. PMID:26386884

  13. Emergency medical dispatch.

    PubMed

    Dunford, James V

    2002-11-01

    EMD will always remain somewhat of an imprecise science by nature. 911 is, after all, the access point for lifesaving assistance, and citizens must have absolute freedom to this service. The consequence of having the freedom to request help from any location at any time is that some individuals will use it for the wrong reasons. Present-day dispatchers must serve ever-broadening communities with multiple languages, cultural diversity, and unique health needs. Along with other essential personnel that make up the fabric of the public safety net, emergency medical dispatchers have now become essential to the provision of time-critical skills and compassion for perceived medical emergency.

  14. Kind and estimated stocking amount of antidotes for initial treatment for acute poisoning at emergency medical centers in Korea.

    PubMed

    Sohn, Chang Hwan; Ryoo, Seung Mok; Lim, Kyoung Soo; Kim, Won; Lim, Hoon; Oh, Bum Jin

    2014-11-01

    Antidotes for toxicological emergencies can be life-saving. However, there is no nationwide estimation of the antidotes stocking amount in Korea. This study tried to estimate the quantities of stocking antidotes at emergency department (ED). An expert panel of clinical toxicologists made a list of 18 emergency antidotes. The quantity was estimated by comparing the antidote utilization frequency in a multicenter epidemiological study and the nation-wide EDs' data of National Emergency Department Information System (NEDIS). In an epidemiological study of 11 nationwide EDs from January 2009 to December 2010, only 92 (1.9%) patients had been administered emergency antidotes except activated charcoal among 4,870 cases of acute adult poisoning patients. Comparing with NEDIS data, about 1,400,000 patients visited the 124 EDs nationwide due to acute poisoning and about 103,348 adult doses of the 18 emergency antidotes may be required considering poisoning severity score. Of these, 13,224 (1.9%) adult doses of emergency antidotes (575 of atropine, 144 of calcium gluconate or other calcium salts, 2,587 of flumazenil, 3,450 of N-acetylcysteine, 5,893 of pralidoxime, 287 of hydroxocobalamin, 144 of sodium nitrite, and 144 of sodium thiosulfate) would be needed for maintaining the present level of initial treatment with emergency antidotes at EDs in Korea.

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

    PubMed

    Ojino, Mayo; Ishii, Masami

    2014-02-01

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

  16. Medical Emergencies in Pediatric Dentistry

    PubMed Central

    Jurković, Josipa; Jeličić, Jesenka; Balenović, Antonija; Stipančić, Gordana; Čuković-Bagić, Ivana

    2016-01-01

    Medical emergencies that are life threatening can occur in dental practice. Complications may arise because of an underlying disease or a reaction to medication. Reactions to medications may be allergic and toxic. The most common reactions are toxic reactions to local anesthetics, whereas allergies occur mainly as a consequence of the application of antibiotics, usually penicillin. In response to stress, vasovagal syncope typically occurs. Other causes may be related to an underlying disease-specific pathology (such as acute asthma attack, diabetic ketoacidosis, hypoglycemia, or seizures) or accidents (aspiration of a foreign body causing obstruction of the respiratory system). For all the above conditions, guidelines have been established that need to be known. If complications occur or necessary measures are not taken, it can lead to cardiac and respiratory arrest. Therefore, cardiopulmonary resuscitation is needed. All procedures and dosages should be adapted to the age of the child. PMID:27688429

  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. 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:…

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

    PubMed

    Silbereisen, C; Hoffmann, F

    2015-01-01

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

  20. Acute post-disaster medical needs of patients with diabetes: emergency department use in New York City by diabetic adults after Hurricane Sandy

    PubMed Central

    Lee, David C; Gupta, Vibha K; Carr, Brendan G; Malik, Sidrah; Ferguson, Brandy; Wall, Stephen P; Smith, Silas W; Goldfrank, Lewis R

    2016-01-01

    Objective To evaluate the acute impact of disasters on diabetic patients, we performed a geospatial analysis of emergency department (ED) use by New York City diabetic adults in the week after Hurricane Sandy. Research design and methods Using an all-payer claims database, we retrospectively analyzed the demographics, insurance status, and medical comorbidities of post-disaster ED patients with diabetes who lived in the most geographically vulnerable areas. We compared the patterns of ED use among diabetic adults in the first week after Hurricane Sandy's landfall to utilization before the disaster in 2012. Results In the highest level evacuation zone in New York City, postdisaster increases in ED visits for a primary or secondary diagnosis of diabetes were attributable to a significantly higher proportion of Medicare patients. Emergency visits for a primary diagnosis of diabetes had an increased frequency of certain comorbidities, including hypertension, recent procedure, and chronic skin ulcers. Patients with a history of diabetes visited EDs in increased numbers after Hurricane Sandy for a primary diagnosis of myocardial infarction, prescription refills, drug dependence, dialysis, among other conditions. Conclusions We found that diabetic adults aged 65 years and older are especially at risk for requiring postdisaster emergency care compared to other vulnerable populations. Our findings also suggest that there is a need to support diabetic adults particularly in the week after a disaster by ensuring access to medications, aftercare for patients who had a recent procedure, and optimize their cardiovascular health to reduce the risk of heart attacks. PMID:27547418

  1. Recognizing medical emergencies

    MedlinePlus

    ... and call your local emergency number (such as 911). Start CPR (cardiopulmonary resuscitation) or rescue breathing, if ... wait. CALL YOUR LOCAL EMERGENCY NUMBER (SUCH AS 911) IF: The person's condition is life-threatening (for ...

  2. [Acute pulmonary edema as a nursing emergency].

    PubMed

    Navarro Aldana, M C

    2001-01-01

    The presence of Acute Pulmonary Edema represents a severe emergency condition that requires immediate and efficient treatment; otherwise, imminent death of the patient occurs. Therefore it is of utter importance to perform frequent reviews of the literature to keep up with the newest procedures to warrant the best quality nursing care of our patients. This article reviews the physiopathology, clinical manifestations, and medical treatment of the Acute Pulmonary Edema, emphasizing on the nursing aspects of the treatment and pointing out the need to treat the predisposing cardiac alteration as soon as possible.

  3. Emergency Victim Care. A Training Manual for Emergency Medical Technicians. Module 7--Medical Emergencies. 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 medical emergencies. The objectives for the chapter are for students to be able to describe the causes, signs, and symptoms for specified medical emergencies and to describe emergency care for them. Informative…

  4. EFFECTIVENESS OF THE EMERGENCY RESPONSE COURSE IN IMPROVING STUDENT PHYSICAL THERAPISTS' AND LICENSED PHYSICAL THERAPISTS' DECISION‐MAKING RELATED TO ACUTE SPORTS INJURIES AND MEDICAL CONDITIONS

    PubMed Central

    Cross, Patrick Stephen; Hauer, Patrick L.; Blom, Heather; Burcham, Jared; Myers, Amanda K.; Grimsrud, Casey

    2013-01-01

    Purpose: To analyze the effectiveness of the American Red Cross Emergency Response Course (ARC ERC) in improving decision‐making skills of physical therapists (PTs) and third semester clinical doctorate student physical therapists (SPTs) when assessing acute sports injuries and medical conditions. Methods: An existing questionnaire was modified, with permission from the original authors of the instrument. The questionnaire was administered to PTs and SPTs before the start of and immediately after the completion of 5 different ARC ERCs. The overall percentages of “Appropriate” responses for the 17 case scenarios were calculated for each participant for the pre‐and post‐tests. Participants also rated their perceived level of preparedness for managing various conditions using a 5‐point Likert Scale (ranging from Prepared to Unprepared). The overall percentage of “Prepared/Somewhat Prepared” responses for the 16 medical conditions was calculated for each participant for the pre‐and post‐tests. In addition, mean Likert scale scores were calculated for level of perceived preparedness for each of the 16 medical conditions. Paired t‐tests, calculated with SPSS 20.0, were used to analyze the data. Results: 37 of 37 (100.0%) of eligible PTs and 45 of 48 (93.8%) of eligible SPTs completed the pre‐ and post‐test questionnaires. The percentage of “Appropriate” responses for all 17 cases in the aggregate (PTs: 76.8% pre‐test, 89.0% post‐test; SPTs: 68.5%, 84.3%), as well as the percentage of “Prepared/Somewhat Prepared” responses for all conditions in the aggregate (PTs: 67.5%, 96.5%; SPTs: 37.1%, 90.6%) were significantly different from pre‐test to post‐test (P = .000). There was also a significant difference (P < .05) in the mean overall preparedness Likert scale scores from pre‐test to post‐test for each medical condition for the SPT's, and 15 of the 16 medical conditions (muscle strains: P = .119) for the PTs. Conclusions: The

  5. In-flight Medical Emergencies

    PubMed Central

    Chandra, Amit; Conry, Shauna

    2013-01-01

    Introduction: Research and data regarding in-flight medical emergencies during commercial air travel are lacking. Although volunteer medical professionals are often called upon to assist, there are no guidelines or best practices to guide their actions. This paper reviews the literature quantifying and categorizing in-flight medical incidents, discusses the unique challenges posed by the in-flight environment, evaluates the legal aspects of volunteering to provide care, and suggests an approach to managing specific conditions at 30,000 feet. Methods: We conducted a MEDLINE search using search terms relevant to aviation medical emergencies and flight physiology. The reference lists of selected articles were reviewed to identify additional studies. Results: While incidence studies were limited by data availability, syncope, gastrointestinal upset, and respiratory complaints were among the most common medical events reported. Chest pain and cardiovascular events were commonly associated with flight diversion. Conclusion: When in-flight medical emergencies occur, volunteer physicians should have knowledge about the most common in-flight medical incidents, know what is available in on-board emergency medical kits, coordinate their therapy with the flight crew and remote resources, and provide care within their scope of practice. PMID:24106549

  6. NASA Worldwide Emergency Medical Assistance

    NASA Technical Reports Server (NTRS)

    Martin, George A.; Tipton, David A.; Long, Irene D.

    1997-01-01

    In an effort to maintain employee health and welfare, ensure customer satisfaction, and to deliver high quality emergency medical care when necessary to employees located overseas, NASA has instituted a new contract with International SOS Assistance INC. International SOS Assistance INC. will provide civil servants and contractors engaged in official NASA business with many services upon request during a medical or personal emergency. Through the years, International SOS Assistance INC. has developed the expertise necessary to provide medical service in all remote areas of the world. One phone call connects you to the SOS network of multilingual staff trained to help resolve travel, medical, legal, and security problems. The SOS network of critical care and aeromedical specialists operates 24 hours a day, 365 days a year from SOS Alarm Centers around the world. This exhibit illustrates the details of the NASA-International SOS Assistance INC. agreement.

  7. Emerging Standards for Medical Logic

    PubMed Central

    Clayton, Paul D.; Hripcsak, George; Pryor, T. Allan

    1990-01-01

    Sharing medical logic has traditionally occurred in the form of lectures, conversations, books and journals. As knowledge based computer systems have demonstrated their utility in the health care arena, individuals have pondered the best way to transfer knowledge in a computer based representation (1). A simple representation which allows the knowledge to be shared can be constructed when the knowledge base is modular. Within this representation, units have been named Medical Logic Modules (MLM's) and a syntax has emerged which would allow multiple users to create, criticize, and share those types of medical logic which can be represented in this format. In this paper we talk about why standards exist and why they emerge in some areas and not in others. The appropriateness of using the proposed standards for medical logic modules is then examined against this broader context.

  8. Endotracheal administration of emergency medications.

    PubMed

    Powers, R D; Donowitz, L G

    1984-03-01

    When vascular access is delayed or unreliable in emergency situations, an endotracheal tube provides a rapid and reliable route for administration of medication. Epinephrine, lidocaine, and atropine have shown clinical efficacy when given by the endotracheal route. There is evidence that other medications including naloxone and diazepam may also be suitable for endotracheal use, but clear-cut recommendations await further studies of pharmacokinetics and toxicity.

  9. Acute liver failure and self-medication

    PubMed Central

    de OLIVEIRA, André Vitorio Câmara; ROCHA, Frederico Theobaldo Ramos; ABREU, Sílvio Romero de Oliveira

    2014-01-01

    Introduction Not responsible self-medication refers to drug use in high doses without rational indication and often associated with alcohol abuse. It can lead to liver damage and drug interactions, and may cause liver failure. Aim To warn about how the practice of self-medication can be responsible for acute liver failure. Method Were used the Medline via PubMed, Cochrane Library, SciELO and Lilacs, and additional information on institutional sites of interest crossing the headings acute liver failure [tiab] AND acetaminophen [tiab]; self-medication [tiab] AND acetaminophen [tiab]; acute liver failure [tiab] AND dietary supplements [tiab]; self-medication [tiab] AND liver failure [tiab] and self-medication [tiab] AND green tea [tiab]. In Lilacs and SciELO used the descriptor self medication in Portuguese and Spanish. From total surveyed were selected 27 articles and five sites specifically related to the purpose of this review. Conclusions Legislation and supervision disabled and information inaccessible to people, favors the emergence of cases of liver failure drug in many countries. In the list of released drugs that deserve more attention and care, are some herbal medicines used for the purpose of weight loss, and acetaminophen. It is recommended that institutes of health intensify supervision and better orient their populations on drug seemingly harmless, limiting the sale of products or requiring a prescription for release them. PMID:25626943

  10. Time Interval from Symptom Onset to Hospital Care in Patients with Acute Heart Failure: A Report from the Tokyo Cardiac Care Unit Network Emergency Medical Service Database

    PubMed Central

    Shiraishi, Yasuyuki; Kohsaka, Shun; Harada, Kazumasa; Sakai, Tetsuro; Takagi, Atsutoshi; Miyamoto, Takamichi; Iida, Kiyoshi; Tanimoto, Shuzou; Fukuda, Keiichi; Nagao, Ken; Sato, Naoki; Takayama, Morimasa

    2015-01-01

    Aims There seems to be two distinct patterns in the presentation of acute heart failure (AHF) patients; early- vs. gradual-onset. However, whether time-dependent relationship exists in outcomes of patients with AHF remains unclear. Methods The Tokyo Cardiac Care Unit Network Database prospectively collects information of emergency admissions via EMS service to acute cardiac care facilities from 67 participating hospitals in the Tokyo metropolitan area. Between 2009 and 2011, a total of 3811 AHF patients were registered. The documentation of symptom onset time was mandated by the on-site ambulance team. We divided the patients into two groups according to the median onset-to-hospitalization (OH) time for those patients (2h); early- (presenting ≤2h after symptom onset) vs. gradual-onset (late) group (>2h). The primary outcome was in-hospital mortality. Results The early OH group had more urgent presentation, as demonstrated by a higher systolic blood pressure (SBP), respiratory rate, and higher incidence of pulmonary congestion (48.6% vs. 41.6%; P<0.001); whereas medical comorbidities such as stroke (10.8% vs. 7.9%; P<0.001) and atrial fibrillation (30.0% vs. 26.0%; P<0.001) were more frequently seen in the late OH group. Overall, 242 (6.5%) patients died during hospitalization. Notably, a shorter OH time was associated with a better in-hospital mortality rate (odds ratio, 0.71; 95% confidence interval, 0.51−0.99; P = 0.043). Conclusions Early-onset patients had rather typical AHF presentations (e.g., higher SBP or pulmonary congestion) but had a better in-hospital outcome compared to gradual-onset patients. PMID:26562780

  11. Teamwork in emergency medical services.

    PubMed

    Williams, K A; Rose, W D; Simon, R

    1999-01-01

    Emergency medical care is delivered by highly trained and motivated individuals working in groups. In some cases, these groups function as teams, but their teamwork has been poorly studied and rarely is the result of focused training. Medical outcome traditionally is described using patient parameters and often is related to the economics of care delivery. Errors in medical care typically are blamed on individuals and occasionally on system problems. Teams and teamwork, although a major part of the medical delivery system, usually are not included in training, outcome measures, or rigorous quality improvement efforts. This article outlines issues involved in the analysis of medical errors as they relate to measures of individual and team performance and introduces concepts related to emergency care teamwork and team training. Through analogy with aviation analysis of errors and corrective training medical care similarly is being analyzed and error-reduction efforts studied and implemented. The potential benefit of teamwork training for EMS personnel, including air medical crews, is discussed.

  12. [Medical emergencies and sea rescue].

    PubMed

    Lefebvre, Fabien; Albert, Christophe; Gunepin, David; Pondaven, Eric; Querellou, Emgan

    2013-01-01

    Military nurses and doctors are on permanent standby to respond to any medical emergency which may arise at sea. This atypical form of practice is part of a specific organisation, in order to provide optimal, high-quality care in the most remote places of the oceans.

  13. Emergency Medical Services Program Standards.

    ERIC Educational Resources Information Center

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

    This guide contains 45 program standards for the emergency medical services program conducted in technical institutes in Georgia. The standards are divided into 12 categories: foundations (philosophy, purpose, goals, program objectives, availability, evaluation); admissions (admission requirements, provisional admission requirements, recruitment,…

  14. Patient and System-Related Delays of Emergency Medical Services Use in Acute ST-Elevation Myocardial Infarction: Results from the Third Gulf Registry of Acute Coronary Events (Gulf RACE-3Ps)

    PubMed Central

    AlHabib, Khalid F.; Sulaiman, Kadhim; Al Suwaidi, Jassim; Almahmeed, Wael; Alsheikh-Ali, Alawi A.; Amin, Haitham; Al Jarallah, Mohammed; Alfaleh, Hussam F.; Panduranga, Prashanth; Hersi, Ahmad; Kashour, Tarek; Al Aseri, Zohair; Ullah, Anhar; Altaradi, Hani B.; Nur Asfina, Kazi; Welsh, Robert C.; Yusuf, Salim

    2016-01-01

    Background Little is known about Emergency Medical Services (EMS) use and pre-hospital triage of patients with acute ST-elevation myocardial infarction (STEMI) in Arabian Gulf countries. Methods Clinical arrival and acute care within 24 h of STEMI symptom onset were compared between patients transferred by EMS (Red Crescent and Inter-Hospital) and those transferred by non-EMS means. Data were retrieved from a prospective registry of 36 hospitals in 6 Arabian Gulf countries, from January 2014 to January 2015. Results We enrolled 2,928 patients; mean age, 52.7 (SD ±11.8) years; 90% men; and 61.7% non-Arabian Gulf citizens. Only 753 patients (25.7%) used EMS; which was mostly via Inter-Hospital EMS (22%) rather than direct transfer from the scene to the hospital by the Red Crescent (3.7%). Compared to the non-EMS group, the EMS group was more likely to arrive initially at a primary or secondary health care facility; thus, they had longer median symptom-onset-to-emergency department arrival times (218 vs. 158 min; p˂.001); they were more likely to receive primary percutaneous coronary interventions (62% vs. 40.5%, p = 0.02); they had shorter door-to-needle times (38 vs. 42 min; p = .04); and shorter door-to-balloon times (47 vs. 83 min; p˂.001). High EMS use was independently predicted mostly by primary/secondary school educational levels and low or moderate socioeconomic status. Low EMS use was predicted by a history of angina and history of percutaneous coronary intervention. The groups had similar in-hospital deaths and outcomes. Conclusion Most acute STEMI patients in the Arabian Gulf region did not use EMS services. Improving Red Crescent infrastructure, establishing integrated STEMI networks, and launching educational public campaigns are top health care system priorities. PMID:26807577

  15. 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…

  16. Intelligent Medical Systems for Aerospace Emergency Medical Services

    NASA Technical Reports Server (NTRS)

    Epler, John; Zimmer, Gary

    2004-01-01

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

  17. Emergency Victim Care. A Textbook for Emergency Medical Personnel.

    ERIC Educational Resources Information Center

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

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

  18. 38 CFR 1.485 - Medical emergencies.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Medical emergencies. 1... PROVISIONS Disclosures Without Patient Consent § 1.485 Medical emergencies. (a) General rule. Under the... §§ 1.460 through 1.499 of this part may be disclosed to medical personnel who have a need...

  19. 38 CFR 1.485 - Medical emergencies.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Medical emergencies. 1... PROVISIONS Disclosures Without Patient Consent § 1.485 Medical emergencies. (a) General rule. Under the... §§ 1.460 through 1.499 of this part may be disclosed to medical personnel who have a need...

  20. Acute disseminated encephalomyelitis presenting with hypertensive emergency.

    PubMed

    Ganguly, Samrat; Das, Mousumi; Bagchi, Nilay Ranjan

    2014-04-01

    We report a 12-year-old girl presenting with acute disseminated encephalomyelitis (ADEM) along with hypertensive emergency. Hypertension persisted for few weeks following recovery and subsided with oral clonidine. Although autonomic instability in ADEM has been reported before, hypertensive emergency was not previously documented as presenting feature of ADEM.

  1. Focused Acute Medicine Ultrasound (FAMUS) - point of care ultrasound for the Acute Medical Unit.

    PubMed

    Smallwood, Nicholas; Dachsel, Martin; Matsa, Ramprasad; Tabiowo, Eugene; Walden, Andrew

    2016-01-01

    Point of care ultrasound (POCU) is becoming increasingly popular as an extension to clinical examination techniques. Specific POCU training pathways have been developed in specialties such as Emergency and Intensive Care Medicine (CORE Emergency Ultrasound and Core UltraSound Intensive Care, for example), but until this time there has not been a curriculum for the acutely unwell medical patient outside of Critical Care. We describe the development of Focused Acute Medicine Ultrasound (FAMUS), a curriculum designed specifically for the Acute Physician to learn ultrasound techniques to aid in the management of the unwell adult patient. We detail both the outline of the curriculum and the process involved for a candidate to achieve FAMUS accreditation. It is anticipated this will appeal to both Acute Medical Unit (AMU) clinicians and general physicians who deal with the unwell or deteriorating medical or surgical patient. In time, the aspiration is for FAMUS to become a core part of the AIM curriculum.

  2. 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.

  3. Emergency Surgery for Acute Complicated Diverticulitis

    PubMed Central

    Köckerling, Ferdinand

    2015-01-01

    Background The optimal treatment of acute complicated diverticulitis is a matter of debate and has undergone significant changes. Currently, the main focus of surgical treatment concepts is on controlling the emergency situation triggered by acute complicated sigmoid diverticulitis through interventional and minimally invasive measures. Methods This article presents the current data and recommendations on differentiated treatment of acute complicated sigmoid diverticulitis, which are also summarized in a decision tree. Results In general, resection of the diverticular sigmoid is needed to treat acute complicated sigmoid diverticulitis, because without resection the recurrence rate is too high at 40%. Since the morbidity and mortality rates associated with emergency resection are extremely high, resulting in the creation of a stoma, efforts are made to control the acute situation through interventional and laparoscopic measures. Therefore, pericolic and pelvic abscesses (Hinchey stages I, II) are eliminated through percutaneous or laparoscopic drainage. Likewise, laparoscopic lavage and drainage are performed for purulent and feculent peritonitis (Hinchey stages III, IV). After elimination of the acute septic situation, interval elective sigmoid resection is conducted. If emergency resection cannot be avoided, it is performed, while taking account of the patient's overall condition, with primary anastomosis and a protective stoma or as discontinuity resection using Hartmann's procedure. Conclusion Thanks to the progress made in interventional and laparoscopic treatment, differentiated concepts are now used to treat acute complicated sigmoid diverticulitis. PMID:26989380

  4. Medical emergencies in the oral health care setting.

    PubMed

    Nunn, P

    2000-01-01

    On any given day a patient seen by the dental hygienist has the potential of experiencing a life-threatening medical emergency. All dental hygiene practitioners should be aware of potential risks that a patient may present, take steps to prevent life-threatening events from occurring, and plan for problems in advance of their happening. The primary goal of this course is to help dental hygienists carry out the ethical, moral, legal, and professional obligation owed any patient. The course will review the basics of medical emergencies, with particular emphasis on those that are most likely to occur in the dental office. Discussion will center on general aspects of prevention and preparation, and will focus on the recognition and emergency treatment of specific conditions. Vasodepressor syncope, orthostatic hypotension, acute adrenal insufficiency, hyperventilation, asthma, heart failure and acute pulmonary edema, cerebrovascular accident seizures, hyperglycemia, hypoglycemia, myocardial infarction, angina pectoris, and anaphylaxis will be emphasized.

  5. 10 CFR 4.14 - Medical emergencies.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 1 2011-01-01 2011-01-01 false Medical emergencies. 4.14 Section 4.14 Energy NUCLEAR... and Title IV of the Energy Reorganization Act of 1974 Discrimination Prohibited § 4.14 Medical... health, and such service or other benefit cannot be provided except by or through a medical...

  6. 10 CFR 4.14 - Medical emergencies.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Medical emergencies. 4.14 Section 4.14 Energy NUCLEAR... and Title IV of the Energy Reorganization Act of 1974 Discrimination Prohibited § 4.14 Medical... health, and such service or other benefit cannot be provided except by or through a medical...

  7. 42 CFR 2.51 - Medical emergencies.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Medical emergencies. 2.51 Section 2.51 Public... OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Disclosures Without Patient Consent § 2.51 Medical... identifying information may be disclosed to medical personnel who have a need for information about a...

  8. Emergency Medical Rescue in a Radiation Environment

    SciTech Connect

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

    1999-09-14

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

  9. Emergency medical care in developing countries: is it worthwhile?

    PubMed Central

    Razzak, Junaid A.; Kellermann, Arthur L.

    2002-01-01

    Prevention is a core value of any health system. Nonetheless, many health problems will continue to occur despite preventive services. A significant burden of diseases in developing countries is caused by time-sensitive illnesses and injuries, such as severe infections, hypoxia caused by respiratory infections, dehydration caused by diarrhoea, intentional and unintentional injuries, postpartum bleeding, and acute myocardial infarction. The provision of timely treatment during life-threatening emergencies is not a priority for many health systems in developing countries. This paper reviews evidence indicating the need to develop and/or strengthen emergency medical care systems in these countries. An argument is made for the role of emergency medical care in improving the health of populations and meeting expectations for access to emergency care. We consider emergency medical care in the community, during transportation, and at first-contact and regional referral facilities. Obstacles to developing effective emergency medical care include a lack of structural models, inappropriate training foci, concerns about cost, and sustainability in the face of a high demand for services. A basic but effective level of emergency medical care responds to perceived and actual community needs and improves the health of populations. PMID:12481213

  10. Emergency medical care in developing countries: is it worthwhile?

    PubMed

    Razzak, Junaid A; Kellermann, Arthur L

    2002-01-01

    Prevention is a core value of any health system. Nonetheless, many health problems will continue to occur despite preventive services. A significant burden of diseases in developing countries is caused by time-sensitive illnesses and injuries, such as severe infections, hypoxia caused by respiratory infections, dehydration caused by diarrhoea, intentional and unintentional injuries, postpartum bleeding, and acute myocardial infarction. The provision of timely treatment during life-threatening emergencies is not a priority for many health systems in developing countries. This paper reviews evidence indicating the need to develop and/or strengthen emergency medical care systems in these countries. An argument is made for the role of emergency medical care in improving the health of populations and meeting expectations for access to emergency care. We consider emergency medical care in the community, during transportation, and at first-contact and regional referral facilities. Obstacles to developing effective emergency medical care include a lack of structural models, inappropriate training foci, concerns about cost, and sustainability in the face of a high demand for services. A basic but effective level of emergency medical care responds to perceived and actual community needs and improves the health of populations.

  11. S(p)O(2) values in acute medical admissions breathing air--implications for the British Thoracic Society guideline for emergency oxygen use in adult patients?

    PubMed

    Smith, Gary B; Prytherch, David R; Watson, Duncan; Forde, Val; Windsor, Alastair; Schmidt, Paul E; Featherstone, Peter I; Higgins, Bernie; Meredith, Paul

    2012-10-01

    S(p)O(2) is routinely used to assess the well-being of patients, but it is difficult to find an evidence-based description of its normal range. The British Thoracic Society (BTS) has published guidance for oxygen administration and recommends a target S(p)O(2) of 94-98% for most adult patients. These recommendations rely on consensus opinion and small studies using arterial blood gas measurements of saturation (S(a)O(2)). Using large datasets of routinely collected vital signs from four hospitals, we analysed the S(p)O(2) range of 37,593 acute general medical inpatients (males: 47%) observed to be breathing room air. Age at admission ranged from 16 to 105 years with a mean (SD) of 64 (21) years. 19,642 admissions (52%) were aged <70 years. S(p)O(2) ranged from 70% to 100% with a median (IQR) of 97% (95-98%). S(p)O(2) values for males and females were similar. In-hospital mortality for the study patients was 5.27% (range 4.80-6.27%). Mortality (95% CI) for patients with initial S(p)O(2) values of 97%, 96% and 95% was 3.65% (3.22-4.13); 4.47% (3.99-5.00); and 5.67% (5.03-6.38), respectively. Additional analyses of S(p)O(2) values for 37,299 medical admissions aged ≥18 years provided results that were distinctly different to those upon which the current BTS guidelines based their definition of normality. Our findings suggest that the BTS should consider changing its target saturation for actively treated patients not at risk of hypercapnic respiratory failure to 96-98%.

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

    PubMed

    Dick, W

    1994-01-01

    Emergency medicine is subjected worldwide to financial stringencies and organizational evaluations of cost-effectiveness. The various links in the chain of survival are affected differently. Bystander assistance or bystander CPR is available in only 30% of the emergencies, response intervals--if at all required by legislation--are observed to only a limited degree or are too extended for survival in cardiac arrest. A single emergency telephone number is lacking. Too many different phone numbers for emergency reporting result in confusion and delays. Organizational realities are not fully overcome and impair efficiency. The position of the emergency physician in the EMS System is inadequately defined, the qualification of too many emergency physicians are unsatisfactory. In spite of this, emergency physicians are frequently forced to answer out-of-hospital emergency calls. Conflicts between emergency physicians and EMTs may be overcome by providing both groups with comparable qualifications as well as by providing an explicit definition of emergency competence. A further source of conflict occurs at the juncture of prehospital and inhospital emergency care in the emergency department. Deficiencies on either side play a decisive role. At least in principle there are solutions to the deficiencies in the EMSS and in intensive care medicine. They are among others: Adequate financial compensation of emergency personnel, availability of sufficient numbers of highly qualified personnel, availability of a central receiving area with an adjacent emergency ward, constant information flow to the dispatch center on the number of available emergency beds, maintaining 5% of all beds as emergency beds, establishing intermediate care facilities. Efficiency of emergency physician activities can be demonstrated in polytraumatized patients or in patients with ventricular fibrillation or acute myocardial infarction, in patients with acute myocardial insufficiency and other emergency

  13. Emergency Victim Care. A Training Manual for Emergency Medical Technicians. Module 11--Childbirth, Pediatric Emergencies. 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 childbirth and pediatric emergencies. Objectives stated for the two chapters are for the students to be able to describe: emergency procedures for normal childbirth, unusual childbirth emergencies, emergency care for…

  14. Pediatric mental health emergencies in the emergency medical services system.

    PubMed

    Dolan, Margaret A; Mace, Sharon E

    2006-10-01

    Emergency departments are vital in the management of pediatric patients with mental health emergencies. Pediatric mental health emergencies are an increasing part of emergency medical practice because emergency departments have become the safety net for a fragmented mental health infrastructure that is experiencing critical shortages in services in all sectors. Emergency departments 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, and attention-deficit/hyperactivity disorder and those experiencing a behavioral crisis. Emergency departments also manage patients with suicidal ideation, depression, escalating aggression, substance abuse, posttraumatic stress disorder, and maltreatment and those exposed to violence and unexpected deaths. Emergency departments 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 advocacy for increased mental health resources, including improved pediatric mental health tools for the emergency department, increased mental health insurance coverage, and 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.

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

    ERIC Educational Resources Information Center

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

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

  16. Autonomic dysreflexia: a medical emergency

    PubMed Central

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

    2005-01-01

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

  17. Utilizations and Perceptions of Emergency Medical Services by Patients with ST-Segments Elevation Acute Myocardial Infarction in Abu Dhabi: A Multicenter Study

    PubMed Central

    Callachan, Edward Lance; Alsheikh-Ali, Alawi A.; Nair, Satish Chandrasekhar; Bruijns, Stevan; Wallis, Lee A.

    2016-01-01

    Background: Data on the use of emergency medical services (EMS) by patients with cardiac conditions in the Gulf region are scarce, and prior studies have suggested underutilization. Patient perception and knowledge of EMS care is critical to proper utilization of such services. Objectives: To estimate utilization, knowledge, and perceptions of EMS among patients with ST-elevation myocardial infarction (STEMI) in the Emirate of Abu Dhabi. Methods: We conducted a multicenter prospective study of consecutive patients admitted with STEMI in four government-operated hospitals in Abu Dhabi. Semi-structured interviews were conducted with patients to assess the rationale for choosing their prehospital mode of transport and their knowledge of EMS services. Results: Of 587 patients with STEMI (age 51 ± 11 years, male 95%), only 15% presented through EMS, and the remainder came via private transport. Over half of the participants (55%) stated that they did not know the telephone number for EMS. The most common reasons stated for not using EMS were that private transport was quicker (40%) or easier (11%). A small percentage of participants (7%) did not use EMS because they did not think their symptoms were cardiac-related or warranted an EMS call. Stated reasons for not using EMS did not significantly differ by age, gender, or primary language of the patients. Conclusions: EMS care for STEMI is grossly underutilized in Abu Dhabi. Patient knowledge and perceptions may contribute to underutilization, and public education efforts are needed to raise their perception and knowledge of EMS. PMID:27512532

  18. Emergency Medical Treatment for the "Wilderness" Context.

    ERIC Educational Resources Information Center

    National Association for Search and Rescue, Fairfax, VA.

    This paper offers a brief outline of the training curriculum developed by the National Association for Search and Rescue (NASAR) for its Wilderness Medicine Programs. The training modules are designed for wilderness search and rescue units, rural emergency medical services (EMS) squads, military medics, backcountry rangers, epedition leaders,…

  19. 42 CFR 2.51 - Medical emergencies.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Disclosures Without Patient Consent § 2.51 Medical emergencies. (a) General Rule. Under the procedures required by paragraph (c) of this section, patient identifying information may be disclosed to medical personnel who have a need for information about a...

  20. 42 CFR 2.51 - Medical emergencies.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Disclosures Without Patient Consent § 2.51 Medical emergencies. (a) General Rule. Under the procedures required by paragraph (c) of this section, patient identifying information may be disclosed to medical personnel who have a need for information about a...

  1. 42 CFR 2.51 - Medical emergencies.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Disclosures Without Patient Consent § 2.51 Medical emergencies. (a) General Rule. Under the procedures required by paragraph (c) of this section, patient identifying information may be disclosed to medical personnel who have a need for information about a...

  2. Emergency Medical Services: Initial Survey Report.

    ERIC Educational Resources Information Center

    Huff, Hugh; Caltagirone, Norma

    This report presents the findings of an initial survey that was designed to systematically determine the educational needs of citizens with regards to the emergency medical services system in their county. Specifically, the survey sampled the knowledge of respondents concerning: (1) what medical service is; (2) what services are available; (3) how…

  3. International Conference on Remote Emergency Medical Services

    NASA Technical Reports Server (NTRS)

    1975-01-01

    An emergency medical system is characterized. Applications of NASA technology in biomedical telecommunication and bioinstrumentation are explored. The training and effectiveness of paramedics, technicians, nurses, and physicians are evaluated as applied to emergency situations and the operations of trauma centers. Civilian and military aeromedical evacuation is discussed.

  4. Shuttle abort landing site emergency medical services

    NASA Technical Reports Server (NTRS)

    Mckenas, David K.; Jennings, Richard T.

    1991-01-01

    NASA and DOD studies of medical-planning and logistical problems are reviewed as applicable to providing emergency medical care at remote transoceanic abort landing (TAL) sites. Two options are analyzed including a modified surgical response team and a combination physician/medical technician team. The two concepts are examined in terms of cost-effectiveness, specific types of medical support such as blood procurement, and search-and-rescue requirements. It is found that the physician/technician team is more economically efficient, and the description of the concept permits the development of an effective TAL-site astronaut medical-support system. A balance is struck between the competing problems of cost and medical capability by planning for on-scene medical stabilization and air evacuation to DOD tertiary medical centers.

  5. Scientific basis for selection of emergency medical examination gloves for emergency medical technicians, paramedics, firefighters, and emergency department personnel.

    PubMed

    Edlich, Richard F; Taylor, Catherine C; Winters, Kathryne; Martin, Marcus L; Anima, Gloria; Long, William B; Werner, Charles L; Perches, Colette R

    2004-01-01

    Dusting powders were first applied to gloves to facilitate donning. After 1980, manufacturers devised innovative techniques to manufacture gloves without dusting powders. It has been well documented that the powders on gloves present a health hazard to patients, as well as healthcare workers. First, these powders elicit tissue toxicity in every tissue in the body. Second, these powders serve as carriers of latex allergen and may precipitate a life-threatening allergic reaction in sensitized patients. These well-documented hazards of glove powders have caused a growing number of emergency medical technicians, paramedics, firelighters, and hospitals to abandon the use of powdered emergency medical examination gloves, using only powder-free gloves. Powder-free latex as well as non-latex gloves are now available to emergency medical technicians, paramedics, firefighters, and emergency department personnel. The use of powder-free natural rubber latex-free gloves is especially important to emergency medical technicians, paramedics, firefighters, as well as emergency department personnel to avoid eliciting an allergic reaction in the latex sensitized patient. The majority of our emergency medical technicians, paramedics and firefighters are now wearing powder-free emergency medical examination gloves that comply with the stringent Codes and Standards established by the National Fire Protection Association (NFPA), while very few hospital emergency department personnel have been provided with NFPA approved gloves. It is the purpose of this report to review the stringent regulations for emergency medical examination gloves that are outlined by the NFPA. This design and performance Standard was devised by the NFPA to address protective clothing for emergency medical operations. The design and performance requirement of the emergency medical examination gloves were described in the NFPA 1999, Standard on Protective Clothing for Emergency Medical Operations, 1997 Edition. In

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

    PubMed Central

    2011-01-01

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

  7. Usefulness of emergency medical teams in sport stadiums.

    PubMed

    Leusveld, E; Kleijn, S; Umans, V A W M

    2008-03-01

    In August 2006, the new AZ Alkmaar soccer stadium (capacity 17,000) opened. To provide adequate emergency support, medical teams of Red Cross volunteers and coronary care unit and emergency room nurses were formed, and facilities including automated external defibrillators were made available at the stadium. During every match, 3 teams are placed among the spectators. All patients who had cardiac events were stabilized by the teams and transported to the hospital. They formed the study group. From August 2006 to May 2007, >800,000 individuals attended soccer matches at the new stadium. Four cardiac events (3 out-of-hospital-resuscitations for ventricular fibrillation, 1 patient with chest pain) requiring emergency medical support occurred. On-site resuscitations using defibrillators were successful. Two patients with triple-vessel disease subsequently underwent coronary bypass surgery and implantable cardioverter-defibrillator implantation. One patient had single-vessel disease of the circumflex branch, for which he received a coronary stent. All had uneventful recoveries. An acute coronary syndrome was ruled out in the patient presenting with chest pain. In conclusion, the presence of emergency medical teams at a large sport stadium was of vital importance in the immediate care of critically ill patients. On-site resuscitation using automated external defibrillators was lifesaving in all cases. The presence of medical teams equipped with defibrillators and emergency action plans is recommended at large venues that host sports and other activities.

  8. 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…

  9. Emergency Medical Services; Recommendations For An Approach To An Urgent National Problem.

    ERIC Educational Resources Information Center

    American Coll. of Surgeons, Chicago, IL.

    Medical technicians such as ambulance attendants must be trained to administer life-saving measures to the acutely ill and injured and transport them safely to a medical facility. Thus, the purpose of this conference was to bring together, for a discussion of all aspects of emergency medical services, representatives of all those groups which are…

  10. Helicopter emergency medical service in mountainous areas.

    PubMed

    Tomazin, Iztok

    2009-01-01

    The outcome of patient care can be dramatically improved by bringing rapid rescue-medical treatment to the scene and by rapid transport to a medical facility. In mountainous areas this is usually possible only with the use of helicopters. ICAR MEDCOM suggests international standards for competent and safe response to medical problems in mountainous and wilderness areas. Rescue helicopters should work within the existing emergency medical system with appropriate mountain rescue and medically-trained personnel and with medical and rescue equipment on board. Safety is most important issue in mountain rescue. Activation and approach time should be as short as possible. All persons responsible for activation and realization of a helicopter rescue operation should be aware of all specific problems in the mountains and wilderness.

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

    PubMed

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

    2016-01-01

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

  12. 75 FR 49507 - Recovery Policy, RP9525.4, Emergency Medical Care and Medical Evacuations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-13

    ... SECURITY Federal Emergency Management Agency Recovery Policy, RP9525.4, Emergency Medical Care and Medical..., Emergency Medical Care and Medical Evacuations. This is an existing policy that is scheduled for review to... policy identifies the extraordinary emergency medical care and medical evacuation expenses that...

  13. Helicopter emergency medical service scene communications made easy.

    PubMed

    Koval, Michael

    2014-01-01

    Narrowbanding has caused numerous communication issues. The solution is to use a mutual aid frequency like 123.025. That frequency is 155.3400, and every helicopter emergency medical service operator and emergency medical service agency should name this frequency as "EMS [Emergency Medical Services] Mutual Aid" and preset this frequency for all helicopter emergency medical service scene operations.

  14. 78 FR 59623 - Emergency Medical Equipment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-27

    ... kits to amend the ``no go'' provision. Data show that allowing these items to be incomplete, missing...) should remain, ``no-go'' items. See 66 FR 19033. That final rule's preamble also states that the current... emergency medical equipment items are ``no-go'' items and AEDs should also be considered ``no-go''...

  15. Emergency Medical Technician Series. Duty Task List.

    ERIC Educational Resources Information Center

    Oklahoma State Dept. of Vocational and Technical Education, Stillwater. Curriculum and Instructional Materials Center.

    This document contains the occupational duty/task lists for 12 duties in the occupation of emergency medical technician. Each duty is divided into a number of tasks. A separate page for each duty lists the task with its code number and columns to indicate whether that particular duty has been taught and to provide space for comments. The 12 duties…

  16. Basic Emergency Medical Technician Skills Manual.

    ERIC Educational Resources Information Center

    Oklahoma State Dept. of Vocational and Technical Education, Stillwater. Curriculum and Instructional Materials Center.

    This manual was developed to help students preparing to become emergency medical technicians (EMTs) learn standardized basic skills in the field. The manual itemizes the steps and performance criteria of each required skill and uses an accompanying videotape series (not included) to enhance the educational experience. The five units of the manual,…

  17. 38 CFR 1.485 - Medical emergencies.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... PROVISIONS Disclosures Without Patient Consent § 1.485 Medical emergencies. (a) General rule. Under the procedures required by paragraph (c) of this section, patient identifying information from records covered by... information about a patient for the purpose of treating a condition which poses an immediate threat to...

  18. 38 CFR 1.485 - Medical emergencies.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... PROVISIONS Disclosures Without Patient Consent § 1.485 Medical emergencies. (a) General rule. Under the procedures required by paragraph (c) of this section, patient identifying information from records covered by... information about a patient for the purpose of treating a condition which poses an immediate threat to...

  19. 38 CFR 1.485 - Medical emergencies.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... PROVISIONS Disclosures Without Patient Consent § 1.485 Medical emergencies. (a) General rule. Under the procedures required by paragraph (c) of this section, patient identifying information from records covered by... information about a patient for the purpose of treating a condition which poses an immediate threat to...

  20. Emergency Medical Services. Final Survey Report.

    ERIC Educational Resources Information Center

    Huff, Hugh; Caltagirone, Norma

    In this follow-up study, an examination of the level of awareness of and knowledge about the Emergency Medical Services System in Region J of North Carolina was made to detect any changes from the earlier survey which might be due to a six-month campaign publicizing the system. To further pinpoint the channels through which the citizens of the…

  1. Emergency Medical Services. Final Project Report.

    ERIC Educational Resources Information Center

    Huff, Hugh; Caltagirone, Norma

    This report presents the procedures and activities of a year-long Public Education Project conducted in Region J of North Carolina to help citizens of this region learn what Emergency Medical Services (EMS) are available, how to obtain them, and when to call upon them. Previous reports provide the sampling methodology used to survey the…

  2. Pediatric emergency medical services and their drawbacks

    PubMed Central

    Al-Anazi, Abdullah Foraih

    2012-01-01

    Aim: To survey the literature on Pediatric Emergency Medical Services (PEMS) with an aim to focus its drawbacks and emphasize the means of improvement. Materials and Methods: Published articles selected for inclusion were based on the significance and understanding of literature search on different aspects of PEMS. To meet this criterion, PubMed, PubMed Central, Science Direct, Uptodate, Med Line, comprehensive databases, Cochrane library and the Internet (Google, Yahoo) were thoroughly searched. Results: PEMS provide out-of-hospital medical care and/or transport the patients to definitive care. The task force represents specialties of ambulance transport, first aid, emergency medical care, life saving, trauma, emergency medicine, water rescue, and extrication. Preliminary care is undertaken to save the patients from different medical exigencies. The techniques and procedures of basic and advanced life-support are employed. A large number of weaknesses are recorded in PEMS system, such as ambulance transport irregularities, deficit equipment, lack of expertise, and ignorance of the pre-hospital care providers. These are discussed with special reference to a few examples of medical exigencies. Conclusions: The appointments in PEMS should be regularized with specific qualifications, experience, and expertise in different areas. Responsibility of PEMS should not be left to pre-hospital care providers, who are non clinicians and lack proper education and training. Pediatricians should be adequately trained to play an active role in PEMS. Meetings should be convened to discuss the lapses and means of improvement. Networks of co-operation between pre-hospital providers and experts in the emergency department should be established. PMID:22988399

  3. Distributed virtual environment for emergency medical training

    NASA Astrophysics Data System (ADS)

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

    1997-07-01

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

  4. Emergency medical training for dental students.

    PubMed Central

    Mutzbauer, T. S.; Rossi, R.; Ahnefeld, F. W.; Sitzmann, F.

    1996-01-01

    Twenty-four of the thirty-two German universities that have dental schools replied to a questionnaire survey that showed that all the schools responding held lectures on the topic "Medical Emergencies" although this is not mandatory for registration. All of the universities in the former East Germany also offered practical training sessions as part of the curriculum. The proportion of West German universities offering such courses is only 60%. The basic essentials of the theory and practice of emergency medicine should only be taught in courses with mandatory participation. PMID:10323124

  5. 5 CFR 630.910 - Termination of medical emergency.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Termination of medical emergency. 630.910... AND LEAVE Voluntary Leave Transfer Program § 630.910 Termination of medical emergency. (a) The medical... that the leave recipient is no longer affected by a medical emergency; (3) At the end of the...

  6. Knowledge translation in international emergency medical care.

    PubMed

    Arnold, L Kristian; Alomran, Hisham; Anantharaman, V; Halpern, Pinchas; Hauswald, Mark; Malmquist, Pia; Molyneux, Elizabeth; Rajapakse, Bishan; Ranney, Megan; Razzak, Junaid

    2007-11-01

    More than 90% of the world population receives emergency medical care from different types of practitioners with little or no specific training in the field and with variable guidance and oversight. Emergency medical care is being recognized by actively practicing physicians around the world as an increasingly important domain in the overall health services package for a community. The know-do gap is well recognized as a major impediment to high-quality health care in much of the world. Knowledge translation principles for application in this highly varied young domain will require investigation of numerous aspects of the knowledge synthesis, exchange, and application domains in order to bring the greatest benefit of both explicit and tacit knowledge to increasing numbers of the world's population. This article reviews some of the issues particular to knowledge development and transfer in the international domain. The authors present a set of research proposals developed from a several-month online discussion among practitioners and teachers of emergency medical care in 16 countries from around the globe and from all economic strata, aimed at improving the flow of knowledge from developers and repositories of knowledge to the front lines of clinical care.

  7. 42 CFR 483.372 - Medical treatment for injuries resulting from an emergency safety intervention.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Psychiatric Residential Treatment Facilities Providing Inpatient Psychiatric Services for Individuals Under... as a result of an emergency safety intervention. (b) The psychiatric residential treatment facility... medical care or acute psychiatric care; (2) Medical and other information needed for care of the...

  8. 42 CFR 483.372 - Medical treatment for injuries resulting from an emergency safety intervention.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Psychiatric Residential Treatment Facilities Providing Inpatient Psychiatric Services for Individuals Under... as a result of an emergency safety intervention. (b) The psychiatric residential treatment facility... medical care or acute psychiatric care; (2) Medical and other information needed for care of the...

  9. 42 CFR 483.372 - Medical treatment for injuries resulting from an emergency safety intervention.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Psychiatric Residential Treatment Facilities Providing Inpatient Psychiatric Services for Individuals Under... as a result of an emergency safety intervention. (b) The psychiatric residential treatment facility... medical care or acute psychiatric care; (2) Medical and other information needed for care of the...

  10. 42 CFR 483.372 - Medical treatment for injuries resulting from an emergency safety intervention.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Psychiatric Residential Treatment Facilities Providing Inpatient Psychiatric Services for Individuals Under... as a result of an emergency safety intervention. (b) The psychiatric residential treatment facility... medical care or acute psychiatric care; (2) Medical and other information needed for care of the...

  11. 42 CFR 483.372 - Medical treatment for injuries resulting from an emergency safety intervention.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Psychiatric Residential Treatment Facilities Providing Inpatient Psychiatric Services for Individuals Under... as a result of an emergency safety intervention. (b) The psychiatric residential treatment facility... medical care or acute psychiatric care; (2) Medical and other information needed for care of the...

  12. Time-motion analysis of emergency radiologists and emergency physicians at an urban academic medical center.

    PubMed

    Perry, Warren M; Lee, Christoph I; Steers, W Neil; Post, Lori A; Forman, Howard P

    2013-10-01

    Our objective was to characterize the tasks of emergency radiologists and emergency physicians and quantify the proportion of time spent on these tasks to assess their roles in patient evaluation. Our study involved emergency radiologists and emergency physicians at an urban academic level I trauma medical center. Participants were observed for continuous 2-h periods during which all of their activities were timed and categorized into the following tasks: patient history, patient physical findings, assessment/plan, procedures, technical/administration, paperwork, and personal time. We performed multivariate analyses to compare the proportion of time spent on task categories between specialties. Twenty physicians (10 emergency medicine and 10 radiology) were observed for a total of 146,802 s (2,446.7 min). Radiologists spent a significantly larger combined proportion of time on determining physical findings and paperwork than emergency physicians (61.9 vs. 28.3 %, p<0.0001). Emergency physicians spent a significantly larger proportion of time than radiologists on determining patient history (17.5 vs. 2.5 %, p=0.0008) and assessment/plan (42.3 vs. 19.3 %, p<0.0001). Both specialties devoted minimal time toward personal tasks. Radiologists play a major role in the diagnostic evaluation of a subset of acute patients, spending significantly more of their time determining physical findings than their emergency physician counterparts.

  13. Terrorism and the ethics of emergency medical care.

    PubMed

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

    2001-06-01

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

  14. 30 CFR 57.18014 - Emergency medical assistance and transportation.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... NONMETAL MINES Safety Programs Surface and Underground § 57.18014 Emergency medical assistance and transportation. Arrangements shall be made in advance for obtaining emergency medical assistance and... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Emergency medical assistance and...

  15. 30 CFR 56.18014 - Emergency medical assistance and transportation.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... MINES Safety Programs § 56.18014 Emergency medical assistance and transportation. Arrangements shall be made in advance for obtaining emergency medical assistance and transportation for injured persons. ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Emergency medical assistance and...

  16. 30 CFR 57.18014 - Emergency medical assistance and transportation.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... NONMETAL MINES Safety Programs Surface and Underground § 57.18014 Emergency medical assistance and transportation. Arrangements shall be made in advance for obtaining emergency medical assistance and... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Emergency medical assistance and...

  17. 30 CFR 56.18014 - Emergency medical assistance and transportation.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... MINES Safety Programs § 56.18014 Emergency medical assistance and transportation. Arrangements shall be made in advance for obtaining emergency medical assistance and transportation for injured persons. ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Emergency medical assistance and...

  18. 32 CFR 1656.20 - Expenses for emergency medical care.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false Expenses for emergency medical care. 1656.20... ALTERNATIVE SERVICE § 1656.20 Expenses for emergency medical care. (a) Claims for payment of actual and reasonable expenses for emergency medical care, including hospitalization, of ASWs who suffer illness...

  19. 5 CFR 630.1010 - Termination of medical emergency.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Termination of medical emergency. 630... ABSENCE AND LEAVE Voluntary Leave Bank Program § 630.1010 Termination of medical emergency. (a) The medical emergency affecting a leave recipient shall terminate— (1) When the leave recipient's...

  20. 77 FR 36039 - Federal Interagency Committee on Emergency Medical Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-15

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

  1. 31 CFR 590.507 - Authorization of emergency medical services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... of emergency medical services. The provision of nonscheduled emergency medical services in the United... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Authorization of emergency medical services. 590.507 Section 590.507 Money and Finance: Treasury Regulations Relating to Money and...

  2. 31 CFR 576.509 - Authorization of emergency medical services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... of emergency medical services. The provision of nonscheduled emergency medical services in the United... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Authorization of emergency medical services. 576.509 Section 576.509 Money and Finance: Treasury Regulations Relating to Money and...

  3. 48 CFR 1842.7003 - Emergency medical services and evacuation.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 6 2012-10-01 2012-10-01 false Emergency medical services... NASA Contract Clauses 1842.7003 Emergency medical services and evacuation. The contracting officer must insert the clause at 1852.242-78, Emergency Medical Services and Evacuation, in all solicitations...

  4. 48 CFR 1842.7003 - Emergency medical services and evacuation.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 6 2013-10-01 2013-10-01 false Emergency medical services... NASA Contract Clauses 1842.7003 Emergency medical services and evacuation. The contracting officer must insert the clause at 1852.242-78, Emergency Medical Services and Evacuation, in all solicitations...

  5. 31 CFR 547.508 - Authorization of emergency medical services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... of emergency medical services. The provision of nonscheduled emergency medical services in the United... 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...

  6. 31 CFR 547.508 - Authorization of emergency medical services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  7. 31 CFR 593.508 - Authorization of emergency medical services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Authorization of emergency medical services. The provision of nonscheduled emergency medical services in the... 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...

  8. 31 CFR 590.507 - Authorization of emergency medical services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... of emergency medical services. The provision of nonscheduled emergency medical services in the United... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Authorization of emergency medical services. 590.507 Section 590.507 Money and Finance: Treasury Regulations Relating to Money and...

  9. 31 CFR 544.508 - Authorization of emergency medical services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Authorization of emergency medical services. The provision of nonscheduled emergency medical services in the... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Authorization of emergency medical services. 544.508 Section 544.508 Money and Finance: Treasury Regulations Relating to Money and...

  10. 31 CFR 576.509 - Authorization of emergency medical services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... of emergency medical services. The provision of nonscheduled emergency medical services in the United... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Authorization of emergency medical services. 576.509 Section 576.509 Money and Finance: Treasury Regulations Relating to Money and...

  11. 31 CFR 576.509 - Authorization of emergency medical services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... of emergency medical services. The provision of nonscheduled emergency medical services in the United... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Authorization of emergency medical services. 576.509 Section 576.509 Money and Finance: Treasury Regulations Relating to Money and...

  12. 31 CFR 547.508 - Authorization of emergency medical services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... of emergency medical services. The provision of nonscheduled emergency medical services in the United... 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...

  13. 48 CFR 1842.7003 - Emergency medical services and evacuation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 6 2011-10-01 2011-10-01 false Emergency medical services... NASA Contract Clauses 1842.7003 Emergency medical services and evacuation. The contracting officer must insert the clause at 1852.242-78, Emergency Medical Services and Evacuation, in all solicitations...

  14. 31 CFR 544.508 - Authorization of emergency medical services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Authorization of emergency medical services. The provision of nonscheduled emergency medical services in the... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Authorization of emergency medical services. 544.508 Section 544.508 Money and Finance: Treasury Regulations Relating to Money and...

  15. 31 CFR 590.507 - Authorization of emergency medical services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... of emergency medical services. The provision of nonscheduled emergency medical services in the United... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Authorization of emergency medical services. 590.507 Section 590.507 Money and Finance: Treasury Regulations Relating to Money and...

  16. 31 CFR 576.509 - Authorization of emergency medical services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... of emergency medical services. The provision of nonscheduled emergency medical services in the United... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Authorization of emergency medical services. 576.509 Section 576.509 Money and Finance: Treasury Regulations Relating to Money and...

  17. 31 CFR 593.508 - Authorization of emergency medical services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  18. 31 CFR 593.508 - Authorization of emergency medical services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Authorization of emergency medical services. The provision of nonscheduled emergency medical services in the... 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...

  19. Acute treatment of mania: an update on new medications.

    PubMed

    Gajwani, Prashant; Kemp, David E; Muzina, David J; Xia, Guohua; Gao, Keming; Calabrese, Joseph R

    2006-12-01

    Acute mania is frequently a medical emergency requiring hospitalization for behavioral control, rapid resolution of irritability, agitation, de-escalation of mood, and decreasing of risk-taking behavior. Lithium efficacy in the management of acute mania was reported in 1949 and approved by the US Food and Drug Administration (FDA) in 1970. Chlorpromazine, from the class of typical antipsychotics, was approved for treatment of bipolar disorder in 1973. Typical antipsychotics were frequently used alone and as adjunct for the treatment of bipolar mania for the next 2 decades. Divalproex was approved by the FDA for the treatment of acute mania in 1994. Since the approval of olanzapine in 2000, all five atypical antipsychotics, namely risperidone (2003), quetiapine (2004), ziprasidone (2004), and aripiprazole (2004), have been approved by the FDA for the management of acute mania. Clozapine is the only atypical antipsychotic not FDA approved for any phase of bipolar disorder. This article will systematically review some of the major studies published, randomized controlled monotherapy, and adjunct therapy trials involving five atypical antipsychotics and newer anticonvulsants for the treatment of acute bipolar mania.

  20. The Emergency Medical Services Safety Champions

    PubMed Central

    Patterson, P. Daniel; Anderson, Michelle S.; Zionts, Nancy D.; Paris, Paul M.

    2014-01-01

    The overarching mission of prehospital Emergency Medical Services (EMS) is to deliver life-saving care for people when their needs are greatest. Fulfilling this mission is challenged by threats to patient and provider safety. The EMS setting is high-risk because care is delivered rapidly in the out-of-hospital setting where patient-benefiting resources are limited. There is growing evidence that safety culture varies widely across EMS agencies. A poor safety culture may manifest as error in medication, back injuries, and other poor outcomes for patient and provider. Recently, federal and national leaders of EMS (i.e., the National Highway Traffic Safety Administration) have made improving EMS safety culture a national priority. Unfortunately, there are few initiatives that can help local EMS leaders achieve that priority. We describe the successful EMS Champs Fellowship program supported by the Jewish Healthcare Foundation (JHF) designed to train EMS leaders to improve safety for patients and providers. PMID:23150883

  1. EMS incident management: emergency medical logistics.

    PubMed

    Maniscalco, P M; Christen, H T

    1999-01-01

    If you had to get x amount of supplies to point A or point B, or both, in 10 minutes, how would you do it? The answer lies in the following steps: 1. Develop a logistics plan. 2. Use emergency management as a partner agency for developing your logistics plan. 3. Implement a push logistics system by determining what supplies/medications and equipment are important. 4. Place mass casualty/disaster caches at key locations for rapid deployment. Have medication/fluid caches available at local hospitals. 5. Develop and implement command caches for key supervisors and managers. 6. Anticipate the logistics requirements of a terrorism/tactical violence event based on a community threat assessment. 7. Educate the public about preparing a BLS family disaster kit. 8. Test logistics capabilities at disaster exercises. 9. Budget for logistics needs. 10. Never underestimate the importance of logistics. When logistics support fails, the EMS system fails.

  2. Mammalian synthetic biology: emerging medical applications.

    PubMed

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

    2015-05-06

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

  3. Mammalian synthetic biology: emerging medical applications

    PubMed Central

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

    2015-01-01

    In this review, we discuss new emerging medical applications of the rapidly evolving field of mammalian synthetic biology. We start with simple mammalian synthetic biological components and move towards more complex and therapy-oriented gene circuits. A comprehensive list of ON–OFF switches, categorized into transcriptional, post-transcriptional, translational and post-translational, is presented in the first sections. Subsequently, Boolean logic gates, synthetic mammalian oscillators and toggle switches will be described. Several synthetic gene networks are further reviewed in the medical applications section, including cancer therapy gene circuits, immuno-regulatory networks, among others. The final sections focus on the applicability of synthetic gene networks to drug discovery, drug delivery, receptor-activating gene circuits and mammalian biomanufacturing processes. PMID:25808341

  4. The Community In-reach Rehabilitation and Care Transition (CIRACT) clinical and cost-effectiveness randomisation controlled trial in older people admitted to hospital as an acute medical emergency

    PubMed Central

    Pulikottil-Jacob, Ruth; Marshall, Fiona; Montgomery, Alan; Tan, Wei; Sach, Tracey; Logan, Pip; Kendrick, Denise; Watson, Alison; Walker, Maria; Waring, Justin

    2017-01-01

    Abstract Objective to compare the clinical and cost-effectiveness of a Community In-reach Rehabilitation and Care Transition (CIRACT) service with the traditional hospital-based rehabilitation (THB-Rehab) service. Design pragmatic randomised controlled trial with an integral health economic study. Settings large UK teaching hospital, with community follow-up. Subjects frail older people aged 70 years and older admitted to hospital as an acute medical emergency. Measurements Primary outcome: hospital length of stay; secondary outcomes: readmission, day 91-super spell bed days, functional ability, co-morbidity and health-related quality of life; cost-effectiveness analysis. Results a total of 250 participants were randomised. There was no significant difference in length of stay between the CIRACT and THB-Rehab service (median 8 versus 9 days; geometric mean 7.8 versus 8.7 days, mean ratio 0.90, 95% confidence interval (CI) 0.74–1.10). Of the participants who were discharged from hospital, 17% and 13% were readmitted within 28 days from the CIRACT and THB-Rehab services, respectively (risk difference 3.8%, 95% CI −5.8% to 13.4%). There were no other significant differences in any of the other secondary outcomes between the two groups. The mean costs (including NHS and personal social service) of the CIRACT and THB-Rehab service were £3,744 and £3,603, respectively (mean cost difference £144; 95% CI −1,645 to 1,934). Conclusion the CIRACT service does not reduce major hospital length of stay nor reduce short-term readmission rates, compared to the standard THB-Rehab service; however, a modest (<2.3 days) effect cannot be excluded. Further studies are necessary powered with larger sample sizes and cluster randomisation. Trial registration ISRCTN 94393315, 25th April 2013 PMID:28180236

  5. [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.

  6. Prehospital emergency medical services in Malaysia.

    PubMed

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

    2007-05-01

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

  7. Endovascular vs medical management of acute ischemic stroke

    PubMed Central

    Ding, Dale; Starke, Robert M.; Mehndiratta, Prachi; Crowley, R. Webster; Liu, Kenneth C.; Southerland, Andrew M.; Worrall, Bradford B.

    2015-01-01

    Objective: To compare the outcomes between endovascular and medical management of acute ischemic stroke in recent randomized controlled trials (RCT). Methods: A systematic literature review was performed, and multicenter, prospective RCTs published from January 1, 2013, to May 1, 2015, directly comparing endovascular therapy to medical management for patients with acute ischemic stroke were included. Meta-analyses of modified Rankin Scale (mRS) and mortality at 90 days and symptomatic intracranial hemorrhage (sICH) for endovascular therapy and medical management were performed. Results: Eight multicenter, prospective RCTs (Interventional Management of Stroke [IMS] III, Local Versus Systemic Thrombolysis for Acute Ischemic Stroke [SYNTHESIS] Expansion, Mechanical Retrieval and Recanalization of Stroke Clots Using Embolectomy [MR RESCUE], Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands [MR CLEAN], Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness [ESCAPE], Extending the Time for Thrombolysis in Emergency Neurological Deficits–Intra-Arterial [EXTEND-IA], Solitaire With the Intention For Thrombectomy as Primary Endovascular Treatment [SWIFT PRIME], and Endovascular Revascularization With Solitaire Device Versus Best Medical Therapy in Anterior Circulation Stroke Within 8 Hours [REVASCAT]) comprising 2,423 patients were included. Meta-analysis of pooled data demonstrated functional independence (mRS 0–2) at 90 days in favor of endovascular therapy (odds ratio [OR] = 1.71; p = 0.005). Subgroup analysis of the 6 trials with large vessel occlusion (LVO) criteria also demonstrated functional independence at 90 days in favor of endovascular therapy (OR = 2.23; p < 0.00001). Subgroup analysis of the 5 trials that primarily utilized stent retriever devices (≥70%) in the intervention arm demonstrated functional independence at 90 days in favor of endovascular therapy

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

    PubMed Central

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

    2009-01-01

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

  9. The role of the pediatrician in rural emergency medical services for children.

    PubMed

    Moore, Brian; Sapien, Robert

    2012-11-01

    In rural America, pediatricians can play a key role in the development, implementation, and ongoing supervision of emergency medical services for children (EMSC). Pediatricians may represent the only source of pediatric expertise for a large region and are a vital resource for rural physicians (eg, general and family practice, emergency medicine) and other rural health care professionals (physician assistants, nurse practitioners, and emergency medical technicians), providing education about management and prevention of pediatric illness and injury; appropriate equipment for the acutely ill or injured child; and acute, chronic, and rehabilitative care. In addition to providing clinical expertise, the pediatrician may be involved in quality assurance, clinical protocol development, and advocacy, and may serve as a liaison between emergency medical services and other entities working with children (eg, school nurses, child care centers, athletic programs, and programs for children with special health care needs).

  10. Scientific basis for the selection of emergency medical examination gloves for emergency medical technicians, paramedics, firefighters, and emergency department personnel. An update.

    PubMed

    Edlich, Richard F; Winters, Kathryne L; Martin, Marcus L; Long Iii, William B; Werner, Charles L; Gubler, K Dean

    2005-01-01

    The use of powder-free natural rubber or latex-free emergency medical examination gloves is especially important to emergency medical technicians, paramedics, firefighters, and emergency department personnel to avoid eliciting an allergic reaction in the latex sensitized patient. The majority of our emergency medical technicians, paramedics, and firefighters are now wearing powder-free emergency medical examination gloves that comply with the stringent codes and standards established by the National Fire Protection Association (NFPA), while very few hospital emergency department personnel have been provided with NFPA-approved gloves. There are four well-defined goals of this report that will assist emergency medical services, fire departments, and hospitals in the selection and purchase of emergency medical examination gloves. First, we will review again the stringent regulations for emergency medical examination gloves that are outlined by the NFPA. This design and performance standard was devised by the NFPA to address protective clothing for emergency medical operations. The design and performance requirement of the emergency medical examination gloves were described in the NFPA 1999, Standard on Protective Clothing for Emergency Medical Operations, 1997 Edition. As of September 2003, the emergency medical examination glove must meet the new design and performance requirements of emergency medical examination gloves discussed in NFPA 1999, Standard on Protective Clothing for Emergency Medical Operations, 2003 Edition.

  11. Overview of the Shenzhen Emergency Medical Service Call Pattern

    PubMed Central

    Man Lo, Shuk; Min Yu, Yi; Larry Lee, Lap Yip; Eliza Wong, Mi Ling; Ying Chair, Sek; J Kalinowski, Edward; Jimmy Chan, Tak Shing

    2012-01-01

    BACKGROUND: In Shenzhen, the Emergency Medical Service (EMS) system has been in service since 1997. This study aims to examine the operation of Shenzhen 120 EMS center and to identify the reasons of calling EMS. METHODS: In this retrospective quantitative descriptive study, the data from the Shenzhen 120 EMS registry in 2011 were analyzed. RESULTS: Shenzhen 120 EMS center is a communication command center. When the number of 120 are dialed, it is forwarded to the closest appropriate hospital for ambulance dispatch. In 2011, the Shenzhen 120 EMS center received 153 160 ambulance calls, with an average of 420 calls per day. Calling emergency services was mainly due to traffic accidents. Trauma and other acute diseases constituted a majority of ambulance transports. The adult patients aged 15–60 years are the principal users of EMS. There are no recognized ‘paramedic’ doctors and nurses. The pre-hospital emergency service is under the operation of emergency departments of hospitals. Shenzhen at present does not have specialized pre-hospital training for doctors and nurses in post-trauma management. Moreover, specialized pre-hospital training, financial support, and public health education on proper use of EMS should be emphasized. CONCLUSION: The Shenzhen 120 EMS center has its own epidemiology characteristics. Traumatic injury and traffic accident are the main reasons for calling ambulance service. In-depth study emphasizing the distribution and characteristics of trauma patients is crucial to the future development of EMS. PMID:25215072

  12. The Institute of Medicine report on emergency medical services for children: thoughts for emergency medical technicians, paramedics, and emergency physicians.

    PubMed

    Cook, R T

    1995-07-01

    The emergency medical technician, the paramedic, and the emergency physician, as well as emergency physicians who have additional expertise in emergency medical service (EMS) prehospital care or pediatric emergency medicine (through experience or formal fellowship training), will all find the Institute of Medicine's report, Emergency Medical Services for Children (EMS-C), to be an invaluable background resource as well as a guide for EMS system and EMS-C-related planning. With both breadth and depth, it reviews many of the issues in EMS-C today from many perspectives and provides practical information to enable these care givers to understand better the "big picture" of EMS-C as well as to assist them in continuing to make a difference in the day-to-day emergency care for children. It is well referenced, engenders respect for all members of the team within the broad continuum of EMS-C, and provides encouragement to them to work together to identify and address issues and solve problems to improve the quality of care for our nation's children.

  13. Hazard perception in emergency medical service responders.

    PubMed

    Johnston, K A; Scialfa, C T

    2016-10-01

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

  14. 31 CFR 588.508 - Authorization of emergency medical services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  15. 31 CFR 594.507 - Authorization of emergency medical services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... medical services. The provision of nonscheduled emergency medical services in the United States to persons... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Authorization of emergency medical services. 594.507 Section 594.507 Money and Finance: Treasury Regulations Relating to Money and...

  16. 31 CFR 594.507 - Authorization of emergency medical services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... medical services. The provision of nonscheduled emergency medical services in the United States to persons... 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...

  17. 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…

  18. 28 CFR 115.182 - Access to emergency medical services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Access to emergency medical services. 115... to emergency medical treatment. (b) Treatment services shall be provided to the victim without... ACT NATIONAL STANDARDS Standards for Lockups Medical and Mental Care § 115.182 Access to...

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

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... medical services. The provision of nonscheduled emergency medical services in the United States to persons... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Authorization of emergency medical services. 588.508 Section 588.508 Money and Finance: Treasury Regulations Relating to Money and...

  20. 28 CFR 115.182 - Access to emergency medical services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Access to emergency medical services. 115... to emergency medical treatment. (b) Treatment services shall be provided to the victim without... ACT NATIONAL STANDARDS Standards for Lockups Medical and Mental Care § 115.182 Access to...

  1. 31 CFR 594.507 - Authorization of emergency medical services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... medical services. The provision of nonscheduled emergency medical services in the United States to persons... 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...

  2. 31 CFR 545.517 - Authorization of emergency medical services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  3. 31 CFR 594.507 - Authorization of emergency medical services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... medical services. The provision of nonscheduled emergency medical services in the United States to persons... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Authorization of emergency medical services. 594.507 Section 594.507 Money and Finance: Treasury Regulations Relating to Money and...

  4. 31 CFR 588.508 - Authorization of emergency medical services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... medical services. The provision of nonscheduled emergency medical services in the United States to persons... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Authorization of emergency medical services. 588.508 Section 588.508 Money and Finance: Treasury Regulations Relating to Money and...

  5. 28 CFR 115.182 - Access to emergency medical services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Access to emergency medical services. 115... to emergency medical treatment. (b) Treatment services shall be provided to the victim without... ACT NATIONAL STANDARDS Standards for Lockups Medical and Mental Care § 115.182 Access to...

  6. 31 CFR 594.507 - Authorization of emergency medical services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  7. Psychiatric and medical management of marijuana intoxication in the emergency department.

    PubMed

    Bui, Quan M; Simpson, Scott; Nordstrom, Kimberly

    2015-05-01

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

  8. Psychiatric and Medical Management of Marijuana Intoxication in the Emergency Department

    PubMed Central

    Bui, Quan M.; Simpson, Scott; Nordstrom, Kimberly

    2015-01-01

    We use a case report to describe the acute psychiatric and medical management of marijuana intoxication in the emergency setting. A 34-year-old woman presented with erratic, disruptive behavior and psychotic symptoms after recreational ingestion of edible cannabis. She was also found to have mild hypokalemia and QT interval prolongation. Psychiatric management of cannabis psychosis involves symptomatic treatment and maintenance of safety during detoxification. Acute medical complications of marijuana use are primarily cardiovascular and respiratory in nature; electrolyte and electrocardiogram monitoring is indicated. This patient’s psychosis, hypokalemia and prolonged QTc interval resolved over two days with supportive treatment and minimal intervention in the emergency department. Patients with cannabis psychosis are at risk for further psychotic sequelae. Emergency providers may reduce this risk through appropriate diagnosis, acute treatment, and referral for outpatient care. PMID:25987916

  9. [Nurse anesthetist for the French emergency medical services].

    PubMed

    Dinot, Emmanuel

    2013-10-01

    Nurse anaesthetist for the French emergency medical services. Emmanuel Dinot is a nurse anaesthetist for the emergency medical services in Yvelines, France. Fascinated by the management of emergency situations in non-hospital settings, he paints the portrait of a nursing context where teamwork, rigour, technical expertise and flexibility in spite of stress increase the efficiency of care.

  10. 31 CFR 546.508 - Authorization of emergency medical services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Licenses, Authorizations, and Statements of Licensing Policy § 546.508 Authorization of emergency medical services. The provision of nonscheduled emergency medical services in the United States to persons whose... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Authorization of emergency...

  11. 31 CFR 595.507 - Authorization of emergency medical services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Licenses, Authorizations, and Statements of Licensing Policy § 595.507 Authorization of emergency medical services. The provision of nonscheduled emergency medical services to a specially designated terrorist... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Authorization of emergency...

  12. 31 CFR 595.507 - Authorization of emergency medical services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Licenses, Authorizations, and Statements of Licensing Policy § 595.507 Authorization of emergency medical services. The provision of nonscheduled emergency medical services to a specially designated terrorist... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Authorization of emergency...

  13. 31 CFR 595.507 - Authorization of emergency medical services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Licenses, Authorizations, and Statements of Licensing Policy § 595.507 Authorization of emergency medical services. The provision of nonscheduled emergency medical services to a specially designated terrorist... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Authorization of emergency...

  14. 31 CFR 537.508 - Authorization of emergency medical services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Licenses, Authorizations and Statements of Licensing Policy § 537.508 Authorization of emergency medical services. The provision of nonscheduled emergency medical services in the United States to persons whose... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Authorization of emergency...

  15. 31 CFR 549.508 - Authorization of emergency medical services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Licenses, Authorizations, and Statements of Licensing Policy § 549.508 Authorization of emergency medical services. The provision of nonscheduled emergency medical services in the United States to persons whose... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Authorization of emergency...

  16. 31 CFR 595.507 - Authorization of emergency medical services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Licenses, Authorizations, and Statements of Licensing Policy § 595.507 Authorization of emergency medical services. The provision of nonscheduled emergency medical services to a specially designated terrorist... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Authorization of emergency...

  17. 31 CFR 570.507 - Authorization of emergency medical services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Licenses, Authorizations, and Statements of Licensing Policy § 570.507 Authorization of emergency medical services. The provision of nonscheduled emergency medical services in the United States to persons whose... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Authorization of emergency...

  18. 31 CFR 541.508 - Authorization of emergency medical services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Licenses, Authorizations and Statements of Licensing Policy § 541.508 Authorization of emergency medical services. The provision of nonscheduled emergency medical services in the United States to persons whose... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Authorization of emergency...

  19. 31 CFR 549.508 - Authorization of emergency medical services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Licenses, Authorizations, and Statements of Licensing Policy § 549.508 Authorization of emergency medical services. The provision of nonscheduled emergency medical services in the United States to persons whose... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Authorization of emergency...

  20. 31 CFR 541.508 - Authorization of emergency medical services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Licenses, Authorizations and Statements of Licensing Policy § 541.508 Authorization of emergency medical services. The provision of nonscheduled emergency medical services in the United States to persons whose... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Authorization of emergency...

  1. 31 CFR 587.508 - Authorization of emergency medical services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  2. 31 CFR 570.507 - Authorization of emergency medical services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Licenses, Authorizations, and Statements of Licensing Policy § 570.507 Authorization of emergency medical services. The provision of nonscheduled emergency medical services in the United States to persons whose... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Authorization of emergency...

  3. 31 CFR 543.508 - Authorization of emergency medical services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Licenses, Authorizations and Statements of Licensing Policy § 543.508 Authorization of emergency medical services. The provision of nonscheduled emergency medical services in the United States to persons whose... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Authorization of emergency...

  4. 31 CFR 543.508 - Authorization of emergency medical services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Licenses, Authorizations and Statements of Licensing Policy § 543.508 Authorization of emergency medical services. The provision of nonscheduled emergency medical services in the United States to persons whose... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Authorization of emergency...

  5. 31 CFR 595.507 - Authorization of emergency medical services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Licenses, Authorizations, and Statements of Licensing Policy § 595.507 Authorization of emergency medical services. The provision of nonscheduled emergency medical services to a specially designated terrorist... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Authorization of emergency...

  6. 31 CFR 570.507 - Authorization of emergency medical services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Licenses, Authorizations, and Statements of Licensing Policy § 570.507 Authorization of emergency medical services. The provision of nonscheduled emergency medical services in the United States to persons whose... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Authorization of emergency...

  7. 31 CFR 537.508 - Authorization of emergency medical services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Licenses, Authorizations and Statements of Licensing Policy § 537.508 Authorization of emergency medical services. The provision of nonscheduled emergency medical services in the United States to persons whose... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Authorization of emergency...

  8. 31 CFR 570.507 - Authorization of emergency medical services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Licenses, Authorizations, and Statements of Licensing Policy § 570.507 Authorization of emergency medical services. The provision of nonscheduled emergency medical services in the United States to persons whose... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Authorization of emergency...

  9. 31 CFR 546.508 - Authorization of emergency medical services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Licenses, Authorizations, and Statements of Licensing Policy § 546.508 Authorization of emergency medical services. The provision of nonscheduled emergency medical services in the United States to persons whose... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Authorization of emergency...

  10. Does telephone triage of emergency (999) calls using advanced medical priority dispatch (AMPDS) with Department of Health (DH) call prioritisation effectively identify patients with an acute coronary syndrome? An audit of 42 657 emergency calls to Hampshire Ambulance Service NHS Trust

    PubMed Central

    Deakin, C D; Sherwood, D M; Smith, A; Cassidy, M

    2006-01-01

    Introduction The National Service Framework for Coronary Heart Disease requires identification of patients with an acute coronary syndrome (ACS) to enable prompt identification of those who may subsequently require pre‐hospital thrombolysis. The Advanced Medical Priority Despatch System (AMPDS) with Department of Health (DH) call prioritisation is now the common triage tool for emergency (‘999') calls in the UK. We retrospectively examined patients with ACS to identify whether this triage tool had been able to allocate an appropriate emergency response. Methods All emergency calls to Hampshire Ambulance Service NHS Trust (HAST) from the Southampton area over an 8 month period (January to August 2004) were analysed. The classification allocated to the patient by AMPDS (version 10.4) was specifically identified. Data from the Myocardial Infarct National Audit Project) were obtained from the receiving hospital in Southampton to identify the actual number of patients with a true ACS. Results In total, 42 657 emergency calls were made to HAST from the Southampton area. Of these, 263 patients were subsequently diagnosed in hospital as having an ACS. Of these 263 patients, 76 presented without chest pain. Sensitivity of AMPDS for detecting ACS in this sample was 71.1% and specificity 92.5%. Positive predictive value was 5.6% (95% confidence interval 4.8 to 6.4%), and 12.5% (33/263) of patients with confirmed ACS were classified as non‐life threatening (category B) incidents. Conclusion Only one of approximately every 18 patients with chest pain has an ACS. AMPDS with DH call prioritisation is not a tool designed for clinical diagnosis, and its extension into this field does not enable accurate identification of patients with ACS. PMID:16498168

  11. Comparative effectiveness of helicopter emergency medical services compared to ground emergency medical services.

    PubMed

    Galvagno, Samuel M

    2013-07-16

    The use of helicopter emergency medical services (HEMS) for the transportation and treatment of trauma patients, while commonplace in most developed nations, remains controversial. The purported beneficial effects of HEMS compared to ground emergency medical services is likely to be some combination of speed, crew expertise, and the fact that HEMS is part of an organized trauma system. When the HEMS literature is assessed as a whole, considerable heterogeneity of effects and study methodologies preclude an accurate estimate of composite effect. However, when the outcome of mortality is studied using advanced multivariable regression techniques to control for multiple known confounders, an improved odds of survival has been repeatedly demonstrated. Future HEMS research must rely on robust observational study designs and assessments of a variety of patient outcomes. Questions about the role of speed, distance, and other potentially beneficial elements of HEMS remain.

  12. The potential harm of oxygen therapy in medical emergencies.

    PubMed

    Cornet, Alexander D; Kooter, Albertus J; Peters, Mike J L; Smulders, Yvo M

    2013-04-18

    In medical emergencies, supplemental oxygen is often administrated routinely. Most paramedics and physicians believe that high concentrations of oxygen are life-saving 1. Over the last century, however, a plethora of studies point to possible detrimental effects of hyperoxia induced by supplemental oxygen in a variety of medical emergencies. This viewpoint provides a historical overview and questions the safety of routine high-dose oxygen administration and is based on pathophysiology and (pre)clinical findings in various medical emergencies.

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

    PubMed

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

    2017-02-23

    Introduction Little is known about the existence, distribution, and characteristics of Emergency Medical Services (EMS) systems in Africa, or the corresponding epidemiology of prehospital illness and injury.

  14. 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.

  15. Emergency management of acute adult asthma.

    PubMed Central

    Grunfeld, A. F.; Ho, K.

    1995-01-01

    Despite advances in understanding the pathophysiology of acute asthma and the development of new, effective therapies, patients still die. While physicians agree that most asthma deaths could be prevented if patients were treated adequately, evidence suggests that both patients and physicians continue to underestimate the severity of asthma attacks and delay adequate treatment. PMID:8563508

  16. Emergency Medicine Resident Perceptions of Medical Professionalism

    PubMed Central

    Jauregui, Joshua; Gatewood, Medley O.; Ilgen, Jonathan S.; Schaninger, Caitlin; Strote, Jared

    2016-01-01

    Introduction Medical professionalism is a core competency for emergency medicine (EM) trainees; but defining professionalism remains challenging, leading to difficulties creating objectives and performing assessment. Because professionalism is dynamic, culture-specific, and often taught by modeling, an exploration of trainees’ perceptions can highlight their educational baseline and elucidate the importance they place on general conventional professionalism domains. To this end, our objective was to assess the relative value EM residents place on traditional components of professionalism. Methods We performed a cross-sectional, multi-institutional survey of incoming and graduating EM residents at four programs. The survey was developed using the American Board of Internal Medicine’s “Project Professionalism” and the Accreditation Council of Graduate Medical Education definition of professionalism competency. We identified 27 attributes within seven domains: clinical excellence, humanism, accountability, altruism, duty and service, honor and integrity, and respect for others. Residents were asked to rate each attribute on a 10-point scale. We analyzed data to assess variance across attributes as well as differences between residents at different training levels or different institutions. Results Of the 114 residents eligible, 100 (88%) completed the survey. The relative value assigned to different professional attributes varied considerably, with those in the altruism domain valued significantly lower and those in the “respect for others” and “honor and integrity” valued significantly higher (p<0.001). Significant differences were found between interns and seniors for five attributes primarily in the “duty and service” domain (p<0.05). Among different residencies, significant differences were found with attributes within the “altruism” and “duty and service” domains (p<0.05). Conclusion Residents perceive differences in the relative

  17. 78 FR 30727 - Emergency Medical Services Week, 2013

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-22

    ... Documents#0;#0; ] Proclamation 8982 of May 17, 2013 Emergency Medical Services Week, 2013 By the President... calm under pressure delivers comfort to neighbors in need. During Emergency Medical Services Week, we... society's well-being. In recent weeks, we have again seen the critical role EMS professionals play...

  18. 14 CFR 1250.103-6 - Medical emergencies.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Medical emergencies. 1250.103-6 Section... Medical emergencies. Notwithstanding the provisions of §§ 1250.103 to 1250.103-5, a recipient of Federal... impairment of his health, and such service or other benefit cannot be provided except by or through a...

  19. 14 CFR 1250.103-6 - Medical emergencies.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Medical emergencies. 1250.103-6 Section 1250... Medical emergencies. Notwithstanding the provisions of §§ 1250.103 to 1250.103-5, a recipient of Federal... impairment of his health, and such service or other benefit cannot be provided except by or through a...

  20. 22 CFR 71.10 - Emergency medical assistance.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... expended for: (1) Medical examination, when required; (2) Emergency treatment; (3) Non-elective surgery; (4... possible the estimated costs of recommended treatment or surgery; (4) Obtain the names and addreses of...) Immediate emergency medical treatment or surgery is necessary to prevent death or permanent disablement,...

  1. Employability Competencies for Entry Level Emergency Medical Aides.

    ERIC Educational Resources Information Center

    Werner, Claire

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

  2. 75 FR 27917 - Emergency Medical Services Week, 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-18

    ... emergency medical services (EMS) professionals and volunteers for critical care in our homes, on our roads, in our hospitals, and wherever needs exist. EMS teams serve all Americans, standing ready to respond... Emergency Medical Services Week, we recommit to supporting all EMS providers, and we celebrate...

  3. Emergency Medical Services - Multiple Languages: MedlinePlus

    MedlinePlus

    ... Are Here: Home → Multiple Languages → All Health Topics → Emergency Medical Services URL of this page: https://medlineplus.gov/languages/ ... V W XYZ List of All Topics All Emergency Medical Services - Multiple Languages To use the sharing features on ...

  4. The Emergency Medical Services Survey of Metro Atlanta Employers.

    ERIC Educational Resources Information Center

    DeKalb Tech. Inst., Clarkston, GA.

    A survey was conducted in the Atlanta, Georgia, metropolitan area to determine emergency medical services (EMS) employer needs for persons with basic emergency medical technician (EMT) skills and higher paramedic skills. Information was gathered through a telephone survey to which 24 (60 percent) of the 40 EMS employers in the area responded. The…

  5. Chemical and Biological Terrorism: Improvements to Emergency Medical Response.

    ERIC Educational Resources Information Center

    DeGraffenreid, Jeff Gordon

    The challenge facing many emergency medical services (EMS) is the implementation of a comprehensive educational strategy to address emergency responses to terrorism. One such service, Johnson County (Kansas) Medical Action, needed a strategy that would keep paramedics safe and offer the community an effective approach to mitigation. A…

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

    PubMed Central

    Seyedin, Hesam; Jamshidi-Orak, Roohangiz

    2014-01-01

    Transfer of patients in medical emergency situations is one of the most important missions of emergency medical service (EMS) staffs. So this study was performed to explore affecting factors in EMS staffs' decision during transporting of patients in medical situations to medical facilities. The participants in this qualitative study consisted of 18 EMS staffs working in prehospital care facilities in Tehran, Iran. Data were gathered through semistructured interviews. The data were analyzed using a content analysis approach. The data analysis revealed the following theme: “degree of perceived risk in EMS staffs and their patients.” This theme consisted of two main categories: (1) patient's condition' and (2) the context of the EMS mission'. The patent's condition category emerged from “physical health statuses,” “socioeconomic statuses,” and “cultural background” subcategories. The context of the EMS mission also emerged from two subcategories of “characteristics of the mission” and EMS staffs characteristics'. EMS system managers can consider adequate technical, informational, financial, educational, and emotional supports to facilitate the decision making of their staffs. Also, development of an effective and user-friendly checklist and scoring system was recommended for quick and easy recognition of patients' needs for transportation in a prehospital situation. PMID:24891953

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

    PubMed

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

    2014-01-01

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

  8. The criteria nurses use in assessing acute trauma in military emergency care.

    PubMed

    Andersson, Sten-Ove; Dahlgren, Lars Owe; Lundberg, Lars; Sjöström, Björn

    2007-07-01

    Emergency medical care for seriously injured patients in war or warlike situations is highly important when it comes to soldiers' survival and morale. The Swedish Armed Forces sends nurses, who have limited experience of caring for injured personnel in the field, on a variety of international missions. The aim of this investigation was to identify the kind of criteria nurses rely on when assessing acute trauma and what factors are affecting the emergency care of injured soldiers. A phenomenographic research approach based on interviews was used. The database for the study consists of twelve nurses who served in Bosnia in 1994-1996. The criteria nurses rely on, when assessing acute trauma in emergency care, could be described in terms of domain-specific criteria such as a physiological, an anatomical, a causal and a holistic approach as well as contextual criteria such as being able to communicate, having a sense of belonging, the military environment, the conscript medical orderly and familiarity with health-caring activity. The present study shows that the specific contextual factors affecting emergency care in the field must also be practised before the nurse faces military emergency care situations. This calls for realistic exercises and training programs, where experience from civilian emergency care is interwoven with the knowledge specific to military medical care.

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

    PubMed

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

    1989-10-14

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

  10. Emergency Transcatheter Arterial Embolization for Acute Renal Hemorrhage.

    PubMed

    Wang, Hong Liang; Xu, Chun Yang; Wang, Hong Hui; Xu, Wei

    2015-10-01

    The aims of this study were to identify arteriographic manifestations of acute renal hemorrhage and to evaluate the efficacy of emergency embolization. Emergency renal artery angiography was performed on 83 patients with acute renal hemorrhage. As soon as bleeding arteries were identified, emergency embolization was performed using gelatin sponge, polyvinyl alcohol particles, and coils. The arteriographic presentation and the effect of the treatment for acute renal hemorrhage were analyzed retrospectively. Contrast extravasation was observed in 41 patients. Renal arteriovenous fistulas were found in 12 of the 41 patients. In all, 8 other patients had a renal pseudoaneurysm, 5 had pseudoaneurysm rupture complicated by a renal arteriovenous fistula, and 1 had pseudoaneurysm rupture complicated by a renal artery-calyceal fistula. Another 16 patients had tumor vasculature seen on arteriography. Before the procedure, 35 patients underwent renal artery computed tomography angiography (CTA). Following emergency embolization, complete hemostasis was achieved in 80 patients, although persistent hematuria was present in 3 renal trauma patients and 1 patient who had undergone percutaneous nephrolithotomy (justifying surgical removal of the ipsilateral kidney in this patient). Two-year follow-up revealed an overall effective rate of 95.18 % (79/83) for emergency embolization. There were no serious complications. Emergency embolization is a safe, effective, minimally invasive treatment for renal hemorrhage. Because of the diversified arteriographic presentation of acute renal hemorrhage, proper selection of the embolic agent is a key to successful hemostasis. Preoperative renal CTA plays an important role in diagnosing and localizing the bleeding artery.

  11. Emergency Transcatheter Arterial Embolization for Acute Renal Hemorrhage

    PubMed Central

    Wang, Hong Liang; Xu, Chun Yang; Wang, Hong Hui; Xu, Wei

    2015-01-01

    Abstract The aims of this study were to identify arteriographic manifestations of acute renal hemorrhage and to evaluate the efficacy of emergency embolization. Emergency renal artery angiography was performed on 83 patients with acute renal hemorrhage. As soon as bleeding arteries were identified, emergency embolization was performed using gelatin sponge, polyvinyl alcohol particles, and coils. The arteriographic presentation and the effect of the treatment for acute renal hemorrhage were analyzed retrospectively. Contrast extravasation was observed in 41 patients. Renal arteriovenous fistulas were found in 12 of the 41 patients. In all, 8 other patients had a renal pseudoaneurysm, 5 had pseudoaneurysm rupture complicated by a renal arteriovenous fistula, and 1 had pseudoaneurysm rupture complicated by a renal artery-calyceal fistula. Another 16 patients had tumor vasculature seen on arteriography. Before the procedure, 35 patients underwent renal artery computed tomography angiography (CTA). Following emergency embolization, complete hemostasis was achieved in 80 patients, although persistent hematuria was present in 3 renal trauma patients and 1 patient who had undergone percutaneous nephrolithotomy (justifying surgical removal of the ipsilateral kidney in this patient). Two-year follow-up revealed an overall effective rate of 95.18 % (79/83) for emergency embolization. There were no serious complications. Emergency embolization is a safe, effective, minimally invasive treatment for renal hemorrhage. Because of the diversified arteriographic presentation of acute renal hemorrhage, proper selection of the embolic agent is a key to successful hemostasis. Preoperative renal CTA plays an important role in diagnosing and localizing the bleeding artery. PMID:26496273

  12. Common medical emergencies: a dilemma in dental education.

    PubMed

    Hendler, B H; Rose, L F

    1975-09-01

    A four-week hospital-based program offers a comprehensive course for dental students in the evaluation and management of medical emergencies. The program first emphasizes medical evaluation with the taking of accurate, comprehensive patient histories and the performance of physical examinations; information about supportive care, including intravenous techniques and airway maintenance, is given. The diagnostic signs and treatment of common medical emergencies, as taught in the program, are described.

  13. Treatment for acute asthma in the Emergency Department: practical aspects.

    PubMed

    Urso, D L

    2010-03-01

    This article describes the management of acute asthma exacerbation in the Emergency Department (ED). An asthma exacerbation can be defined as clinical worsening of disease or an asymptomatic decrease in peak flows. Acute exacerbations of asthma may represent reactions to airway irritants or failures of chronic treatment. Hospitalizations and ED visits account for a large proportion of the health-care cost burden of asthma. The assessment of an asthma exacerbation constitutes a process with two different dimensions: to determine the severity of attack, and to evaluate the response to treatment. The principal goals of managing an asthma acute exacerbation may be summarized as maintenance of adequate arterial oxygen saturation with supplemental oxygen, relief of airflow obstruction with repetitive administration of short acting beta-2 agonists (SABA), and treatment of airway inflammation with systemic corticosteroids (CS) to prevent future relapses. SABA, oxygen, and CS form the basis of management of acute asthma exacerbation but a role is emerging for anthicolinergics.

  14. Dilemma in the emergency setting: hypomagnesemia mimicking acute stroke

    PubMed Central

    Rico, María; Martinez-Rodriguez, Laura; Larrosa-Campo, Davinia; Calleja, Sergio

    2016-01-01

    Background Stroke mimics may account for up to 30% of all acute stroke consultations. However, in the emergency setting, accurate diagnosis is not always possible. Methods Case report and review of the literature. Results A 73-year-old woman was admitted to the emergency department with acute aphasia and right hemiparesis. The National Institute of Health Stroke Score was 21, compatible with severe stroke, so she received thrombolysis. Laboratory testing demonstrated severe hypomagnesemia. She had been taking proton pump inhibitors for years and neuroimaging did not demonstrate signs of acute ischemic disease. After correcting the metabolic alterations with intravenous and oral supplemental magnesium, the patient was discharged asymptomatic. No further episodes have been registered to date. Conclusion Hypomagnesemia might cause acute neurological symptoms that could be confused with stroke. A careful history is essential for diagnosis but suspicion of stroke mimic should not prevent tPA administration. PMID:27354832

  15. Emerging Therapies for Acute Coronary Syndromes

    PubMed Central

    Lilly, Scott M.; Wilensky, Robert L.

    2011-01-01

    In the majority of cases acute coronary syndromes (ACS) are caused by activation and aggregation of platelets and subsequent thrombus formation leading to a decrease in coronary artery blood flow. Recent focus on the treatment of ACS has centered on reducing the response of platelets to vascular injury as well as inhibiting fibrin deposition. Novel therapies include more effective P2Y12 receptor blockers thereby reducing inter-individual variability, targeting the platelet thrombin receptor (protease activated receptor 1) as well as directly inhibiting factor Xa or thrombin activity. In this review we discuss the clinical data evaluating the effectiveness of these various new ACS treatment options. PMID:22028691

  16. Acute migraine: Current treatment and emerging therapies

    PubMed Central

    Kalra, Arun A; Elliott, Debra

    2007-01-01

    Migraine is a common disabling primary headache disorder. Despite the need for a perfect treatment of this debilitating condition, the ideal “cure” eludes us. In 1992, the first triptan was released in the US for use in acute migraine. Triptans are more specific for the serotonin receptor 5-hydroxy triptamine (5-HT) 1 than previously prescribed drugs, such as ergotamines, with fewer side effects. This was an important first step in specific acute migraine therapy. Today however, triptans continue to be underutilized. There remains a concern, among practitioners and patients, about possible cardiovascular safety issues, despite the lack of strong evidence of serious adverse events. In fact, triptans now have a safe track record over more than a decade of use. Other perceived downfalls to use, include cost and variable efficacy. The more we learn about the clinical features and pathophysiology of migraine, the closer we are to finding a satisfactory monotherapy. Until then, recognizing that mixed mechanisms underlie migraine symptoms, rational polytherapy can be useful. Research on the roles of serotonin, calcitonin gene related peptide, glutamine and N-methyl-D-aspartate in the trigeminovascular system holds promise for those searching for the perfect migraine headache cure. PMID:18488069

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

    PubMed Central

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

    2006-01-01

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

  18. Medical emergency motorcycle – is it useful in a Scandinavian Emergency Medical Service?

    PubMed Central

    Nakstad, Anders Rostrup; Bjelland, Bjørn; Sandberg, Mårten

    2009-01-01

    Background Medical emergency motorcycles (MEM) can be used in time-critical conditions like cardiac arrest and multi-traumatized patients in an attempt to reduce the response time. Other potential benefits with MEM are more efficient patient evaluation, reduction of unnecessary EMS car ambulance missions and reduced cost. The potential benefits have been evaluated in this study. The incidence of accidents when operating the vehicle was also of interest. Methods A prospective study was performed when MEM was introduced as a trial in an urban ambulance service in Norway. Results A total of 703 MEM missions were registered in the period. The mean emergency driving time was significantly shorter for the MEM than for the ambulance car located at the same station (6 min 24 seconds vs. 6 min 54 seconds). In addition to time-critical conditions, the MEM was used to evaluate patients when the need for emergency medical assistance was uncertain, and this practice lead to a reduced number of unnecessary car ambulance missions. No accidents involving the MEM were registered in the study period. The hourly cost of running the MEM was € 29 vs. € 75 for a car ambulance. However, the actual cost benefit is smaller since the weather conditions make it impossible to run a MEM in wintertime. Conclusion The small reduction in driving time when using a MEM instead of a car ambulance was statistically significant but probably of little clinical importance. The number of unnecessary car ambulance missions was reduced. It was cheaper to operate a MEM than a car ambulance, but the cost-effectiveness was reduced since the MEM could not operate 12 months a year. The lack of accidents may be contributed to the extensive training of the drivers and the fact that the vehicle was operated in daylight only. PMID:19239681

  19. 42 CFR 2.51 - Medical emergencies.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... identifying information may be disclosed to medical personnel who have a need for information about a patient... information may be disclosed to medical personnel of the Food and Drug Administration (FDA) who assert a reason to believe that the health of any individual may be threatened by an error in the...

  20. Resuscitation decision making by New Mexico emergency medical technicians.

    PubMed

    Johnson, D R; Maggiore, W A

    1993-03-01

    The extent to which Emergency Medical Service personnel are placed in situations in which difficult cardiopulmonary resuscitation decisions must be made has been poorly explored. Further, it is not known whether this kind of decision making is troubling to emergency medical technicians. Although it is likely that emergency medical service systems handle withholding cardiopulmonary resuscitation in a variety of ways, the authors chose to examine a cross-section of New Mexico emergency medical technicians. Using a survey instrument, emergency medical technicians of all training levels, representing several emergency medical service systems around the state were asked how many times in their career they had been in a situation in which cardiopulmonary resuscitation had been withheld without a direct physician order. Of 310 individuals surveyed, 211 (66.8%) responded that this had occurred at least once. When asked whether they had been troubled by one of these situations, 86 of 211 (41%) individuals responded "yes." When a variety of demographic factors were evaluated, only training to the paramedic level was identified as being an independent predictor of those who were troubled (P = .019). Emergency medical technician training, protocols, and do not resuscitate programs may need to be expanded to give further guidance to prehospital personnel when making difficult resuscitation decisions.

  1. Development of an emergency department response to acute stroke ("Code Stroke").

    PubMed

    Leira, Enrique C; Ahmed, Azeemuddin

    2009-01-01

    Minimizing delays is a crucial step in improving outcomes with acute stroke therapies whose efficacy is clearly time dependent. Logistic and human barriers to rapid stroke care can be overcome with a systematic "Code Stroke" approach provided by a structured multidisciplinary acute stroke response team. Such teams should include Emergency Medical Services providers, neurologists, neurosurgeons, diagnostic radiologists, nurses, radiology technicians, laboratory personnel, hospital administrators, and emergency medicine, intensive care, and neurointerventional physicians. An acute stroke team improves treatment practices and provides a gratifying experience for patients, families, and referring physicians. On the other hand, maintaining proficiency of the team's operation is time consuming and personally onerous for team responders. Successful maintenance requires strong departmental and institutional commitment.

  2. Gallbladder Volvulus: A Rare Emergent Cause of Acute Cholecystitis, if Untreated, Progresses to Necrosis and Perforation

    SciTech Connect

    Justin L, Regner Angela, Lomas

    2016-03-25

    An 86 year-old woman with a past medical history significant for abdominal hernia and Alzheimer dementia presented to the Emergency Department with a 24 hour history of acute right upper quadrant pain associated with nausea and non-bilious emesis. Physical exam revealed right sided abdominal tenderness with associated mass. All laboratory values were within normal ranges. Both abdominal ultrasound and computed tomography of the abdomen/pelvis revealed a large distended gallbladder with wall thickening and gallstones. Based on presentation and radiologic findings, the emergency general surgery service was consulted for suspected acute cholecystitis. The patient was then admitted for intravenous antibiotics and scheduled for laparoscopic cholecystectomy the following day. Intra-operative findings revealed volvulus with acute necrosis of the entire gallbladder. The gallbladder had a long pedunculated cystic duct and artery that was detorsed before proceeding with resection. Postoperatively, the patient did well and was discharged a few days later tolerating a regular diet.

  3. Toward Ubiquitous Communication Platform for Emergency Medical Care

    NASA Astrophysics Data System (ADS)

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

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

  4. High Feasibility of Empiric HIV Treatment for Patients With Suspected Acute HIV in an Emergency Department.

    PubMed

    Jacobson, Kathleen R; Arora, Sanjay; Walsh, Kristin B; Lora, Meredith; Merjavy, Stephen; Livermore, Shanna; Menchine, Michael

    2016-07-01

    Earlier intervention in acute HIV infection limits HIV reservoirs and may decrease HIV transmission. We developed criteria for empiric antiretroviral therapy (ART) in an emergency department (ED) routine HIV screening program. We assessed the feasibility and willingness of patients with suspected acute HIV infection in the ED to begin ART. A suspected acute HIV infection was defined as a positive HIV antigen antibody combination immunoassay with pending HIV-antibody differentiation test results and HIV RNA viral load. During the study period, there were 16 confirmed cases of acute HIV infection: 11 met our criteria for empiric ART and agreed to treatment, 10 were prescribed ART, and 1 left the ED against medical advice without a prescription for ART. Eight patients completed at least one follow-up visit. Empiric HIV treatment in an ED is feasible, well received by patients, and offers a unique entry point into the HIV care continuum.

  5. How I treat hematologic emergencies in adults with acute leukemia.

    PubMed

    Zuckerman, Tsila; Ganzel, Chezi; Tallman, Martin S; Rowe, Jacob M

    2012-09-06

    Acute myeloid leukemia and acute lymphoblastic leukemia remain devastating diseases. Only approximately 40% of younger and 10% of older adults are long-term survivors. Although curing the leukemia is always the most formidable challenge, complications from the disease itself and its treatment are associated with significant morbidity and mortality. Such complications, discussed herein, include tumor lysis, hyperleukocytosis, cytarabine-induced cellebellar toxicity, acute promyelocytic leukemia differentiation syndrome, thrombohemorrhagic syndrome in acute promyelocytic leukemia, L-asparaginase-associated thrombosis, leukemic meningitis, neutropenic fever, neutropenic enterocolitis, and transfussion-associated GVHD. Whereas clinical trials form the backbone for the management of acute leukemia, emergent clinical situations, predictable or not, are common and do not readily lend themselves to clinical trial evaluation. Furthermore, practice guidelines are often lacking. Not only are prospective trials impractical because of the emergent nature of the issue at hand, but clinicians are often reluctant to randomize such patients. Extensive practical experience is crucial and, even if there is no consensus, management of such emergencies should be guided by an understanding of the underlying pathophysiologic mechanisms.

  6. Stroke: advances in medical therapy and acute stroke intervention.

    PubMed

    Barrett, Kevin M; Lal, Brajesh K; Meschia, James F

    2015-10-01

    Evidence-based therapeutic options for stroke continue to emerge based on results from well-designed clinical studies. Ischemic stroke far exceeds hemorrhagic stroke in terms of prevalence and incidence, both in the USA and worldwide. The public health effect of reducing death and disability related to ischemic stroke justifies the resources that have been invested in identifying safe and effective treatments. The emergence of novel oral anticoagulants for ischemic stroke prevention in atrial fibrillation has introduced complexity to clinical decision making for patients with this common cardiac arrhythmia. Some accepted ischemic stroke preventative strategies, such as carotid revascularization for asymptomatic carotid stenosis, require reassessment, given advances in risk factor management, antithrombotic therapy, and surgical techniques. Intra-arterial therapy, particularly with stent retrievers after intravenous tissue plasminogen activator, has recently been demonstrated to improve functional outcomes and will require investment in system-based care models to ensure that effective treatments are received by patients in a timely fashion. The purpose of this review is to describe recent advances in medical and surgical approaches to ischemic stroke prevention and acute treatment. Results from recently published clinical trials will be highlighted along with ongoing clinical trials addressing key questions in ischemic stroke management and prevention where equipoise remains.

  7. Implementing an emergency medical services system in Kathmandu, Nepal: a model for "white coat diplomacy".

    PubMed

    Walker, Rebecca; Auerbach, Paul S; Kelley, Benjamin V; Gongal, Rajesh; Amsalem, David; Mahadevan, Swaminatha

    2014-09-01

    Wilderness medicine providers often visit foreign lands, where they come in contact with medical situations that are representative of the prevailing healthcare issues in the host countries. The standards of care for matters of acute and chronic care, public health, and crisis intervention are often below those we consider to be modern and essential. Emergency medical services (EMS) is an essential public medical service that is often found to be underdeveloped. We describe our efforts to support development of an EMS system in the Kathmandu Valley of Nepal, including training the first-ever class of emergency medical technicians in that country. The purpose of this description is to assist others who might attempt similar efforts in other countries and to support the notion that an effective approach to improving foreign relations is assistance such as this, which may be considered a form of "white coat diplomacy."

  8. Mentoring medical students in academic emergency medicine.

    PubMed

    Garmel, Gus M

    2004-12-01

    Mentoring is an important aspect of career development for medical students, residents, and junior faculty. It is vital to the professional growth and maturation of individuals early in each phase of their careers. Additionally, mentoring has a critical role throughout all career stages, because the mentor-mentee relationship provides mutual benefit to both participants. This article will describe the role of the mentor, suggest ways to increase the likelihood of successful mentoring, and identify pitfalls in the mentoring process predominantly related to medical students. In contrast to role models, mentors play an active part in the development of a young physician's career. This difference will be discussed. Finally, this article will describe the responsibilities of career guidance and recommendation letter authorship that mentors assume for medical students.

  9. Emergency medical systems in low- and middle-income countries: recommendations for action.

    PubMed Central

    Kobusingye, Olive C.; Hyder, Adnan A.; Bishai, David; Hicks, Eduardo Romero; Mock, Charles; Joshipura, Manjul

    2005-01-01

    Emergency medical care is not a luxury for rich countries or rich individuals in poor countries. This paper makes the point that emergency care can make an important contribution to reducing avoidable death and disability in low- and middle-income countries. But emergency care needs to be planned well and supported at all levels--at the national, provincial and community levels--and take into account the entire spectrum of care, from the occurrence of an acute medical event in the community to the provision of appropriate care at the hospital. The mix of personnel, materials, and health-system infrastructure can be tailored to optimize the provision of emergency care in settings with different levels of resource availability. The misconception that emergency care cannot be cost effective in low-income settings is demonstrably inaccurate. Emergencies occur everywhere, and each day they consume resources regardless of whether there are systems capable of achieving good outcomes. With better planning, the ongoing costs of emergency care can result in better outcomes and better cost-effectiveness. Every country and community can and should provide emergency care regardless of their place in the ratings of developmental indices. We make the case for universal access to emergency care and lay out a research agenda to fill the gaps in knowledge in emergency care. PMID:16184282

  10. Emerging 21st Century Medical Technologies

    PubMed Central

    Bajwa, Mohammad

    2014-01-01

    Although several medical technologies have been around since decades and are in the continuous process of development, some latest technologies are changing the way medicine would be practiced in the future. These technologies would allow medical practice from anywhere, any time and from any device. These include smart phones, Tablet PCs, Touch screens, digital ink, voice recognition, Electronic Health Records (EHRs), Health Information Exchange (HIE), Nationwide Health Information Network (NwHIN), Personal Health Records (PHRs), patient portals, Nanomedicine, genome-based personalized medicine, Geographical Positioning System (GPS), Radiofrequency Identification (RFID), Telemedicine, clinical decision support (CDS), mobile home healthcare, cloud computing, and social media, to name a few significant. PMID:24948997

  11. The emerging Medical and Geological Association.

    USGS Publications Warehouse

    Finkelman, R.B.; Centeno, J.A.; Selinus, O.

    2005-01-01

    The impact on human health by natural materials such as water, rocks, and minerals has been known for thousands of years but there have been few systematic, multidisciplinary studies on the relationship between geologic materials and processes and human health (the field of study commonly referred to as medical geology). In the past few years, however, there has been a resurgence of interest in medical geology. Geoscientists working with medical researchers and public health scientists have made important contributions to understanding novel exposure pathways and causes of a wide range of environmental health problems such as: exposure to toxic levels of trace essential and non-essential elements such as arsenic and mercury; trace element deficiencies; exposure to natural dusts and to radioactivity; naturally occurring organic compounds in drinking water; volcanic emissions, etc. By linking with biomedical/public health researchers geoscientists are finally taking advantage of this age-old opportunity to help mitigate environmental health problems. The International Medical Geology Association has recently been formed to support this effort.

  12. City emergency medical services system issues

    NASA Astrophysics Data System (ADS)

    Persse, David E.; Bradley, Richard N.

    2003-09-01

    The City of Houston is continuously improving its preparedness for disasters and terrorism. This preparation requires strong and clear leadership. This includes a designated individual to lead the region"s preparation in the health and medical arena. An effective leader requires an effective command and control center. Real-time information on the situation is imperative.

  13. Effective medical leadership in times of emergency: a perspective.

    PubMed

    Hershkovich, Oded; Gilad, David; Zimlichman, Eyal; Kreiss, Yitshak

    2016-01-01

    Leadership, and more specifically medical leadership, is an unmeasured potential that has the power to influence every aspect of a person's professional life and its challenges and is more evident in times of emergency. Medical leadership is receiving increasing recognition especially in discussing actions to be taken in times of stress and emergency. We propose a comprehensive conceptual model that examines the elements that build successful medical leadership, especially during emergency scenarios. The model is based on two sets of medical leadership capabilities and skills, while the first set is more relevant to everyday challenges, the second set represents abilities and characteristics that arise mostly during emergencies. The model gathers together the characteristics and abilities of the medical leader based on our unique personal experiences during conflicts, terror, civilian challenges and numerous humanitarian missions. This article suggests a framework for the foundations on which the medical leader's education should be built and describes our perception of how to establish medical leadership, its unique elements and the processes leading to outstanding performance in times of emergency.

  14. 77 FR 31143 - Emergency Medical Services Week, 2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-24

    ... President Proclamation 8824--Emergency Medical Services Week, 2012 Proclamation 8825--National Safe Boating Week, 2012 Proclamation 8826--National Small Business Week, 2012 Proclamation 8827--World Trade Week... Medical Services Week, 2012 By the President of the United States of America A Proclamation Day and...

  15. Emergency Medical Technician Instructor Training Institute--Final Report.

    ERIC Educational Resources Information Center

    Cleven, Arlene

    The instructor training institutes were conducted to familiarize State and local emergency medical instructional personnel with National Highway Traffic Safety Administration (NHTSA) curriculum materials and to enhance their instructional capabilities with this material. Thirty-hour courses, correlated with the content of the Emergency Medical…

  16. 31 CFR 546.508 - 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. 546.508 Section 546.508 Money and Finance: Treasury Regulations Relating to Money and Finance... Licenses, Authorizations, and Statements of Licensing Policy § 546.508 Authorization of emergency...

  17. 31 CFR 541.508 - 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. 541.508 Section 541.508 Money and Finance: Treasury Regulations Relating to Money and Finance... Licenses, Authorizations and Statements of Licensing Policy § 541.508 Authorization of emergency...

  18. 31 CFR 543.508 - 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. 543.508 Section 543.508 Money and Finance: Treasury Regulations Relating to Money and Finance... Licenses, Authorizations and Statements of Licensing Policy § 543.508 Authorization of emergency...

  19. 31 CFR 537.508 - 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. 537.508 Section 537.508 Money and Finance: Treasury Regulations Relating to Money and Finance... Licenses, Authorizations and Statements of Licensing Policy § 537.508 Authorization of emergency...

  20. 31 CFR 537.508 - 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. 537.508 Section 537.508 Money and Finance: Treasury Regulations Relating to Money and Finance... Licenses, Authorizations, and Statements of Licensing Policy § 537.508 Authorization of emergency...

  1. 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... Licenses, Authorizations, and Statements of Licensing Policy § 546.508 Authorization of emergency...

  2. 31 CFR 541.508 - 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. 541.508 Section 541.508 Money and Finance: Treasury Regulations Relating to Money and Finance... Licenses, Authorizations and Statements of Licensing Policy § 541.508 Authorization of emergency...

  3. 31 CFR 542.508 - 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. 542.508 Section 542.508 Money and Finance: Treasury Regulations Relating to Money and Finance... Licenses, Authorizations and Statements of Licensing Policy § 542.508 Authorization of emergency...

  4. 31 CFR 548.508 - 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. 548.508 Section 548.508 Money and Finance: Treasury Regulations Relating to Money and Finance... Licenses, Authorizations, and Statements of Licensing Policy § 548.508 Authorization of emergency...

  5. 31 CFR 543.508 - 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. 543.508 Section 543.508 Money and Finance: Treasury Regulations Relating to Money and Finance... Licenses, Authorizations and Statements of Licensing Policy § 543.508 Authorization of emergency...

  6. 31 CFR 543.508 - 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. 543.508 Section 543.508 Money and Finance: Treasury Regulations Relating to Money and Finance... Licenses, Authorizations and Statements of Licensing Policy § 543.508 Authorization of emergency...

  7. 31 CFR 541.508 - 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. 541.508 Section 541.508 Money and Finance: Treasury Regulations Relating to Money and Finance... Licenses, Authorizations and Statements of Licensing Policy § 541.508 Authorization of emergency...

  8. 31 CFR 549.508 - 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. 549.508 Section 549.508 Money and Finance: Treasury Regulations Relating to Money and Finance... Licenses, Authorizations, and Statements of Licensing Policy § 549.508 Authorization of emergency...

  9. 31 CFR 542.508 - 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. 542.508 Section 542.508 Money and Finance: Treasury Regulations Relating to Money and Finance... Licenses, Authorizations and Statements of Licensing Policy § 542.508 Authorization of emergency...

  10. 31 CFR 548.508 - 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. 548.508 Section 548.508 Money and Finance: Treasury Regulations Relating to Money and Finance... Licenses, Authorizations, and Statements of Licensing Policy § 548.508 Authorization of emergency...

  11. 31 CFR 546.508 - 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. 546.508 Section 546.508 Money and Finance: Treasury Regulations Relating to Money and Finance... Licenses, Authorizations, and Statements of Licensing Policy § 546.508 Authorization of emergency...

  12. 31 CFR 537.508 - 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. 537.508 Section 537.508 Money and Finance: Treasury Regulations Relating to Money and Finance... Licenses, Authorizations and Statements of Licensing Policy § 537.508 Authorization of emergency...

  13. 31 CFR 549.508 - 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. 549.508 Section 549.508 Money and Finance: Treasury Regulations Relating to Money and Finance... Licenses, Authorizations, and Statements of Licensing Policy § 549.508 Authorization of emergency...

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

    PubMed

    Chalwin, R P; Flabouris, A

    2013-09-01

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

  15. 75 FR 61819 - National Emergency Medical Services Advisory Council (NEMSAC); Teleconference Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-06

    ... National Highway Traffic Safety Administration National Emergency Medical Services Advisory Council (NEMSAC... recognized council of emergency medical services representatives and consumers to provide advice and recommendations regarding Emergency Medical Services (EMS) to the U.S. DOT's NHTSA. DATES: The...

  16. 77 FR 27278 - National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-09

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

  17. 77 FR 12908 - Appointment/Reappointment to the National Emergency Medical Services Advisory Council (NEMSAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-02

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

  18. 76 FR 15043 - National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-18

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

  19. 75 FR 71791 - National Emergency Medical Services Advisory Council Meeting Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-24

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

  20. 76 FR 64174 - National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-17

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

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

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-24

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

  2. 77 FR 9297 - National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-16

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

  3. 78 FR 801 - National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-04

    ... National Highway Traffic Safety Administration National Emergency Medical Services Advisory Council (NEMSAC... to the public. The purpose of NEMSAC, a nationally recognized council of emergency medical services representatives and consumers, is to provide advice and recommendations regarding Emergency Medical Services...

  4. The mosh pit experience: emergency medical care for concert injuries.

    PubMed

    Janchar, T; Samaddar, C; Milzman, D

    2000-01-01

    Effective planning is essential for medical personnel preparing to provide emergency care at mass gatherings. At large concerts where audience members participate in "moshing," crowd surfing, and stage diving, there may be a potential for a dramatic increase in injuries requiring medical attention. Injuries seen at emergency medical stations at 3 concerts, all with large mosh pits, over 4 event days were recorded and evaluated. Each event day had over 60,000 attendees. A total of 1,542 medical incidents (82.9 per 10,000) were reported over the 4 event days. There were 37% (466 patients, 25.1 per 10,000) of incidents related to moshing activity. Hospital transport was required for 2.5% (39 patients, 2.1 per 10,000) of medical visits with 74% (29 patients, 1.5 per 10,000) of those transported being for mosh pit-related injuries. When planning emergency medical care for such concerts with mosh pits, the potential for an increase in the number of medical incidents and injuries requiring medical attention and hospital transport should be taken into account for efficient medical coverage.

  5. Epidemiology of Acute Symptomatic Seizures among Adult Medical Admissions

    PubMed Central

    Nwani, Paul Osemeke; Nwosu, Maduaburochukwu Cosmas; Nwosu, Monica Nonyelum

    2016-01-01

    Acute symptomatic seizures are seizures occurring in close temporal relationship with an acute central nervous system (CNS) insult. The objective of the study was to determine the frequency of presentation and etiological risk factors of acute symptomatic seizures among adult medical admissions. It was a two-year retrospective study of the medical files of adults patients admitted with acute symptomatic seizures as the first presenting event. There were 94 cases of acute symptomatic seizures accounting for 5.2% (95% CI: 4.17–6.23) of the 1,802 medical admissions during the period under review. There were 49 (52.1%) males and 45 (47.9%) females aged between 18 years and 84 years. The etiological risk factors of acute symptomatic seizures were infections in 36.2% (n = 34) of cases, stroke in 29.8% (n = 28), metabolic in 12.8% (n = 12), toxic in 10.6% (n = 10), and other causes in 10.6% (n = 10). Infective causes were more among those below fifty years while stroke was more in those aged fifty years and above. CNS infections and stroke were the prominent causes of acute symptomatic seizures. This is an evidence of the “double tragedy” facing developing countries, the unresolved threat of infectious diseases on one hand and the increasing impact of noncommunicable diseases on the other one. PMID:26904280

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

    PubMed

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

    2014-10-31

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

  7. Impact of Vehicular Networks on Emergency Medical Services in Urban Areas

    PubMed Central

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

    2014-01-01

    The speed with which emergency personnel can provide emergency treatment is crucial to reducing death and disability among acute and critically ill patients. Unfortunately, the rapid development of cities and increased numbers of vehicles are preventing emergency vehicles from easily reaching locations where they are needed. A significant number of researchers are experimenting with vehicular networks to address this issue, but in most studies the focus has been on communication technologies and protocols, with few efforts to assess how network applications actually support emergency medical care. Our motivation was to search the literature for suggested methods for assisting emergency vehicles, and to use simulations to evaluate them. Our results and evidence-based studies were cross-referenced to assess each method in terms of cumulative survival ratio (CSR) gains for acute and critically ill patients. Simulation results indicate that traffic light preemption resulted in significant CSR increases of between 32.4% and 90.2%. Route guidance was found to increase CSRs from 14.1% to 57.8%, while path clearing increased CSRs by 15.5% or less. It is our hope that this data will support the efforts of emergency medical technicians, traffic managers, and policy makers. PMID:25365059

  8. Medical research in emergency research in the European Union member states: tensions between theory and practice.

    PubMed

    Kompanje, Erwin J O; Maas, Andrew I R; Menon, David K; Kesecioglu, Jozef

    2014-04-01

    In almost all of the European Union member states, prior consent by a legal representative is used as a substitute for informed patient consent for non-urgent medical research. Deferred (patient and/or proxy) consent is accepted as a substitute in acute emergency research in approximately half of the member states. In 12 European Union member states emergency research is not mentioned in national law. Medical research in the European Union is covered by the Clinical Trial Directive 2001/20/EC. A proposal for a regulation by the European Commission is currently being examined by the European Parliament and the Council and will replace Directive 2001/20/EC. Deferred patient and/or proxy consent is allowed in the proposed regulation, but does not fit completely in the practice of emergency research. For example, deferred consent is only possible when legal representatives are not available. This criterion will delay inclusion of patients in acute life-threatening conditions in short time frames. As the regulation shall be binding in its entirety in all member states, emergency research in acute situations is still not possible as it should be.

  9. The Danish quality database for prehospital emergency medical services

    PubMed Central

    Frischknecht Christensen, Erika; Berlac, Peter Anthony; Nielsen, Henrik; Christiansen, Christian Fynbo

    2016-01-01

    Aim of database The aim of the Danish quality database for prehospital emergency medical services (QEMS) is to assess, monitor, and improve the quality of prehospital emergency medical service care in the entire prehospital patient pathway. The aim of this review is to describe the design and the implementation of QEMS. Study population The study population consists of all “112 patient contacts” defined as emergency patients, where the entrance to health care is a 112 call forwarded to one of the five regional emergency medical coordination centers in Denmark since January 1, 2014. Estimated annual number of included “112 patients” is 300,000–350,000. Main variables We defined nine quality indicators and the following variables: time stamps for emergency calls received at one of the five regional emergency medical coordination centers, dispatch of prehospital unit(s), arrival of first prehospital unit, arrival of first supplemental prehospital unit, and mission completion. Finally, professional level and type of the prehospital resource dispatched to an incident and end-of-mission status (mission completed by phone, on scene, or admission to hospital) are registered. Descriptive data Descriptive data included age, region, and Danish Index for Emergency Care including urgency level. Conclusion QEMS is a new database under establishment and is expected to provide the basis for quality improvement in the prehospital setting and in the entire patient care pathway, for example, by providing prehospital data for research and other quality databases. PMID:27843347

  10. Medical emergency rescue in disaster: the international emergency response to the Haiyan typhoon in Philippines.

    PubMed

    Ling, Feng; Ye, Zhen; Cai, Wenwei; Lu, Ye; Xia, Shichang; Chen, Zhiping; Chen, Enfu; Wang, Xiaofeng; Wang, Zhen; Lv, Huakun; Gong, Zhenyu

    2014-12-01

    Following Typhoon Haiyan, the World Health Organization (WHO) has been supporting the Government of the Philippines in coordinating the incoming relief supplies from more than 30 international humanitarian health organizations. During the 10 days in Abuyong, Philippines, the Chinese medical rescue team consisting of 50 experts specialized in clinical medicine and disease prevention and control action was taken including, medical treatment, environmental disinfection and health education. A total of 1,831 cases and 2,144 outpatients were treated, blood tests, B-ultrasound, electrocardiogram (ECG) and other laboratory examinations were carried out for more than 615 patients; a cumulative 90,000 square meters in external environment were disinfected, and more than 500 health education materials were handed out. Besides, measures of purifying drinking water, and rebuilding the local hospital have also been carried out. The international emergency response to the Haiyan typhoon in Philippines contributed to reconstruct the local disaster health system by the activities from international medical emergency rescue. To improve the capacity of international medical emergency rescue in disaster, the special project of foreign medical emergency rescue should be set in countries' medical emergency rescue, and disaster emergency medical rescue should be reserved as a conventional capacity.

  11. Acute Abdominal Pain: Bayesian Analysis in the Emergency Room

    PubMed Central

    Harvey, A. C.; Moodie, P. F.

    1982-01-01

    A non-sequential Bayesian analysis was deemed a suitable approach to the important clinical problem of analysis of acute abdominal pain in the Emergency Room. Using series reported in the literature as a data source complemented by expert clinical estimates of probabilities of clinical data a program has been established in St. Boniface, Canada. Prior to implementing the program as an online, quickly available diagnostic aid, a prospective preliminary study has shown that the performance of computer plus clinician is significantly better than either clinician or computer alone. A major emphasis has been developing the acceptability of the program in real-life diagnoses in the Emergency Room.

  12. Survival benefit of helicopter emergency medical services compared to ground emergency medical services in traumatized patients

    PubMed Central

    2013-01-01

    Introduction Physician-staffed helicopter emergency medical services (HEMS) are a well-established component of prehospital trauma care in Germany. Reduced rescue times and increased catchment area represent presumable specific advantages of HEMS. In contrast, the availability of HEMS is connected to a high financial burden and depends on the weather, day time and controlled visual flight rules. To date, clear evidence regarding the beneficial effects of HEMS in terms of improved clinical outcome has remained elusive. Methods Traumatized patients (Injury Severity Score; ISS ≥9) primarily treated by HEMS or ground emergency medical services (GEMS) between 2007 and 2009 were analyzed using the TraumaRegister DGU® of the German Society for Trauma Surgery. Only patients treated in German level I and II trauma centers with complete data referring to the transportation mode were included. Complications during hospital treatment included sepsis and organ failure according to the criteria of the American College of Chest Physicians/Society of Critical Care Medicine (ACCP/SCCM) consensus conference committee and the Sequential Organ Failure Assessment (SOFA) score. Results A total of 13,220 patients with traumatic injuries were included in the present study. Of these, 62.3% (n = 8,231) were transported by GEMS and 37.7% (n = 4,989) by HEMS. Patients treated by HEMS were more seriously injured compared to GEMS (ISS 26.0 vs. 23.7, P < 0.001) with more severe chest and abdominal injuries. The extent of medical treatment on-scene, which involved intubation, chest and treatment with vasopressors, was more extensive in HEMS (P < 0.001) resulting in prolonged on-scene time (39.5 vs. 28.9 minutes, P < 0.001). During their clinical course, HEMS patients more frequently developed multiple organ dysfunction syndrome (MODS) (HEMS: 33.4% vs. GEMS: 25.0%; P < 0.001) and sepsis (HEMS: 8.9% vs. GEMS: 6.6%, P < 0.001) resulting in an increased length of ICU treatment and in-hospital time

  13. Emergency/disaster medical support in the restoration project for the Fukushima nuclear power plant accident.

    PubMed

    Morimura, Naoto; Asari, Yasushi; Yamaguchi, Yoshihiro; Asanuma, Kazunari; Tase, Choichiro; Sakamoto, Tetsuya; Aruga, Tohru

    2013-12-01

    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.

  14. [Diagnosis and treatment in the emergency room of acute asthma in childhood].

    PubMed

    Aldana Vergara, Ruth Saraí; Olivar Lòpez, Victor; Sienra Monge, Juan José Luis; Lezana Fernández, José Luis; Zepeda Ortega, Benjamin

    2009-01-01

    Acute asthma is characterized by acute air way obstruction episodes presented as short breath, increased coughing, wheezing and difficult breathing, reversible with bronchodilator. It constitutes one of the most frequent causes of pediatric ER visits whose diagnosis and treatment is not always adequate. It is necessary to carry out a complete medical history searching for the number of previous attacks, risk factors, associated illnesses, triggers, prior hospitalizations, preventive and maintenance treatment used, along with a complete physical examination. During the management of moderate-severe attacks frequent systematic assessments are required to ensure treatment response. In children above 5 years old, monitoring of expiratory peak flow (EPF) during mild-moderate attacks is recommended. In general, a national consensus to classify and treat acute asthma in emergency services does not exist for which the need to develop a clinical practice guide of diagnosis and management arises.

  15. Conventional and emerging treatments in the management of acute primary angle closure

    PubMed Central

    Boey, Pui Yi; Singhal, Shweta; Perera, Shamira A; Aung, Tin

    2012-01-01

    The management of acute primary angle closure is directed at lowering the intraocular pressure and relieving pupil block. Conventional treatment involves the use of medical treatment and laser peripheral iridotomy, respectively, as a means for achieving these aims. Newer therapeutic strategies have been described that are potentially useful adjuncts or alternatives to conventional treatment. Emerging strategies that lower intraocular pressure include anterior chamber paracentesis, as well as laser procedures such as iridoplasty and pupilloplasty. A possible alternative to relieving pupil block is lens extraction, and may be combined with adjunctive measures such as goniosynechiolysis and viscogoniosynechiolysis. Trabeculectomy has a limited role in the acute setting. This review paper reviews the current evidence regarding conventional and newer treatment modalities for acute primary angle closure. PMID:22536030

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

    PubMed Central

    2012-01-01

    Introduction The purpose of this study was to perform a descriptive, content-based analysis on the different forms of documentation for in-flight medical emergencies that are currently provided in the emergency medical kits on board commercial airlines. Methods Passenger airlines in the World Airline Directory were contacted between March and May 2011. For each participating airline, sample in-flight medical emergency documentation forms were obtained. All items in the sample documentation forms were subjected to a descriptive analysis and compared to a sample "medical incident report" form published by the International Air Transport Association (IATA). Results A total of 1,318 airlines were contacted. Ten airlines agreed to participate in the study and provided a copy of their documentation forms. A descriptive analysis revealed a total of 199 different items, which were summarized into five sub-categories: non-medical data (63), signs and symptoms (68), diagnosis (26), treatment (22) and outcome (20). Conclusions The data in this study illustrate a large variation in the documentation of in-flight medical emergencies by different airlines. A higher degree of standardization is preferable to increase the data quality in epidemiologic aeromedical research in the future. PMID:22397530

  17. Pattern of Investigation Reflects Risk Profile in Emergency Medical Admissions

    PubMed Central

    Cournane, Seán; Byrne, Declan; O’Riordan, Deirdre; Sheehy, Niall; Silke, Bernard

    2015-01-01

    Demand for hospital resources may increase over time; we have examined all emergency admissions (51,136 episodes) from 2005 to 2013 for underlying trends and whether resource utilization and clinical risk are correlated. We used logistic regression of the resource indicator against 30-day in-hospital mortality and adjusted this risk estimate for other outcome predictors. Generally, resource indicators predicted an increased risk of a 30-day in-hospital death. For CT Brain the Odds Ratio (OR) was 1.37 (95% CI: 1.27, 1.50), CT Abdomen 3.48 (95% CI: 3.02, 4.02) and CT Chest, Thorax, Abdomen and Pelvis 2.50 (95% CI: 2.10, 2.97). Services allied to medicine including Physiotherapy 2.57 (95% CI: 2.35, 2.81), Dietetics 2.53 (95% CI: 2.27, 2.82), Speech and Language 5.29 (95% CI: 4.57, 6.05), Occupational Therapy 2.65 (95% CI: 2.38, 2.94) and Social Work 1.65 (95% CI: 1.48, 1.83) all predicted an increased risk. The in-hospital 30-day mortality increased with resource utilization, from 4.7% (none) to 27.0% (five resources). In acute medical illness, the use of radiological investigations and allied professionals increased over time. Resource utilization was calibrated from case complexity/30-day in-hospital mortality suggesting that complexity determined the need for and validated the use of these resources. PMID:26239468

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

    ERIC Educational Resources Information Center

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

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

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

    PubMed

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

    2016-12-01

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

  20. Decreasing Falls in Acute Care Medical Patients: An Integrative Review.

    PubMed

    Rowan, Leslie; Veenema, Tener Goodwin

    2017-02-06

    Falls in acute care medical patients are a complex problem impacted by the constantly changing risk factors affecting this population. This integrative literature review analyzes current evidence to determine factors that continue to make falls a top patient safety problem within the medical unit microsystem. The goal of this review is to develop an evidence-based structure to guide process improvement and effective use of organization resources.

  1. Resveratrol: A medical drug for acute pancreatitis

    PubMed Central

    Ma, Zhen-Hua; Ma, Qing-Yong

    2005-01-01

    Accumulating evidence demonstrates that resveratrol, a natural polyphenolic compound extracted from plants, inhibit inflammation when administered. It has direct effects on suppression of platelet coagulation and cytokines production in many experimental models. Because microcirculation occlusion and cytokines over-production is involved in many diseases such as acute pancreatitis (AP), the discovery of resveratrol as platelet and cytokines inhibitors has shed light on the treatment of AP, which still has significant mortality and morbidity. It is anticipated that this natural polyphenol could serve as a therapeutic compound in managing AP through different pathways. PMID:15929163

  2. Do emergency medical system response times matter for health outcomes?

    PubMed

    Wilde, Elizabeth Ty

    2013-07-01

    The introduction of technology aimed at reducing the response times of emergency medical services has been one of the principal innovations in crisis care over the last several decades. These substantial investments have typically been justified by an assumed link between shorter response times and improved health outcomes. However, current medical research does not generally show a relationship between response time and mortality. In this study, we explain the discrepancy between conventional wisdom and mortality; existing medical research fails to account for the endogeneity of incident severity and response times. Analyzing detailed call-level information from the state of Utah's Bureau of Emergency Medical Services, we measure the impact of response time on mortality and hospital utilization using the distance of the incident from the nearest EMS agency headquarters as an instrument for response time. We find that response times significantly affect mortality and the likelihood of being admitted to the hospital, but not procedures or utilization within the hospital.

  3. Deciding to Seek Emergency Care for Acute Myocardial Infarction.

    PubMed

    Noureddine, Samar; Dumit, Nuhad Y; Saab, Mohammad

    2015-10-01

    The purpose of this qualitative descriptive study was to explore how patients who experience acute myocardial infarction (AMI) decide to seek emergency care. Fifty patients with AMI were interviewed at two hospitals in Lebanon. The perspective of 22 witnesses of the attack was also sought about the cardiac event. The themes that transpired from the data were as follows: making sense of the symptoms, waiting to see what happens, deciding to come to the hospital, and the family influenced the decision to seek care. The witnesses of the cardiac event, mostly family members, supported the decision to seek emergency care. Deciding to seek emergency care for AMI is complex. Nurses must solicit their patients' perception of the cardiac event to provide them with tailored education and counseling about heart attack symptoms and how to respond to them in case they recur. Family members must be included in the education process.

  4. Review on emergency medical response against terrorist attack.

    PubMed

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

    2014-01-01

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

  5. Radiation Dose from Medical Imaging: A Primer for Emergency Physicians

    PubMed Central

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

    2012-01-01

    Introduction Medical imaging now accounts for most of the US population's exposure to ionizing radiation. A substantial proportion of this medical imaging is ordered in the emergency setting. We aim to provide a general overview of radiation dose from medical imaging with a focus on computed tomography, as well as a literature review of recent efforts to decrease unnecessary radiation exposure to patients in the emergency department setting. Methods We conducted a literature review through calendar year 2010 for all published articles pertaining to the emergency department and radiation exposure. Results The benefits of imaging usually outweigh the risks of eventual radiation-induced cancer in most clinical scenarios encountered by emergency physicians. However, our literature review identified 3 specific clinical situations in the general adult population in which the lifetime risks of cancer may outweigh the benefits to the patient: rule out pulmonary embolism, flank pain, and recurrent abdominal pain in inflammatory bowel disease. For these specific clinical scenarios, a physician-patient discussion about such risks and benefits may be warranted. Conclusion Emergency physicians, now at the front line of patients' exposure to ionizing radiation, should have a general understanding of the magnitude of radiation dose from advanced medical imaging procedures and their associated risks. Future areas of research should include the development of protocols and guidelines that limit unnecessary patient radiation exposure. PMID:22900113

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

    PubMed

    Mancini, Michelino

    2014-11-01

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

  7. Extended-duration rivaroxaban thromboprophylaxis in acutely ill medical patients: MAGELLAN study protocol.

    PubMed

    Cohen, Alexander Thomas; Spiro, Theodore Erich; Büller, Harry Roger; Haskell, Lloyd; Hu, Dayi; Hull, Russell; Mebazaa, Alexandre; Merli, Geno; Schellong, Sebastian; Spyropoulos, Alex; Tapson, Victor

    2011-05-01

    Patients with acute medical illnesses are at increased risk of venous thromboembolism (VTE), a significant cause of morbidity and mortality. Thromboprophylaxis is recommended in these patients but questions remain regarding the optimal duration of therapy. The aim of this study is to determine whether oral rivaroxaban is non-inferior to standard-duration (approximately 10 days) subcutaneous (s.c.) enoxaparin for the prevention of VTE in acutely ill medical patients, and whether extended-duration (approximately 5 weeks) rivaroxaban is superior to standard-duration enoxaparin. Patients aged 40 years or older and hospitalized for various acute medical illnesses with risk factors for VTE randomly receive either s.c. enoxaparin 40 mg once daily (od) for 10 ± 4 days or oral rivaroxaban 10 mg od for 35 ± 4 days. The primary efficacy outcomes are the composite of asymptomatic proximal deep vein thrombosis (DVT), symptomatic DVT, symptomatic non-fatal pulmonary embolism (PE), and VTE-related death up to day 10 + 4 and up to day 35 + 4. The primary safety outcome is the composite of treatment-emergent major bleeding and clinically relevant non-major bleeding. As of July 2010, 8,101 patients from 52 countries have been randomized. These patients have a broad range of medical conditions: approximately one-third were diagnosed with acute heart failure, just under one-third were diagnosed with acute infectious disease, and just under one-quarter were diagnosed with acute respiratory insufficiency. MAGELLAN will determine the efficacy, safety, and pharmacological profile of oral rivaroxaban for the prevention of VTE in a diverse population of medically ill patients and the potential of extended-duration therapy to reduce incidence of VTE.

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

    PubMed Central

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

    2017-01-01

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

  9. Cardiac CT angiography in the emergency room: Apical hypertrophic cardiomyopathy presenting as acute coronary syndrome.

    PubMed

    Turner, Michael C; Kerut, Edmund K; Mckinnie, James; Davis, Michael; Hinton, Christine

    2017-03-07

    A 59-year-old male presented to the emergency room with symptoms of chest tightness and palpitations. Following conversion of atrial fibrillation to sinus rhythm, he had deep symmetrical T-wave changes on his electrocardiogram. Symptoms resolved almost immediately, and his initial troponin was negative. He underwent cardiac CT angiography utilizing an emergency room triage protocol which resulted in a diagnosis of nonobstructive coronary artery disease and apical hypertrophic cardiomyopathy. Following a hospital stay of less than 24 hours, he was discharged to outpatient follow-up on medical management and has remained asymptomatic over 6 months. This case presentation illustrates an example of the diversity of pathology that presents in emergency rooms with symptoms consistent with acute coronary syndrome.

  10. 76 FR 15044 - Federal Interagency Committee on Emergency Medical Service (FICEMS) Teleconference Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-18

    ... continuum of emergency medical services and emergency and trauma care for adults and children-including...), hospital-based emergency care and trauma care, and medical-related disaster preparedness. With respect to this full continuum of emergency medical services and emergency and trauma care for adults and...

  11. Emergency medical dispatching by general practitioners in Brussels.

    PubMed

    Renier, W; Seys, B

    1995-09-01

    The objective of this study was to introduce general practitioners (GPs) to the existing emergency medical services (EMS) system, in order to improve the response to emergency residential calls. The study was based in Brussels, which has 1 million residents. A GP dispatcher (GPD) was placed in the emergency dispatch centre, with a stand-by GP, together with adequate equipment, at his or her immediate disposal. A comparative evaluation was conducted in 1994 to measure the changes brought by the availability of a stand-by GP to the emergency medical dispatching performed by the GPD in an experimental zone (EZ) in comparison with a control zone (CZ). The evolution between a first period at the beginning of the year and a second period in September was also analysed. In total, 1059 residential emergency calls were included in the study. The amount of missing data in the filing cards, collaboration between the emergency medical dispatcher (EMD) and the GPD, and evaluation of the emergency levels were improved by training the GPD and the stand-by GP. Intervention times of the stand-by GP varied according to the level of the emergency. The sending of supplementary assistance after dispatching an EMS ambulance, a stand-by GP or a GP of an on-call service was significantly different in the EZ compared with the CZ. The percentage of EMS ambulances and GPs sent increased. The evolution between the two periods was characterized in the CZ by the disappearance of the supplementary assistance performed by the stand-by GP or by the GP of the on-call service and in the EZ by a slight but not significant increased use of the mobile intensive care units (MICUs) for initial assistance. A stand-by GP was used in about 10% of the cases as supplementary assistance. A large number of non-vital urgent complaints arrive at the dispatch centre. The availability of a stand-by GP does not cause an increase (rather a decrease) in MICU use in initial care and supplementary assistance. It causes

  12. 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…

  13. 31 CFR 510.507 - 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. 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...

  14. 31 CFR 510.507 - 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. 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...

  15. 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...

  16. 31 CFR 510.507 - 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. 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...

  17. 76 FR 29131 - Emergency Medical Services Week, 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-19

    ... May 19, 2011 Part V The President Proclamation 8674--Emergency Medical 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...

  18. Emergency Medical Services. Project Report Phase I with Research Findings.

    ERIC Educational Resources Information Center

    Sappe', Hoyt; Squires, Sheila S.

    This report provides results of Phase I of a project that researched the occupational area of emergency medical services (EMS), established appropriate committees, and conducted task verification. These results are intended to guide development of a program designed to train paramedics. Section 1 contains general information: purpose of Phase I;…

  19. 31 CFR 558.508 - 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. 558.508 Section 558.508 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY SOUTH SUDAN SANCTIONS...

  20. 30 CFR 47.83 - Disclosure in a medical emergency.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Disclosure in a medical emergency. 47.83 Section 47.83 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR EDUCATION AND TRAINING HAZARD COMMUNICATION (HazCom) Making HazCom Information Available § 47.83 Disclosure in a...

  1. 31 CFR 552.507 - 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. 552.507 Section 552.507 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY YEMEN SANCTIONS REGULATIONS...

  2. 31 CFR 552.507 - 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. 552.507 Section 552.507 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY YEMEN SANCTIONS REGULATIONS...

  3. [Reflections concerning the care process in the emergency medical services].

    PubMed

    Castañón-González, Jorge Alberto; Barrientos-Fortes, Tomás; Polanco-González, Carlos

    2016-01-01

    In this paper we share some reflections regarding the care process in the emergency medical services, as well as some of the challenges with which these fundamental services deal. We highlight the increasing amount of patients and the complexity of some of the clinical cases, which are some of the causes that lead to the overcrowding of these services.

  4. Emergency Medical Technician Performance Evaluation. NCHSR Research Report Series.

    ERIC Educational Resources Information Center

    Frazier, William H.; Cannon, Joseph F.

    An evaluation was conducted of the diagnostic accuracy and treatment appropriateness of emergency medical technicians (EMTs) in caring for 4,455 consecutive patients during a four-and-one-half month period. Data on EMT diagnosis and treatment and physician diagnosis were collected, and EMT data validated by observers. There were fifty-eight…

  5. [Palliative care at home, transferring information to emergency medical teams].

    PubMed

    Ribeaucoup, Luc; Roche, Blandine

    2015-11-01

    Many people wish to die at home. However, the end-of-life period can be marked by the occurrence of numerous symptoms causing situations of crisis. Emergency medical teams are therefore frequently called upon. In order to be able to make the right decisions in a short space of time, they must have quick access to all the relevant information.

  6. 31 CFR 542.508 - 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. 542.508 Section 542.508 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY SYRIAN SANCTIONS...

  7. 31 CFR 542.508 - 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. 542.508 Section 542.508 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY SYRIAN SANCTIONS...

  8. 31 CFR 542.531 - 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. 542.531 Section 542.531 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY SYRIAN SANCTIONS...

  9. On the Alert: Preparing for Medical Emergencies in Schools

    ERIC Educational Resources Information Center

    Mahoney, Dan

    2012-01-01

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

  10. 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…

  11. Crash Victim Extrication Training Course: Emergency Medical Technician; Course Guide.

    ERIC Educational Resources Information Center

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

    The goal of the National Highway Traffic Safety Administration Department of Transportation has been to upgrade and professionalize the ambulance field, enhance its life-sustaining quality, and encourage its establishment where it does not now exist. The course discusses purpose, mission, and duties of the emergency medical technician; leadership;…

  12. 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... SANCTIONS REGULATIONS Licenses, Authorizations, and Statements of Licensing Policy § 547.508...

  13. 31 CFR 544.508 - 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. 544.508 Section 544.508 Money and Finance: Treasury Regulations Relating to Money and Finance... PROLIFERATORS SANCTIONS REGULATIONS Licenses, Authorizations and Statements of Licensing Policy §...

  14. 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... TAYLOR SANCTIONS REGULATIONS Licenses, Authorizations and Statements of Licensing Policy §...

  15. 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... SANCTIONS REGULATIONS Licenses, Authorizations, and Statements of Licensing Policy § 547.508...

  16. 31 CFR 544.508 - 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. 544.508 Section 544.508 Money and Finance: Treasury Regulations Relating to Money and Finance... PROLIFERATORS SANCTIONS REGULATIONS Licenses, Authorizations and Statements of Licensing Policy §...

  17. 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... TAYLOR SANCTIONS REGULATIONS Licenses, Authorizations and Statements of Licensing Policy §...

  18. 31 CFR 588.508 - 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. 588.508 Section 588.508 Money and Finance: Treasury Regulations Relating to Money and Finance... REGULATIONS Licenses, Authorizations, and Statements of Licensing Policy § 588.508 Authorization of...

  19. 31 CFR 589.508 - 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. 589.508 Section 589.508 Money and Finance: Treasury Regulations Relating to Money and Finance... REGULATIONS Licenses, Authorizations, and Statements of Licensing Policy § 589.508 Authorization of...

  20. 31 CFR 588.508 - 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. 588.508 Section 588.508 Money and Finance: Treasury Regulations Relating to Money and Finance... REGULATIONS Licenses, Authorizations, and Statements of Licensing Policy § 588.508 Authorization of...

  1. 31 CFR 544.508 - 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. 544.508 Section 544.508 Money and Finance: Treasury Regulations Relating to Money and Finance... PROLIFERATORS SANCTIONS REGULATIONS Licenses, Authorizations and Statements of Licensing Policy §...

  2. 31 CFR 548.508 - 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. 548.508 Section 548.508 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY BELARUS SANCTIONS...

  3. 31 CFR 548.508 - 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. 548.508 Section 548.508 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY BELARUS SANCTIONS...

  4. 31 CFR 548.508 - 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. 548.508 Section 548.508 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY BELARUS SANCTIONS...

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

    ERIC Educational Resources Information Center

    Spotts, Sue Ann

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

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

    ERIC Educational Resources Information Center

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

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

  7. Emergency Medical Dispatch. National Standard Curriculum. Instructor Guide. Trainee Guide.

    ERIC Educational Resources Information Center

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

    This guide contains all instructor materials and requirements for the National Highway Traffic Safety Administration (NHTSA), Emergency Medical Dispatch (EMD) National Standard Curriculum. It includes lesson plans, instructional aids, and tools and supporting information designed to elevate trained and experienced public safety telecommunicators…

  8. 31 CFR 562.507 - 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. 562.507 Section 562.507 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY IRANIAN HUMAN RIGHTS...

  9. 31 CFR 562.507 - 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. 562.507 Section 562.507 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY IRANIAN HUMAN RIGHTS...

  10. 31 CFR 562.507 - 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. 562.507 Section 562.507 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY IRANIAN HUMAN RIGHTS...

  11. 31 CFR 562.507 - 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. 562.507 Section 562.507 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY IRANIAN HUMAN RIGHTS...

  12. Emergency Medical Services: Research Methodology. Research Proceedings Series.

    ERIC Educational Resources Information Center

    National Center for Health Services Research and Development (DHEW/PHS), Rockville, MD.

    The thirteen papers included here were presented at a conference on the importance of systematic research in evaluating the Emergency Medical Services (EMS) system and administrative functions. The first paper spells out the roles and responsibilities EMS administrators incur when they make a commitment to participate in a research project. An…

  13. 31 CFR 551.507 - 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. 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...

  14. 31 CFR 551.507 - 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. 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...

  15. 31 CFR 551.507 - 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. 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...

  16. 31 CFR 551.507 - 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. 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...

  17. 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...

  18. 76 FR 22166 - Renewal of Charter for the National Emergency Medical Services Advisory Council (NEMSAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-20

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

  19. 76 FR 39977 - National Emergency Medical Services Advisory Council Teleconference Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-07

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

  20. 78 FR 24802 - National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-26

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

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

    PubMed

    Sharma, Mohit; Brandler, Ethan S

    2014-06-01

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

  2. Acute fulminant necrotizing amoebic colitis: a potentially fatal cause of diarrhoea on the Acute Medical Unit.

    PubMed

    Desai, Purav; Sivaramakrishnan, Nurani

    2011-01-01

    Diarrhoea is a common presenting complaint to the Acute Medical Unit. We report a case of acute fulminant necrotizing amebic colitis in a 73 year old man with no recent travel history preceding his admission. Such cases are often difficult to diagnose and hence associated with a high mortality, unless treated promptly and appropriately. This case report highlights the importance of early diagnosis and prompt initiation of treatment.

  3. Medical management of the acute radiation syndrome.

    PubMed

    López, Mario; Martín, Margarita

    2011-07-13

    The acute radiation syndrome (ARS) occurs after whole-body or significant partial-body irradiation (typically at a dose of >1 Gy). ARS can involve the hematopoietic, cutaneous, gastrointestinal and the neurovascular organ systems either individually or in combination. There is a correlation between the severity of clinical signs and symptoms of ARS and radiation dose. Radiation induced multi-organ failure (MOF) describes the progressive dysfunction of two or more organ systems over time. Radiation combined injury (RCI) is defined as radiation injury combined with blunt or penetrating trauma, burns, blast, or infection. The classic syndromes are: hematopoietic (doses >2-3 Gy), gastrointestinal (doses 5-12 Gy) and cerebrovascular syndrome (doses 10-20 Gy). There is no possibility to survive after doses >10-12 Gy. The Phases of ARS are-prodromal: 0-2 days from exposure, latent: 2-20 days, and manifest illness: 21-60 days from exposure. Granulocyte-colony stimulating factor (G-CSF) at a dose of 5 μg/kg body weight per day subcutaneously has been recommended as treatment of neutropenia, and antibiotics, antiviral and antifungal agents for prevention or treatment of infections. If taken within the first hours of contamination, stable iodine in the form of nonradioactive potassium iodide (KI) saturates iodine binding sites within the thyroid and inhibits incorporation of radioiodines into the gland. Finally, if severe aplasia persists under cytokines for more than 14 days, the possibility of a hematopoietic stem cell (HSC) transplantation should be evaluated. This review will focus on the clinical aspects of the ARS, using the European triage system (METREPOL) to evaluate the severity of radiation injury, and scoring groups of patients for the general and specific management of the syndrome.

  4. Medical management of the acute radiation syndrome

    PubMed Central

    López, Mario; Martín, Margarita

    2011-01-01

    The acute radiation syndrome (ARS) occurs after whole-body or significant partial-body irradiation (typically at a dose of >1 Gy). ARS can involve the hematopoietic, cutaneous, gastrointestinal and the neurovascular organ systems either individually or in combination. There is a correlation between the severity of clinical signs and symptoms of ARS and radiation dose. Radiation induced multi-organ failure (MOF) describes the progressive dysfunction of two or more organ systems over time. Radiation combined injury (RCI) is defined as radiation injury combined with blunt or penetrating trauma, burns, blast, or infection. The classic syndromes are: hematopoietic (doses >2–3 Gy), gastrointestinal (doses 5–12 Gy) and cerebrovascular syndrome (doses 10–20 Gy). There is no possibility to survive after doses >10–12 Gy. The Phases of ARS are—prodromal: 0–2 days from exposure, latent: 2–20 days, and manifest illness: 21–60 days from exposure. Granulocyte-colony stimulating factor (G-CSF) at a dose of 5 μg/kg body weight per day subcutaneously has been recommended as treatment of neutropenia, and antibiotics, antiviral and antifungal agents for prevention or treatment of infections. If taken within the first hours of contamination, stable iodine in the form of nonradioactive potassium iodide (KI) saturates iodine binding sites within the thyroid and inhibits incorporation of radioiodines into the gland. Finally, if severe aplasia persists under cytokines for more than 14 days, the possibility of a hematopoietic stem cell (HSC) transplantation should be evaluated. This review will focus on the clinical aspects of the ARS, using the European triage system (METREPOL) to evaluate the severity of radiation injury, and scoring groups of patients for the general and specific management of the syndrome. PMID:24376971

  5. Rotorcraft-based emergency medical services in the Caribbean Basin

    NASA Technical Reports Server (NTRS)

    Smith, R. W.; Alton, L. R.

    1987-01-01

    There is a pressing need for improved health care in general and emergency health care in particular throughout the Caribbean Basin. The importance of rotorcraft as an integral part of the needed system of emergency medical care in the region was investigated. Many of the larger countries in the region currently have the needed infrastructure to implement a national system of rotorcraft-based emergency medical centers within their borders. By helping to establish a system of rotorcraft based health care centers in strategic locations in the Lesser Antilles, the U.S. can assist the islands of the region by demonstrating the concept and establishing a potential training site for the other larger countries of the region. There is sufficient demand for rotorcraft based emergency health care within the Lesser Antilles to locate one center on the island of Puerto Rico and another one of the southern-most islands. With the use of fixed wing aircraft or long range helicopters, the two rotorcraft based centers could provide the region with rapid and efficient emergency health care. The superior speed and range of the XV-15 Tilt Rotor aircraft make it an attractive possibility for emergency transport and rescue in this region.

  6. Use of Lung Ultrasound For Diagnosing Acute Heart Failure in Emergency Department of Southern India

    PubMed Central

    Gupta, Mrigakshi; Vijan, Vikrant; Vupputuri, Anjith; Chintamani, Sanjeev; Rajendran, Bishnukiran; Thachathodiyal, Rajesh; Chandrasekaran, Rajiv

    2016-01-01

    Introduction Diagnosing heart failure is often a challenge for the healthcare providers due to it’s non-specific and usually subtle physical presentations. The outcomes for treatment are strongly related to the stage of the disease. Considering the importance of early and accurate diagnosis, it is important to have an easy, inexpensive, non-invasive, reliable and reproducible method for diagnosis of heart failure. Recent advancement in radiology and cardiology are supporting the emerging technique of lung ultrasound through B-line evaluation for identifying extravascular lung water. Aim To establish lung ultrasound as an easy, inexpensive, non-invasive, reliable and reproducible method for diagnosing Acute Decompensated Heart Failure (ADHF) in emergency department. Materials and Methods The study was a cross-sectional, prospective, observational, diagnostic validation study of lung ultrasound for diagnosis of acute heart failure in an emergency department and was performed at Amrita Institute of Medical Science, Kochi, Kerala, India. A total of 42 patients presenting with symptoms suggestive of acute decompensated heart failure were evaluated by plasma B-type Natriuretic Peptide (BNP), Echocardiography (ECHO) and X-ray. Lung ultrasound was done to look for the presence of B-lines. Statistical Analysis Sensitivity, specificity and predictive value of diagnostic modalities were calculated using Mc Nemar’s Chi-square test for the presence and absence of heart failure. Results Lung ultrasound showed a sensitivity of 91.9% and a specificity of 100% in diagnosing acute heart failure comparable to plasma BNP which had a sensitivity of 100% and a specificity of 60%. It was also superior to other methods of diagnosing ADHF namely X-ray and ECHO and showed a good association. Conclusion Lung ultrasound and its use to detect ultrasonographic B-lines is an early, sensitive and an equally accurate predictor of ADHF in the emergency setting as compared to BNP. PMID:28050472

  7. Simulation training for emergency teams to manage acute ischemic stroke by telemedicine

    PubMed Central

    Richard, Sébastien; Mione, Gioia; Varoqui, Claude; Vezain, Arnaud; Brunner, Arielle; Bracard, Serge; Debouverie, Marc; Braun, Marc

    2016-01-01

    Abstract Telemedicine contributes to initiating early intravenous recombinant tissue plasminogen activator (rt-PA) treatment for patients with acute cerebral infarction in areas without a stroke unit. However, the experience and skills of the emergency teams in the spokes to prepare patients and administer rt-PA treatment are ill-defined. Improving these skills could vastly improve management of acute stroke by telemedicine. We developed a medical simulation training model for emergency teams to perform intravenous rt-PA treatment in a telestroke system. From February 2013 to May 2015, 225 learners from 6 emergency teams included in the telestroke system “Virtuall”—in Lorrain (northeastern France)—received a standardized medical simulation training module to perform rt-PA treatment. All learners were assessed with the same pretraining and posttraining test consisting of 52 items. The percentage of right answers was determined for every learner before and after training. Median percentages of right answers were significantly higher in the posttraining test overall (82 ± 10 vs. 59 ± 13% pretraining; P < 0.001), but also in all professional subgroups: physicians (88 ± 8 vs. 67 ± 12%; P < 0.001), paramedical staff (80 ± 9 vs. 54 ± 12%; P < 0.001), nurses (80 ± 8 vs. 54 ± 12%; P < 0.001), and auxiliary nurses (76 ± 17 vs. 37 ± 15%; P = 0.002). We describe for the first time a training model for emergency teams in a telestroke system. We demonstrate significant gain in knowledge for all groups of healthcare professionals. This simulation model could be applied in any medical simulation center and form the basis of a standardized training program of spokes in a telestroke system. PMID:27311003

  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. Ethical considerations for vaccination programmes in acute humanitarian emergencies.

    PubMed

    Moodley, Keymanthri; Hardie, Kate; Selgelid, Michael J; Waldman, Ronald J; Strebel, Peter; Rees, Helen; Durrheim, David N

    2013-04-01

    Humanitarian emergencies result in a breakdown of critical health-care services and often make vulnerable communities dependent on external agencies for care. In resource-constrained settings, this may occur against a backdrop of extreme poverty, malnutrition, insecurity, low literacy and poor infrastructure. Under these circumstances, providing food, water and shelter and limiting communicable disease outbreaks become primary concerns. Where effective and safe vaccines are available to mitigate the risk of disease outbreaks, their potential deployment is a key consideration in meeting emergency health needs. Ethical considerations are crucial when deciding on vaccine deployment. Allocation of vaccines in short supply, target groups, delivery strategies, surveillance and research during acute humanitarian emergencies all involve ethical considerations that often arise from the tension between individual and common good. The authors lay out the ethical issues that policy-makers need to bear in mind when considering the deployment of mass vaccination during humanitarian emergencies, including beneficence (duty of care and the rule of rescue), non-maleficence, autonomy and consent, and distributive and procedural justice.

  10. The World Health Organization Network for Radiation Emergency Medical Preparedness and Assistance (REMPAN).

    PubMed Central

    Souchkevitch, G

    1997-01-01

    The World Health Organization (WHO) has established a system of collaborating centers known as the Radiation Emergency Medical Preparedness and Assistance Network (REMPAN) to promote radiation emergency medical preparedness, assistance, and advice to countries in cases of overexposure of populations from any source of radiation. This network consists of 13 specialized institutions located in 10 countries. Within the REMPAN there are three separate but linked activities. The first is aimed at strengthening radiation emergency medical preparedness and assistance to treat and monitor acutely exposed individuals. The second activity is directed toward improving public health advice to mitigate long-term effects of exposure to low and protracted doses that might accrue in populations living in the affected territories. This involves giving advice on protecting public health, e.g., iodine prophylaxis, psychosocial risks associated with countermeasures, and public information strategies. In addition, the REMPAN develops activities aimed at improving long-term follow-up studies and preparedness for epidemiologic investigations in territories contaminated by radionuclides from a nuclear accident. The WHO's response in a radiation emergency depends on the type of accident and its time phase. This includes a wide range of actions from studying the situation to providing medical and public health assistance through the network of collaborating centers and relevant institutions within the REMPAN. The process of creating a reliable international system for radiation emergency medical preparedness and assistance has not yet been completed. Deficiencies in this system are outlined in this paper to attract the attention of specialists in the field of radiation protection and potential donors of the WHO program. PMID:9467087

  11. Management of acute traumatic stress in nuclear and radiological emergencies.

    PubMed

    Vazquez, Marina; Jordan, Osvaldo; Kuper, Enrique; Hernandez, Daniel; Galmarini, Martin; Ferraro, Augusto

    2010-06-01

    In order to effectively respond to and minimize the psychological impact following disasters, such as radio-nuclear ones, it is essential to understand the mechanisms involved in such conditions and how to prevent and treat the psychological impacts, including those related to acute traumatic stress and its consequences across life span. Radio-nuclear emergencies may cause psychological traumatic stress, with its potentially significant consequences in mental health, with both short and long-term effects, which extend beyond the individuals directly affected. Ionizing radiation cannot be perceived by human senses and most people are unaware of the magnitude of its effects, which could result in feelings of helplessness and vulnerability. Those situations with a high degree of uncertainty, regarding potential future health effects, are more psychologically traumatic than others. The present century has witnessed a steady increase in the number of publications concerning the mental health impact of traumatic events, showing the need of increasing the study of traumatic stress and its impact on mental health. A prompt, planned and effective response to manage disaster-induced acute traumatic stress may prevent the evolutionary reactions of traumatic stress into disorders or even chronic stress diseases that can appear after a nuclear or radiological emergency.

  12. Discrepancy among acute guideline levels for emergency response.

    PubMed

    Oberg, Mattias; Palmen, Nicole; Johanson, Gunnar

    2010-12-15

    Acute guidance values are tools for public health risk assessment and management during planning, preparedness and response related to sudden airborne release of hazardous chemicals. The two most frequently used values, i.e. Acute Exposure Guidance Levels (AEGL) and Emergency Response Planning Guideline (ERPG), were compared in qualitative and quantitative terms. There was no significant difference between the general level of AEGL and ERPG values, suggesting the two systems are equally precautious. However, the guidance values diverged by a factor of 3 or more for almost 40% of the substances, including many of high production volume. These deviations could be explained by differences in selection of critical effect or critical study and in a few cases differences in interpretation of the same critical study. Diverging guidance values may hamper proper risk communication and risk management. Key factors for broad international acceptance of harmonized values include transparency of the decision process, agreement on definition of toxicological tiers, and a target population including sensitive groups of the general population. In addition, development of purely health based values is encouraged. Risk management issues, such as land use and emergency response planning should be treated separately, as these rely on national legislation and considerations.

  13. Self-Medication: Initial Treatments Used by Patients Seen in an Ophthalmologic Emergency Room

    PubMed Central

    Carvalho, Regina Souza; Kara-José, Newton; Temporini, Edméa Rita; Kara-Junior, Newton; Noma-Campos, Regina

    2009-01-01

    OJECTIVE This study seeks to identify practices of self-medication in the treatment of ocular emergencies. We examine patients’ use of both homemade preparations and manufactured products before seeking specialized care. MATERIALS AND METHODS We conducted a cross-sectional analytic survey of consecutive patients seen in the ophthalmology emergency room of a teaching hospital. RESULTS The sample included 561 subjects, 51.3% males and 48.7% females, with a mean age of 39.8 years. Prior to seeking emergency care, 40.5% reported self-medicating; 29.4% used a homemade preparation (13.9% referred to an industrialized product like boric acid as a homemade preparation), and 11.1% used a manufactured product. The most frequently used products included a boric acid solution (53.3%), a normal saline solution (35.7%), herbal infusions (6.1%) and breast milk (4.8%). Viral conjunctivitis was the most frequent diagnosis (24.4%), followed by the presence of a corneal foreign body (7.4%). No significant differences were found in the self-treatment of ocular injuries according to gender (p = 0.95), level of education (p = 0.21) or age (p = 0.14). In addition, self-medication practices were not related to the medically judged severity of the condition. CONCLUSION Patients often attempt to treat conditions that require ophthalmologic emergency care by self-medicating with homemade or manufactured products. The most widely used products include boric acid, normal saline, leaf infusions and breast milk. This behavior occurs independently of educational level, gender, age or the nature of the ocular condition. Self-medication is a culturally driven practice that is used even in cases of acute ocular injuries. PMID:19690656

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

    PubMed Central

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

    2017-01-01

    Introduction: Medical applications help physicians to make more rapid and evidence based decisions that may provide better patient care. This study aimed to determine the extent to which smart phones and medical applications are integrated in the emergency department daily practice. Method: In a cross sectional study, a modified standard questionnaire (Payne et al.) consisting of demographic data and information regarding quality and quantity of smartphone and medical app utilization was sent to emergency-medicine residents and interns twice (two weeks apart), in January 2015. The questionnaire was put online using open access "Web-form Module" and the address of the web page was e-mailed along with a cover letter explaining the survey. Finally, responses were analyzed using descriptive statistics and SPSS 22 software. Results: 65 cases participated (response rate 86%). The mean age of interns and residents were 25.03 ± 1.13 and 30.27 ± 4.68 years, respectively (p < 0.001). There was no significant difference between interns and residents in owning a smartphone (p = 0.5). Android was more popular than IOS (67.7% against 25.8%) and the most popular medical apps were Medscape and UpToDate, respectively. 38 (61.3%) of the respondents were using their apps more than once a day and mostly for drug information. English (83.9%), Persian (12.9%), and other languages (3.2%) were preferred languages for designing a medical software among the participants, respectively. Conclusion: The findings of present study showed that smartphones are very popular among Iranian interns and residents in emergency department and a substantial number of them own a smartphone and are using medical apps regularly in their clinical practice. PMID:28286821

  15. Nurses' medication administration practices at two Singaporean acute care hospitals.

    PubMed

    Choo, Janet; Johnston, Linda; Manias, Elizabeth

    2013-03-01

    This study examined registered nurses' overall compliance with accepted medication administration procedures, and explored the distractions they faced during medication administration at two acute care hospitals in Singapore. A total of 140 registered nurses, 70 from each hospital, participated in the study. At both hospitals, nurses were distracted by personnel, such as physicians, radiographers, patients not under their care, and telephone calls, during medication rounds. Deviations from accepted medication procedures were observed. At one hospital, the use of a vest during medication administration alone was not effective in avoiding distractions during medication administration. Environmental factors and distractions can impact on the safe administration of medications, because they not only impair nurses' level of concentration, but also add to their work pressure. Attention should be placed on eliminating distractions through the use of appropriate strategies. Strategies that could be considered include the conduct of education sessions with health professionals and patients about the importance of not interrupting nurses while they are administering medications, and changes in work design.

  16. Tuberculosis diagnosis: primary health care or emergency medical services?

    PubMed Central

    Andrade, Rubia Laine de Paula; Scatolin, Beatriz Estuque; Wysocki, Anneliese Domingues; Beraldo, Aline Ale; Monroe, Aline Aparecida; Scatena, Lúcia Marina; Villa, Tereza Cristina Scatena

    2013-01-01

    OBJECTIVE To assess primary health care and emergency medical services performance for tuberculosis diagnosis. METHODS Cross-sectional study were conducted with 90 health professionals from primary health care and 68 from emergency medical services, in Ribeirao Preto, SP, Southeastern Brazil, in 2009. A structured questionnaire based on an instrument of tuberculosis care assessment was used. The association between health service and the variables of structure and process for tuberculosis diagnosis was assessed by Chi-square test, Fisher's exact test (both with 5% of statistical significance) and multiple correspondence analysis. RESULTS Primary health care was associated with the adequate provision of inputs and human resources, as well as with the sputum test request. Emergencial medical services were associated with the availability of X-ray equipment, work overload, human resources turnover, insufficient availability of health professionals, unavailability of sputum collection pots and do not request sputum test. In both services, tuberculosis diagnosis remained as a physician's responsibility. CONCLUSIONS Emergencial medical services presented weaknesses in its structure to identify tuberculosis suspects. Gaps on the process were identified in both primary health care and emergencial medical services. This situation highlights the need for qualification of health services that are the main gateway to health system to meet sector reforms that prioritize the timely diagnosis of tuberculosis and its control. PMID:24626553

  17. Mental and social health during and after acute emergencies: emerging consensus?

    PubMed Central

    van Ommeren, Mark; Saxena, Shekhar; Saraceno, Benedetto

    2005-01-01

    Mental health care programmes during and after acute emergencies in resource-poor countries have been considered controversial. There is no agreement on the public health value of the post-traumatic stress disorder concept and no agreement on the appropriateness of vertical (separate) trauma-focused services. A range of social and mental health intervention strategies and principles seem, however, to have the broad support of expert opinion. Despite continuing debate, there is emerging agreement on what entails good public health practice in respect of mental health. In terms of early interventions, this agreement is exemplified by the recent inclusion of a "mental and social aspects of health" standard in the Sphere handbook's revision on minimal standards in disaster response. This affirmation of emerging agreement is important and should give clear messages to health planners. PMID:15682252

  18. The Rhode Island Medical Emergency Distribution System (MEDS).

    PubMed

    Banner, Greg

    2004-01-01

    The State of Rhode Island conducted an exercise to obtain and dispense a large volume of emergency medical supplies in response to a mass casualty incident. The exercise was conducted in stages that included requesting supplies from the Strategic National Stockpile and distributing the supplies around the state. The lessons learned included how to better structure an exercise, what types of problems were encountered with requesting and distributing supplies, how to better work with members of the private medical community who are not involved in disaster planning, and how to become aware of the needs of special population groups.

  19. Infections due to emerging and uncommon medically important fungal pathogens.

    PubMed

    Walsh, T J; Groll, A; Hiemenz, J; Fleming, R; Roilides, E; Anaissie, E

    2004-03-01

    The emergence of less common but medically important fungal pathogens contributes to the rate of morbidity and mortality, especially in the increasingly expanding population of immunocompromised patients. These pathogens include septate filamentous fungi (e.g., Fusarium spp., Scedosporium spp., Trichoderma spp.), nonseptate Zygomycetes, the endemic dimorphic pathogen Penicillium marneffei, and non-Cryptococcus, non-Candida pathogenic yeast (e.g., Trichosporon spp.). The medical community is thus called upon to acquire an understanding of the microbiology, epidemiology and pathogenesis of these previously uncommon pathogens in order to become familiar with the options for prevention and treatment.

  20. Dispensing Medical Countermeasures: Emergency Use Authorities and Liability Protections

    PubMed Central

    2015-01-01

    The Pandemic and All-Hazards Preparedness Reauthorization Act of 2013 (PAHPRA) enhances emergency use authorities with respect to both approved and unapproved medical countermeasures (MCMs). PAHPRA authorities can also be critical to preserving tort liability protections for public health stakeholders, since these protections are often contingent upon appropriate authorizations for the MCMs utilized. This article details the evolution of emergency use authorities and liability protections, analyzes how these separate legal doctrines can intersect in practice, and discusses implications for facilitating preparedness and response activities and for protecting associated personnel. PMID:25813980

  1. Medical and Nonstroke Neurologic Causes of Acute, Continuous Vestibular Symptoms.

    PubMed

    Edlow, Jonathan A; Newman-Toker, David E

    2015-08-01

    Most patients with the acute vestibular syndrome (AVS) have vestibular neuritis or stroke or, in the setting of trauma, a posttraumatic vestibular cause. Some medical and nonstroke causes of the AVS must also be considered. Multiple sclerosis is the most common diagnosis in this group. Other less common causes include cerebellar masses, inflammation and infection, mal de debarquement, various toxins, Wernicke disease, celiac-related dizziness, and bilateral vestibulopathy. Finally, there may be unmasking of prior posterior circulation events by various physiologic alterations such as alterations of temperature, blood pressure, electrolytes, or various medications, especially sedating agents.

  2. 24 CFR 291.530 - Eligible firefighter/emergency medical technicians.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... medical technicians. A person qualifies as a firefighter/emergency medical technician for the purposes of the GNND Sales Program if the person is employed full-time as a firefighter or emergency medical technician by a fire department or emergency medical services responder unit of the federal government,...

  3. 24 CFR 291.530 - Eligible firefighter/emergency medical technicians.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... medical technicians. A person qualifies as a firefighter/emergency medical technician for the purposes of the GNND Sales Program if the person is employed full-time as a firefighter or emergency medical technician by a fire department or emergency medical services responder unit of the federal government,...

  4. 24 CFR 291.530 - Eligible firefighter/emergency medical technicians.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... medical technicians. A person qualifies as a firefighter/emergency medical technician for the purposes of the GNND Sales Program if the person is employed full-time as a firefighter or emergency medical technician by a fire department or emergency medical services responder unit of the federal government,...

  5. 24 CFR 291.530 - Eligible firefighter/emergency medical technicians.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... medical technicians. A person qualifies as a firefighter/emergency medical technician for the purposes of the GNND Sales Program if the person is employed full-time as a firefighter or emergency medical technician by a fire department or emergency medical services responder unit of the federal government,...

  6. A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings

    PubMed Central

    Honasoge, Akilesh; Lyons, Neal; Hesse, Kathleen; Parker, Braden; Mokszycki, Robert; Wesselhoff, Kelly; Sweis, Rolla; Kulstad, Erik B.

    2016-01-01

    The available routes of administration commonly used for medications and fluids in the acute care setting are generally limited to oral, intravenous, or intraosseous routes, but in many patients, particularly in the emergency or critical care settings, these routes are often unavailable or time-consuming to access. A novel device is now available that offers an easy route for administration of medications or fluids via rectal mucosal absorption (also referred to as proctoclysis in the case of fluid administration and subsequent absorption). Although originally intended for the palliative care market, the utility of this device in the emergency setting has recently been described. Specifically, reports of patients being treated for dehydration, alcohol withdrawal, vomiting, fever, myocardial infarction, hyperthyroidism, and cardiac arrest have shown success with administration of a wide variety of medications or fluids (including water, aspirin, lorazepam, ondansetron, acetaminophen, methimazole, and buspirone). Device placement is straightforward, and based on the observation of expected effects from the medication administrations, absorption is rapid. The rapidity of absorption kinetics are further demonstrated in a recent report of the measurement of phenobarbital pharmacokinetics. We describe here the placement and use of this device, and demonstrate methods of pharmacokinetic measurements of medications administered by this method. PMID:27911381

  7. Medical emergencies and drugs: an online study guide.

    PubMed

    2008-05-01

    The Editorial Board of the Journal of Endodontics has developed a literature-based study guide of topical areas related to endodontics. This study guide is intended to give the reader a focused review of the essential endodontic literature and does not cite all possible articles related to each topic. Although citing all articles would be comprehensive, it would defeat the idea of a study guide. This section will cover medical emergencies and drugs.

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

    ERIC Educational Resources Information Center

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

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

  9. 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…

  10. [Emergence of new pneumonia: besides severe acute respiratory syndrome].

    PubMed

    Mangiarotti, P; Pozzi, E

    2006-10-01

    Important epidemiological modifications have been registered in respiratory infections, both in immunocompetent and immunocompromised hosts. Pathogens with modified antibiotic susceptibility patterns have emerged, which display an increased antibiotic resistance, such as S. pneumoniae, S. aureus, H. influenzae. This trait has a strong impact on the therapeutic choices, particularly when an empiric antibiotic treatment is selected. The prevalence of bacterial species showing non-susceptibility to the most common prescribed antibiotics (betalactams, macrolides etc.) follows a different geographic distribution. Some pathogens have acquired a new epidemiological role in patients affected with immune deficiencies: among them P. carinii and other bacterial, fungal and viral pathogens. The emergence of new, previously unknown, species, has been registered, both bacteria (C. pneumoniae) and viruses (Metapneumovirus, Hantavirus etc.). Such aspects must be considered in the diagnosis of respiratory infections, which should include diagnostic tests for the identification of such pathogens. Among the new respiratory infections severe acute respiratory syndrome (SARS) has quickly become a health care emergency, so that efforts have been made to identify the aetiological agent as well as the main epidemiological and clinical characteristics of the disease. Avian influenza has raised great interest immediately after the first cases of human infection caused by the avian virus, especially after the outbreaks in Asian countries and in the Netherlands. A crucial step in containing infection is the prevention of the disease; efforts are directed toward this endpoint.

  11. Medical expenses in treating acute esophageal variceal bleeding

    PubMed Central

    Liu, Chueh-Ling; Wu, Cheng-Kun; Shi, Hon-Yi; Tai, Wei-Chen; Liang, Chih-Ming; Yang, Shih-Cheng; Wu, Keng-Liang; Chiu, Yi-Chun; Chuah, Seng-Kee

    2016-01-01

    Abstract Acute variceal bleeding in patients with cirrhosis is related to high mortality and medical expenses. The purpose of present studies was to analyze the medical expenses in treating acute esophageal variceal bleeding among patients with cirrhosis and potential influencing clinical factors. A total of 151,863 patients with cirrhosis with International Classification of Diseases-9 codes 456.0 and 456.20 were analyzed from the Taiwan National Health Insurance Research Database from January 1, 1996 to December 31, 2010. Time intervals were divided into three phases for analysis as T1 (1996–2000), T2 (2001–2005), and T3 (2006–2010). The endpoints were prevalence, length of hospital stay, medical expenses, and mortality rate. Our results showed that more patients were <65 years (75.6%) and of male sex (78.5%). Patients were mostly from teaching hospitals (90.8%) with high hospital volume (50.9%) and high doctor service load (51.1%). The prevalence of acute esophageal variceal bleeding and mean length of hospital stay decreased over the years (P < 0.001), but the overall medical expenses increased (P < 0.001). Multiple regression analysis showed that older age, female sex, Charlson comorbidity index (CCI) score >1, patients from teaching hospitals, and medium to high or very high patient numbers were independent factors for longer hospital stay and higher medical expenses. Aged patients, female sex, increased CCI score, and low doctor service volume were independent factors for both in-hospital and 5-year mortality. Patients from teaching hospitals and medium to high or very high service volume hospitals were independent factors for in-hospital mortality, but not 5-year mortality. Medical expenses in treating acute esophageal variceal bleeding increased despite the decreased prevalence rate and length of hospital stay in Taiwan. Aged patients, female sex, patients with increased CCI score from teaching hospitals, and medium to high or very high

  12. [Emergency medical training through simulation : Always the same for everyone?

    PubMed

    Schaumberg, A; Schröder, T; Sander, M

    2017-03-01

    Simulation assumes a growing importance in the field of emergency medical education. Many rescue service schools work with simulators or even have their own simulation center. Classic resuscitation training in the classroom is increasingly being replaced by realistic case scenarios. But simulators themselves do not train! Using a simulator in emergency medical training does not necessarily mean achieving sustained learning success among the participants. Depending on the skills, abilities or competences being taught, there seems to be different requirements for simulation. However, there is no scientific evidence about how strong learners should be stressed in order to achieve the best learning effect. However, it can be stated that for training purely technical skills, simulators that represent the anatomical or physiological reality as accurately as possible should be used. If soft skills, practical knowledge and decision-making are the learning objectives, a scenario with extremly realistic conditions needs to be embedded. Mid-fidelity simulators seem to be able to cover the widest range of imparting skills for emergency medical training. No matter what simulator is used, the following applies: The selected scenario must be realistic and the simulation as well as technical capabilities of the simulator must be coordinated. A well-presented scenario with a well-trained teacher using a simple resuscitation doll appears to be better than a highly complex, however unrealistic, amateur simulation scenario for successful learning.

  13. 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

  14. [Despite medication, overdrive pacing is required to stabilize the electrical storm associated with acute coronary syndrome: a case report].

    PubMed

    Umeda, Masanobu; Morimoto, Atsushi; Yokoyama, Kaori; Tateishi, Emi; Makino, Kanako; Yamamoto, Kazuo; Nakagawa, Yoko; Fukuhara, Shinya; Takase, Eiji

    2007-10-01

    A 75-year-old female complained of severe chest pain and was emergently admitted to our hospital because of anterior acute myocardial infarction. Emergent coronary angiography was performed and revealed occlusion in segment 7, so a stent was implanted. Lidocaine, carvedilol, amiodarone, magnesium, and nifekalant were administered successively because non-sustained ventricular tachycardia (NSVT) frequently appeared like an electrical storm. After nifekalant administration, QTc was significantly prolonged and torsades de pointes was induced. Overdrive pacing was performed and finally the NSVT was completely controlled. If fatal arrhythmias such as NSVT show resistance to medication, overdrive pacing should be considered to stabilize the arrhythmia associated with acute coronary syndrome.

  15. MANAGEMENT OF ACUTE SPORTS INJURIES AND MEDICAL CONDITIONS BY PHYSICAL THERAPISTS: ASSESSMENT VIA CASE SCENARIOS

    PubMed Central

    Karges, Joy Renae; Salsbery, Mitchell A.; Smith, Danna; Stanley, Erica J.

    2011-01-01

    Purpose/Background: Some physical therapists (PTs) provide services at sporting events, but there are limited studies investigating whether PTs are properly prepared to provide such services. The purpose of this study was to assess acute sports injury and medical condition management decision-making skills of PTs. Methods: A Web-based survey presented 17 case scenarios related to acute medical conditions and sport injuries. PTs from the Sports Physical Therapy Section of The American Physical Therapy Association were e-mailed a cover letter/Web link to the survey and invited to participate over a 30-day period. Data were analyzed using SPSS 18.0. Results: A total of 411 of 5158 PTs who were members of the Sports Physical Therapy Association in 2009 and had valid e-mail addresses completed the survey, of which 389 (7.5%) were appropriate for analysis. Over 75.0% of respondents felt “prepared” or “somewhat prepared” to provide immediate care for 13 out of 16 medical conditions, with seizures, spinal cord injuries, and internal organ injuries having the lowest percentages. Over 75.0% of the respondents made “appropriate” or “overly cautious” decisions for 11 of the 17 acute injury or medical condition cases. Conclusions: Results of the current study indicate that PTs felt more “prepared” and tended to make “appropriate” return to play decisions on the acute sports injury and medical condition case studies more often than coaches who participated in a similar study, regardless of level of importance of the game or whether the athlete was a starter vs. non-starter. However, for PTs who plan on assisting at sporting events, additional preparation/education may be recommended, such as what is taught in an emergency responder course. PMID:21904695

  16. Emerging applications of fluorescence spectroscopy in medical microbiology field.

    PubMed

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

    2009-11-26

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

  17. Emerging applications of fluorescence spectroscopy in medical microbiology field

    PubMed Central

    2009-01-01

    There are many diagnostic techniques and methods available for diagnosis of medically important microorganisms like bacteria, viruses, fungi and parasites. But, almost all these techniques and methods have some limitations or inconvenience. Most of these techniques are laborious, time consuming and with chances of false positive or false negative results. It warrants the need of a diagnostic technique which can overcome these limitations and problems. At present, there is emerging trend to use Fluorescence spectroscopy as a diagnostic as well as research tool in many fields of medical sciences. Here, we will critically discuss research studies which propose that Fluorescence spectroscopy may be an excellent diagnostic as well as excellent research tool in medical microbiology field with high sensitivity and specificity. PMID:19941643

  18. Emergency department discharge prescription errors in an academic medical center

    PubMed Central

    Belanger, April; Devine, Lauren T.; Lane, Aaron; Condren, Michelle E.

    2017-01-01

    This study described discharge prescription medication errors written for emergency department patients. This study used content analysis in a cross-sectional design to systematically categorize prescription errors found in a report of 1000 discharge prescriptions submitted in the electronic medical record in February 2015. Two pharmacy team members reviewed the discharge prescription list for errors. Open-ended data were coded by an additional rater for agreement on coding categories. Coding was based upon majority rule. Descriptive statistics were used to address the study objective. Categories evaluated were patient age, provider type, drug class, and type and time of error. The discharge prescription error rate out of 1000 prescriptions was 13.4%, with “incomplete or inadequate prescription” being the most commonly detected error (58.2%). The adult and pediatric error rates were 11.7% and 22.7%, respectively. The antibiotics reviewed had the highest number of errors. The highest within-class error rates were with antianginal medications, antiparasitic medications, antacids, appetite stimulants, and probiotics. Emergency medicine residents wrote the highest percentage of prescriptions (46.7%) and had an error rate of 9.2%. Residents of other specialties wrote 340 prescriptions and had an error rate of 20.9%. Errors occurred most often between 10:00 am and 6:00 pm.

  19. Patients with acute chest pain - experiences of emergency calls and pre-hospital care.

    PubMed

    Forslund, Kerstin; Kihlgren, Mona; Ostman, Ingela; Sørlie, Venke

    2005-01-01

    Acute chest pain is a common reason why people call an emergency medical dispatch (EMD) centre. We examined how patients with acute chest pain experience the emergency call and their pre-hospital care. A qualitative design was used with a phenomenological-hermeneutic approach. Thirteen patients were interviewed, three women and 10 men. The patients were grateful that their lives had been saved and in general were satisfied with their pre-hospital contact. Sometimes they felt that it took too long for the emergency operators to answer and to understand the urgency. They were in a life-threatening situation and their feeling of vulnerability and dependency was great. Time seemed to stand still while they were waiting for help during their traumatic experience. The situation was fraught with pain, fear and an experience of loneliness. A sense of individualized care is important to strengthen trust and confidence between the patient and the pre-hospital personnel. Patients were aware of what number to call to reach the EMD centre, but were uncertain about when to call. More lives can be saved if people do not hesitate to call for help.

  20. 76 FR 17485 - Meeting Notice Correction-Federal Interagency Committee on Emergency Medical Services; Correction...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-29

    ... Emergency Medical Services; Correction to Meeting Notice To Clarify Time Zone AGENCY: National Highway... Service (FICEMS) Teleconference Meeting. ACTION: Meeting Notice Correction--Federal Interagency Committee on Emergency Medical Services; Correction to Meeting Notice to clarify time zone. SUMMARY: NHTSA...

  1. The inaugural European emergency medical dispatch conference--a synopsis of proceedings.

    PubMed

    Lyon, Richard M; Bohm, Katarina; Christensen, Erika Frischknecht; Olasveengen, Theresa M; Castrén, Maaret

    2013-09-23

    The inaugural European Emergency Medical Dispatch conference was held in Stockholm, Sweden, in May 2013. We provide a synopsis of the conference proceedings, highlight key topic areas of emergency medical dispatch and suggest future research priorities.

  2. Emerging Therapies for the Prevention of Acute Respiratory Distress Syndrome

    PubMed Central

    Ruthman, Carl A.; Festic, Emir

    2015-01-01

    The development of the acute respiratory distress syndrome (ARDS) carries significant risk of morbidity and mortality. To date, pharmacologic therapy has been largely ineffective for patients with ARDS. We present our personal review aimed at outlining current and future directions for the pharmacologic prevention of ARDS. Several available risk-stratification or prediction scores strategies for identification of patients at risk of ARDS have been reported. Although not ready for the clinical everyday use, they are and will be instrumental in the ongoing and future trials of pharmacoprevention of ARDS. Several systemic medications established the potential role in ARDS prevention based on the preclinical studies and observational data. Due to potential for systemic adverse effects to neutralize any pharmacologic benefits of systemic therapy, inhaled medications appear particularly attractive candidates for ARDS prevention. This is because of their direct delivery to the site of the proposed action (lungs), while pulmonary epithelial surface is still functional. We postulate that overall morbidity and mortality rates from ARDS in the future will be contingent upon decreasing the overall incidence of ARDS through effective identification of those at risk and early application of proven supportive care and pharmacologic interventions. PMID:26002528

  3. Emerging Security Mechanisms for Medical Cyber Physical Systems.

    PubMed

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

    2016-01-01

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

  4. 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.

  5. Procedures Performed by Emergency Medical Services in the United States.

    PubMed

    Carlson, Jestin N; Karns, Christopher; Mann, N Clay; E Jacobson, Karen; Dai, Mengtao; Colleran, Caroline; Wang, Henry E

    2016-01-01

    Emergency medical services (EMS) must provide a wide range of care for patients in the out-of-hospital setting. Although previous work has detailed that EMS providers rarely perform certain procedures, (e.g., endotracheal intubation) there are limited data detailing the frequency of procedures across the breadth of EMS providers' scope of practice. We sought to characterize procedures performed by EMS in the United States. We conducted an analysis of the 2011 National Emergency Medical Services Information System (NEMSIS) research data set, encompassing EMS emergency response data from 40 states and two territories. From these data, we report the number and incidence of EMS procedures. We also characterize procedures performed. There were 14,371,941 submitted EMS responses, of which 7,680,559 had complete information on procedures performed on adults. Of these, 4,206,360 EMS responses had procedures performed totaling 11,407,396 procedures. The most common procedures performed were peripheral venous access (28.4%), cardiac monitoring (16.1%) pulse oximetry (13.5%), and blood glucose analysis (10.4%). Procedures were performed most often in patients with traumatic injury (20.0%) followed by chest pain/discomfort (14.0%). Critical procedures (cardioversion, defibrillation, endotracheal intubation, etc.) were infrequently performed (n = 277,785, 2.4%). These data highlight the frequency with which EMS providers perform procedures across the United States. This may help to guide future EMS training and education efforts by highlighting the relative frequency and infrequency of specific procedures.

  6. Emergency medical services data for cardiovascular disease surveillance, program planning, and evaluation in Maine.

    PubMed

    Meyer, Katie A; Decker, Kathy; Mervis, Cynthia A; Louder, Danielle; Bradshaw, Jay; DeVader, Shannon; Wigand, Debra

    2008-04-01

    Rapid access to medical treatment is a key determinant of outcomes for cardiovascular events. Emergency medical services (EMS) play an important role in delivering early treatment for acute cardiovascular events. Attention has increased on the potential for EMS data to contribute to our understanding of prehospital treatment. Maine recently began to explore the possible role of EMS data in cardiovascular disease surveillance and cardiovascular health program planning and evaluation. We describe the Maine EMS data system, discuss findings on ease of data use and data quality, provide a sample of findings, and share how we plan to use EMS data for program planning and evaluation of community-level interventions and to partner with EMS provider organizations to improve treatment. Our objective is to increase understanding of the promise and limitations of using EMS data for cardiovascular disease surveillance and program planning and evaluation.

  7. Medical direction of wilderness and other operational emergency medical services programs.

    PubMed

    Warden, Craig R; Millin, Michael G; Hawkins, Seth C; Bradley, Richard N

    2012-03-01

    Within a healthcare system, operational emergency medical services (EMS) programs provide prehospital emergency care to patients in austere and resource-limited settings. Some of these programs are additionally considered to be wilderness EMS programs, a specialized type of operational EMS program, as they primarily function in a wilderness setting (eg, wilderness search and rescue, ski patrols, water rescue, beach patrols, and cave rescue). Other operational EMS programs include urban search and rescue, air medical support, and tactical law enforcement response. The medical director will help to ensure that the care provided follows protocols that are in accordance with local and state prehospital standards, while accounting for the unique demands and needs of the environment. The operational EMS medical director should be as qualified as possible for the specific team that is being supervised. The medical director should train and operate with the team frequently to be effective. Adequate provision for compensation, liability, and equipment needs to be addressed for an optimal relationship between the medical director and the team.

  8. 14 CFR Appendix A to Part 121 - First Aid Kits and Emergency Medical Kits

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false First Aid Kits and Emergency Medical Kits A... REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Pt. 121, App. A Appendix A to Part 121—First Aid Kits and Emergency Medical Kits Approved first-aid kits, at least one approved emergency medical kit,...

  9. 14 CFR Appendix A to Part 121 - First Aid Kits and Emergency Medical Kits

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false First Aid Kits and Emergency Medical Kits A... REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Pt. 121, App. A Appendix A to Part 121—First Aid Kits and Emergency Medical Kits Approved first-aid kits, at least one approved emergency medical kit,...

  10. 75 FR 71792 - Federal Interagency Committee on Emergency Medical Services Meeting Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-24

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

  11. 76 FR 36174 - Federal Interagency Committee on Emergency Medical Services; Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-21

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

  12. 48 CFR 1852.242-78 - Emergency Medical Services and Evacuation.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 6 2012-10-01 2012-10-01 false Emergency Medical Services... Provisions and Clauses 1852.242-78 Emergency Medical Services and Evacuation. As prescribed in 1842.7003, insert the following clause: Emergency Medical Services and Evacuation—April 2001 The Contractor...

  13. 48 CFR 1852.242-78 - Emergency Medical Services and Evacuation.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 6 2013-10-01 2013-10-01 false Emergency Medical Services... Provisions and Clauses 1852.242-78 Emergency Medical Services and Evacuation. As prescribed in 1842.7003, insert the following clause: Emergency Medical Services and Evacuation—April 2001 The Contractor...

  14. 48 CFR 1852.242-78 - Emergency Medical Services and Evacuation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Emergency Medical Services... Provisions and Clauses 1852.242-78 Emergency Medical Services and Evacuation. As prescribed in 1842.7003, insert the following clause: Emergency Medical Services and Evacuation—April 2001 The Contractor...

  15. 48 CFR 1852.242-78 - Emergency Medical Services and Evacuation.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 6 2014-10-01 2014-10-01 false Emergency Medical Services... Provisions and Clauses 1852.242-78 Emergency Medical Services and Evacuation. As prescribed in 1842.7003, insert the following clause: Emergency Medical Services and Evacuation—April 2001 The Contractor...

  16. 77 FR 14590 - National Emergency Medical Services Advisory Council (NEMSAC); Correction to the Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-12

    ... National Highway Traffic Safety Administration National Emergency Medical Services Advisory Council (NEMSAC... Emergency Medical Services Advisory Council Meeting on March 29, 2012, to alter the start time from 1 p.m... recognized council of emergency medical services (EMS) representatives and consumers to provide advice...

  17. 48 CFR 1852.242-78 - Emergency Medical Services and Evacuation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 6 2011-10-01 2011-10-01 false Emergency Medical Services... Provisions and Clauses 1852.242-78 Emergency Medical Services and Evacuation. As prescribed in 1842.7003, insert the following clause: Emergency Medical Services and Evacuation—April 2001 The Contractor...

  18. 78 FR 49332 - National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-13

    ... National Highway Traffic Safety Administration National Emergency Medical Services Advisory Council (NEMSAC... nationally recognized council of emergency medical services representatives and consumers, is to advise and... Transportation, Office of Emergency Medical Services, 1200 New Jersey Avenue SE., NTI-140, Washington, DC......

  19. 78 FR 36300 - Federal Interagency Committee on Emergency Medical Services; Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-17

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

  20. Efficacy and safety of emergency endoscopic retrograde cholangiopancreatography for acute cholangitis in the elderly

    PubMed Central

    Tohda, Gen; Ohtani, Masahiro; Dochin, Masaki

    2016-01-01

    AIM To investigate the efficacy and safety of emergency endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients with acute cholangitis. METHODS From June 2008 to May 2016, emergency ERCPs were performed in 207 cases of acute cholangitis at our institution. Patients were classified as elderly if they were aged 80 years and older (n = 102); controls were under the age of 80 years (n = 105). The patients’ medical records were retrospectively reviewed for comorbidities, laboratory data, etiology of cholangitis (presence of biliary stones, biliary stricture and malignancy), details of the ERCP (therapeutic approaches, technical success rates, procedure duration), ERCP-related complications and mortality. RESULTS The frequency of comorbidities was higher in the elderly group than the control group (91.2% vs 67.6%). Periampullary diverticulum was observed in the elderly group at a higher frequency than the control group (24.5% vs 13.3%). Between the groups, there was no significant difference in the technical success rates (95.1% vs 95.2%) or endoscopic procedure durations. With regard to the frequency of ERCP-related complications, there was no significant difference between the two groups (6.9% vs 6.7%), except for a lower rate of post-ERCP pancreatitis in the elderly group than in the control group (1.0% vs 3.8%). Neither angiographic nor surgical intervention was required in any of the cases with ERCP-related complications. There was no mortality during the observational periods. CONCLUSION Emergency ERCP for acute cholangitis can be performed safely even in elderly patients aged 80 years and older. PMID:27729744

  1. An Overview of Shiraz Emergency Medical Services, Dispatch to Treatment

    PubMed Central

    Peyravi, Mahmoudreza; Örtenwal, Per; Djalali, Ahmadreza; Khorram-Manesh, Amir

    2013-01-01

    Background Advanced ambulance service (Emergency Medical Services/EMS) is considered to be an integral part of emergency medical care as the first assets responding to emergencies and disasters in the prehospital setting in most developed countries. Objectives The aim of this study was to evaluate the current situation of Shiraz’s EMS by comparing data obtained during two different time periods. Materials and Methods This is a retrospective analytic and comparative study in which data obtained from Shiraz EMS during two one-year periods (21st of March 2011 to 20th of March 2012 and 22nd of September 1999 to 21st of September 2000) were compared. Furthermore, these data were also compared with available data from Gothenburg’s EMS (2010). Results Of 84084 missions performed by Shiraz EMS during one year trauma cases were the most common [39282 (46.7%)]. The most common cause of trauma was road traffic accidents (RTA) (27257; 76.5%). Near 56% of all patients were transported to hospitals; some 47% by ambulances and 8.8% by private cars. Around 36.2% of patients received definitive medical treatment at the scene. While there was an increase in response and evacuation times, the number of deaths at scene before ambulance arrival decreased. Conclusions Although Shiraz’s EMS has expanded during last decade and the mortality rate at scene has decreased, the number of RTA-related trauma cases, along with the response and evacuation time, has increased. More than one third of the patients received definitive treatment and could be dismissed directly from the scene. Standardized triage and treatment protocols are needed to improve the EMS activity. PMID:24616794

  2. Interactive Algorithms for Teaching and Learning Acute Medicine in the Network of Medical Faculties MEFANET

    PubMed Central

    Štourač, Petr; Komenda, Martin; Harazim, Hana; Kosinová, Martina; Gregor, Jakub; Hůlek, Richard; Smékalová, Olga; Křikava, Ivo; Štoudek, Roman; Dušek, Ladislav

    2013-01-01

    Background Medical Faculties Network (MEFANET) has established itself as the authority for setting standards for medical educators in the Czech Republic and Slovakia, 2 independent countries with similar languages that once comprised a federation and that still retain the same curricular structure for medical education. One of the basic goals of the network is to advance medical teaching and learning with the use of modern information and communication technologies. Objective We present the education portal AKUTNE.CZ as an important part of the MEFANET’s content. Our focus is primarily on simulation-based tools for teaching and learning acute medicine issues. Methods Three fundamental elements of the MEFANET e-publishing system are described: (1) medical disciplines linker, (2) authentication/authorization framework, and (3) multidimensional quality assessment. A new set of tools for technology-enhanced learning have been introduced recently: Sandbox (works in progress), WikiLectures (collaborative content authoring), Moodle-MEFANET (central learning management system), and Serious Games (virtual casuistics and interactive algorithms). The latest development in MEFANET is designed for indexing metadata about simulation-based learning objects, also known as electronic virtual patients or virtual clinical cases. The simulations assume the form of interactive algorithms for teaching and learning acute medicine. An anonymous questionnaire of 10 items was used to explore students’ attitudes and interests in using the interactive algorithms as part of their medical or health care studies. Data collection was conducted over 10 days in February 2013. Results In total, 25 interactive algorithms in the Czech and English languages have been developed and published on the AKUTNE.CZ education portal to allow the users to test and improve their knowledge and skills in the field of acute medicine. In the feedback survey, 62 participants completed the online questionnaire (13

  3. Implementation of Emergency Medical Text Classifier for Syndromic Surveillance

    PubMed Central

    Travers, Debbie; Haas, Stephanie W.; Waller, Anna E.; Schwartz, Todd A.; Mostafa, Javed; Best, Nakia C.; Crouch, John

    2013-01-01

    Public health officials use syndromic surveillance systems to facilitate early detection and response to infectious disease outbreaks. Emergency department clinical notes are becoming more available for surveillance but present the challenge of accurately extracting concepts from these text data. The purpose of this study was to implement a new system, Emergency Medical Text Classifier (EMT-C), into daily production for syndromic surveillance and evaluate system performance and user satisfaction. The system was designed to meet user preferences for a syndromic classifier that maximized positive predictive value and minimized false positives in order to provide a manageable workload. EMT-C performed better than the baseline system on all metrics and users were slightly more satisfied with it. It is vital to obtain user input and test new systems in the production environment. PMID:24551413

  4. Implementation of Emergency Medical Text Classifier for syndromic surveillance.

    PubMed

    Travers, Debbie; Haas, Stephanie W; Waller, Anna E; Schwartz, Todd A; Mostafa, Javed; Best, Nakia C; Crouch, John

    2013-01-01

    Public health officials use syndromic surveillance systems to facilitate early detection and response to infectious disease outbreaks. Emergency department clinical notes are becoming more available for surveillance but present the challenge of accurately extracting concepts from these text data. The purpose of this study was to implement a new system, Emergency Medical Text Classifier (EMT-C), into daily production for syndromic surveillance and evaluate system performance and user satisfaction. The system was designed to meet user preferences for a syndromic classifier that maximized positive predictive value and minimized false positives in order to provide a manageable workload. EMT-C performed better than the baseline system on all metrics and users were slightly more satisfied with it. It is vital to obtain user input and test new systems in the production environment.

  5. Emergency Medicine: On the Frontlines of Medical Education Transformation

    PubMed Central

    Holmboe, Eric S.

    2015-01-01

    Emergency medicine (EM) has always been on the frontlines of healthcare in the United States. I experienced this reality first hand as a young general medical officer assigned to an emergency department (ED) in a small naval hospital in the 1980s. For decades the ED has been the only site where patients could not be legally denied care. Despite increased insurance coverage for millions of Americans as a result of the Affordable Care Act, ED directors report an increase in patient volumes in a recent survey.1 EDs care for patients from across the socioeconomic spectrum suffering from a wide range of clinical conditions. As a result, the ED is still one of few components of the American healthcare system where social justice is enacted on a regular basis. Constant turbulence in the healthcare system, major changes in healthcare delivery, technological advances and shifting demographic trends necessitate that EM constantly adapt and evolve as a discipline in this complex environment. PMID:26594269

  6. [Emergency Decompressive Craniotomy in the Emergency Room was Effective in Severe Acute Subdural Hematoma Treatment:Two Case Reports].

    PubMed

    Shiomi, Naoto; Echigo, Tadashi; Oka, Hideki; Nozawa, Masahiro; Okada, Michiko; Hiraizumi, Shiho; Kato, Fumitaka; Koseki, Hirokazu; Hashimoto, Yoichi; Hino, Akihiko

    2017-02-01

    The outcome of severe acute subdural hematoma is unfavorable. In particular, patients with levels of consciousness of Glasgow Coma Scale(GCS)3 or 4 tend to be refractory to treatment. Decompressive craniotomy should be promptly performed to remove hematoma. However, if an operating room is not immediately available, emergency burr hole surgery is sometimes performed in the emergency room(primary care room)prior to craniotomy. A previous study has reported that the interval from injury to surgery influences the outcome of severe acute subdural hematoma. Therefore, emergency decompression is important to effectively treat patients with severe acute subdural hematoma. We present the cases of two patients with acute subdural hematomas. In both cases, emergency decompressive craniotomy(hematoma removal after craniotomy and external decompression)was performed in the emergency room of the Emergency and Critical Care Center. In both cases, the surgery was followed by favorable outcomes. Case 1 was a 36-year-old female. The patient's level of consciousness upon arrival was GCS 3. The interval from injury to diagnosis on the basis of CT findings was 75 minutes. Surgery began 20 minutes after diagnosis. Case 2 was a 25-year-old male. The second patient's level of consciousness upon arrival was GCS 4. The interval from injury to diagnosis on the basis of CT findings was 60 minutes. Surgery was begun 40 minutes after diagnosis. In both patients, we observed anisocoria and the loss of the light reflex. However, the postoperative course was favorable, and both patients were discharged. In summary, to treat severe acute subdural hematomas, early emergency decompressive craniotomy is optimal. Emergency decompressive surgery in the emergency room is independent of operating room or staff. Therefore, emergency decompressive craniotomy may improve the outcome of patients with severe acute subdural hematomas.

  7. 22 CFR 71.10 - Emergency medical assistance.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...) Medications and related medical supplies and equipment required on a routine basis to sustain life; (5) Preventive or protective medications and medical supplies and equipment (vaccinations, inoculations,...

  8. Facilities and regionalization--emergency medical services systems.

    PubMed

    Stewart, R D

    1990-02-01

    Advanced life support and the modern EMS system were born out of the hope that by extending hospital emergency facilities outside the bounds of the hospital, earlier and more intensive care could be provided to those patients requiring it. EMS systems have since left the nest and only recently, following a turbulent adolescence, is prehospital care returning as a partner with the medical facilities and physicians that presided over their modern origins. The next decade will see the continuing trend toward hospitals and practitioners regaining some influence in the design and direction of prehospital care.

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

    PubMed

    Frydshou, Andreas; Gillesberg, Inger

    2013-02-18

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

  10. Helicopter emergency medical services (doctor-helicopter) in Fukushima Prefecture: present state and problems.

    PubMed

    Tase, Choichiro; Ohno, Yuko; Hasegawa, Arifumi; Tsukada, Yasuhiro; Shimada, Jiro; Ikegami, Yukihiro

    2010-06-01

    The purpose of this study is to identify the problems in operating an emergency medical service helicopter with an emergency medicine doctor on board (doctor-helicopter) in Fukushima Prefecture, Japan, which covers wide regions and many rural areas. The study looked at the numbers of flights and patients during the 523 days since the start of the doctor-helicopter service at the Fukushima Medical University Hospital. The items investigated were: number of flights, number of helicopter dispatches per month, number of patients, the hospitals where patients were taken to, the fire department dispatch centers that requested the doctor-helicopter, and the number of times each doctor flew on the helicopter. There were 450 flights. When the service was started, there were a few flights, but they gradually increased. The majority of the flights were to emergency scenes (295), while 75 flights were interfacility transports of critically ill patients, 79 flights were cancelled after take-off, and one flight was for a disaster relief operation. The nature of requests differed greatly depending on the fire department dispatch center requesting the service. The majority of patients were trauma patients (62.2%). Stroke (8.5%) and acute coronary syndrome (5.2%) patients requiring emergency treatment were fewer than anticipated. The final destination hospitals were appropriate hospitals in the region. Because the number of flight doctors is small, the burden on individual doctors is large. A system for early on-site diagnosis and helicopter request by emergency rescue team is required to maintain a high quality of emergency care.

  11. Resuscitation center designation: recommendations for emergency medical services practices.

    PubMed

    Mechem, C Crawford; Goodloe, Jeffrey M; Richmond, Neal J; Kaufman, Bradley J; Pepe, Paul E

    2010-01-01

    Regionalization of medical resources by designating specialty receiving centers, such as trauma and stroke centers, within emergency medical services (EMS) systems is intended to ensure the highest-quality patient care in the most efficient and fiscally responsible fashion. Significant advances in the past decade such as induction of therapeutic hypothermia following resuscitation from cardiac arrest and a time-driven, algorithmic approach to management of septic patients have created compelling arguments for similar designation for specialized resuscitative interventions. Resuscitation of critically ill patients is both labor- and resource-intensive. It can significantly interrupt emergency department (ED) patient throughput. In addition, clinical progress in developing resuscitation techniques is often dependent on the presence of a strong research infrastructure to generate and validate new therapies. It is not feasible for many hospitals to make the commitment to care for large numbers of critically ill patients and the accompanying investigational activities, whether in the prehospital, ED, or inpatient arena. Because of this, the question of whether EMS systems should designate specific hospitals as "resuscitation centers" has now come center stage. Just as EMS systems currently delineate criteria and monitor compliance for trauma, ST-elevation myocardial infarction (STEMI), and stroke centers, strong logic now exists to develop similar standards for resuscitation facilities. Accordingly, this discussion reviews the current applicable trends in resuscitation science and presents a rationale for resuscitation center designation within EMS systems. Potential barriers to the establishment of such centers are discussed and strategies to overcome them are proposed.

  12. Emergency department crowding and loss of medical licensure: a new risk of patient care in hallways.

    PubMed

    Derlet, Robert W; McNamara, Robert M; Kazzi, Amin Antoine; Richards, John R

    2014-03-01

    We report the case of a 32-year-old male recently diagnosed with type 2 diabetes treated at an urban university emergency department (ED) crowded to 250% over capacity. His initial symptoms of shortness of breath and feeling ill for several days were evaluated with chest radiograph, electrocardiogram (EKG), and laboratory studies, which suggested mild diabetic ketoacidosis. His medical care in the ED was conducted in a crowded hallway. After correction of his metabolic abnormalities he felt improved and was discharged with arrangements made for outpatient follow-up. Two days later he returned in cardiac arrest, and resuscitation efforts failed. The autopsy was significant for multiple acute and chronic pulmonary emboli but no coronary artery disease. The hospital settled the case for $1 million and allocated major responsibility to the treating emergency physician (EP). As a result the state medical board named the EP in a disciplinary action, claiming negligence because the EKG had not been personally interpreted by that physician. A formal hearing was conducted with the EP's medical license placed in jeopardy. This case illustrates the risk to EPs who treat patients in crowded hallways, where it is difficult to provide the highest level of care. This case also demonstrates the failure of hospital administration to accept responsibility and provide resources to the ED to ensure patient safety.

  13. Emerging New Approaches for the Treatment of Acute Promyelocytic Leukemia

    PubMed Central

    Park, Jae; Jurcic, Joseph G.; Rosenblat, Todd; Tallman, Martin S.

    2011-01-01

    The introduction of all-trans retinoic acid (ATRA) in the late 1980s combined with anthracycline-based chemotherapy has revolutionized the prognosis of acute promyelocytic leukemia (APL) with more than 90% complete response rates and cure rates of approximately 80%. The subsequent advent of arsenic trioxide (ATO) in 1990s and progress in the treatment of APL have changed its course from a highly fatal to a highly curable disease. Despite the dramatic improvement in clinical outcome of APL, treatment failure still occurs due most often to early death. Relapse has become increasingly less frequent, most commonly occurring in patients with high-risk disease. A major focus of research for the past decade has been to develop risk-adapted and rationally targeted nonchemotherapy treatment strategies to reduce treatment-related morbidity and mortality to low- and intermediate-risk or older patients while targeting more intensive or alternative therapy to those patients at most risk of relapse. In this review, emerging new approaches to APL treatment with special emhasis on strategies to reduce early deaths, risk-adapted therapy during induction, consolidation and maintenance, as well as an overview of current and future clinical trials in APL will be discussed. PMID:23556100

  14. 3D Medical Collaboration Technology to Enhance Emergency Healthcare

    PubMed Central

    Welch, Greg; Sonnenwald, Diane H; Fuchs, Henry; Cairns, Bruce; Mayer-Patel, Ketan; Söderholm, Hanna M.; Yang, Ruigang; State, Andrei; Towles, Herman; Ilie, Adrian; Ampalam, Manoj; Krishnan, Srinivas; Noel, Vincent; Noland, Michael; Manning, James E.

    2009-01-01

    Two-dimensional (2D) videoconferencing has been explored widely in the past 15–20 years to support collaboration in healthcare. Two issues that arise in most evaluations of 2D videoconferencing in telemedicine are the difficulty obtaining optimal camera views and poor depth perception. To address these problems, we are exploring the use of a small array of cameras to reconstruct dynamic three-dimensional (3D) views of a remote environment and of events taking place within. The 3D views could be sent across wired or wireless networks to remote healthcare professionals equipped with fixed displays or with mobile devices such as personal digital assistants (PDAs). The remote professionals’ viewpoints could be specified manually or automatically (continuously) via user head or PDA tracking, giving the remote viewers head-slaved or hand-slaved virtual cameras for monoscopic or stereoscopic viewing of the dynamic reconstructions. We call this idea remote 3D medical collaboration. In this article we motivate and explain the vision for 3D medical collaboration technology; we describe the relevant computer vision, computer graphics, display, and networking research; we present a proof-of-concept prototype system; and we present evaluation results supporting the general hypothesis that 3D remote medical collaboration technology could offer benefits over conventional 2D videoconferencing in emergency healthcare. PMID:19521951

  15. Promoting patient safety and preventing medical error in emergency departments.

    PubMed

    Schenkel, S

    2000-11-01

    An estimated 108,000 people die each year from potentially preventable iatrogenic injury. One in 50 hospitalized patients experiences a preventable adverse event. Up to 3% of these injuries and events take place in emergency departments. With long and detailed training, morbidity and mortality conferences, and an emphasis on practitioner responsibility, medicine has traditionally faced the challenges of medical error and patient safety through an approach focused almost exclusively on individual practitioners. Yet no matter how well trained and how careful health care providers are, individuals will make mistakes because they are human. In general medicine, the study of adverse drug events has led the way to new methods of error detection and error prevention. A combination of chart reviews, incident logs, observation, and peer solicitation has provided a quantitative tool to demonstrate the effectiveness of interventions such as computer order entry and pharmacist order review. In emergency medicine (EM), error detection has focused on subjects of high liability: missed myocardial infarctions, missed appendicitis, and misreading of radiographs. Some system-level efforts in error prevention have focused on teamwork, on strengthening communication between pharmacists and emergency physicians, on automating drug dosing and distribution, and on rationalizing shifts. This article reviews the definitions, detection, and presentation of error in medicine and EM. Based on review of the current literature, recommendations are offered to enhance the likelihood of reduction of error in EM practice.

  16. National Training Course. Emergency Medical Technician. Paramedic. Instructor's Lesson Plans. Module I. The Emergency Medical Technician, His Role, Responsibility, and Training.

    ERIC Educational Resources Information Center

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

    This instructor's lesson plan guide is one of fifteen modules designed for use in the training of emergency medical technicians (EMT). Four units are presented: (1) role of the EMT, including the operation of an emerging medical services system; (2) the laws relevant to EMTs functioning in the field; (3) activities and responsibilities of an EMT…

  17. 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.

  18. Challenges implementing bar-coded medication administration in the emergency room in comparison to medical surgical units.

    PubMed

    Glover, Nancy

    2013-03-01

    Bar-coded medication administration has been successfully implemented and utilized to decrease medication errors at a number of hospitals in recent years. The purpose of this article was to discuss the varying success in utilization of bar-coded medication administration on medical-surgical units and in the emergency department. Utilization reports were analyzed to better understand the challenges between the units. Many factors negatively impacted utilization in the emergency department, including the inability to use bar-coded medication administration for verbal orders or to document medications distributed by the prescribing providers, unique aspects of emergency department nursing workflow, additional steps to chart when using bar-coded medication administration, and alert fatigue. Hardware problems affected all users. Bar-coded medication administration in its current form is more suitable for use on medical-surgical floors than in the emergency department. New solutions should be developed for bar-coded medication administration in the emergency department, keeping in mind requirements to chart medications when there is no order in the system, document medications distributed by prescribing providers, adapt to unpredictable nursing workflow, minimize steps to chart with bar-coded medication administration, limit alerts to those that are clinically meaningful, and choose reliable hardware with adequate bar-code scanning capability.

  19. 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…

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

    PubMed Central

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

    2016-01-01

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

  1. WSES Guidelines for the management of acute left sided colonic diverticulitis in the emergency setting.

    PubMed

    Sartelli, Massimo; Catena, Fausto; Ansaloni, Luca; Coccolini, Federico; Griffiths, Ewen A; Abu-Zidan, Fikri M; Di Saverio, Salomone; Ulrych, Jan; Kluger, Yoram; Ben-Ishay, Ofir; Moore, Frederick A; Ivatury, Rao R; Coimbra, Raul; Peitzman, Andrew B; Leppaniemi, Ari; Fraga, Gustavo P; Maier, Ronald V; Chiara, Osvaldo; Kashuk, Jeffry; Sakakushev, Boris; Weber, Dieter G; Latifi, Rifat; Biffl, Walter; Bala, Miklosh; Karamarkovic, Aleksandar; Inaba, Kenji; Ordonez, Carlos A; Hecker, Andreas; Augustin, Goran; Demetrashvili, Zaza; Melo, Renato Bessa; Marwah, Sanjay; Zachariah, Sanoop K; Shelat, Vishal G; McFarlane, Michael; Rems, Miran; Gomes, Carlos Augusto; Faro, Mario Paulo; Júnior, Gerson Alves Pereira; Negoi, Ionut; Cui, Yunfeng; Sato, Norio; Vereczkei, Andras; Bellanova, Giovanni; Birindelli, Arianna; Di Carlo, Isidoro; Kok, Kenneth Y; Gachabayov, Mahir; Gkiokas, Georgios; Bouliaris, Konstantinos; Çolak, Elif; Isik, Arda; Rios-Cruz, Daniel; Soto, Rodolfo; Moore, Ernest E

    2016-01-01

    Acute left sided colonic diverticulitis is one of the most common clinical conditions encountered by surgeons in acute setting. A World Society of Emergency Surgery (WSES) Consensus Conference on acute diverticulitis was held during the 3rd World Congress of the WSES in Jerusalem, Israel, on July 7th, 2015. During this consensus conference the guidelines for the management of acute left sided colonic diverticulitis in the emergency setting were presented and discussed. This document represents the executive summary of the final guidelines approved by the consensus conference.

  2. Naegleria fowleri: a free living amoeba of emerging medical importance.

    PubMed

    Parija, S C; Jayakeerthee, S R

    1999-09-01

    Naegleria fowleri, a free-living amoeba is ubiquitous and word-wide in distribution. Infection is due to inhalation or aspiration of aerosols containing cysts found in the environment. Of late, the amoeba is emerging as a pathogen of medical importance causing primary amoebic meningoencephalitis (PAM) in humans. The diagnosis of the condition is mainly parasitic which depends on the detection and identification of Naegleria trophozoites in the cerebro-spinal fluid (CSF) or biopsied brain tissue. Serological tests are not useful in the diagnosis of PAM. Most cases are fatal and various amoebicidal agents have been tried unsuccessfully. The present paper provides a review of the recent information on the biology and epidemiology of the disease caused by the amoeba Approaches in the diagnosis, pathophysiology and treatment of the condition are also discussed.

  3. Rapid infectious disease screening for field medical emergencies

    NASA Astrophysics Data System (ADS)

    Ho, Winston; Rao, Srivasta V.; Low, Peter W.; Hess, John R.

    2000-08-01

    Current blood tests cannot provide rapid support for field medical emergencies that require blood in excess of the tested supply, especially, when additional blood needs to be drawn from the available walking pool. A fluorescence-based rapid infectious disease screening system, based on a disposable disk with an array of wash-free, one-step, membrane strips and an array of optical probes can be used to quantify a panel of transmissible diseases in parallel with high specificity, high sensitivity, and operational simplicity. We have designed and constructed a sandwich membrane assay platform and a laboratory prototype optoelectronic measuring device and used this combined system to quantify hepatitis C antibody over the concentration range of 2 ng/ml to 100 ng/ml in 3 to 5 minutes.

  4. Simulation and optimization models for emergency medical systems planning.

    PubMed

    Bettinelli, Andrea; Cordone, Roberto; Ficarelli, Federico; Righini, Giovanni

    2014-01-01

    The authors address strategic planning problems for emergency medical systems (EMS). In particular, the three following critical decisions are considered: i) how many ambulances to deploy in a given territory at any given point in time, to meet the forecasted demand, yielding an appropriate response time; ii) when ambulances should be used for serving nonurgent requests and when they should better be kept idle for possible incoming urgent requests; iii) how to define an optimal mix of contracts for renting ambulances from private associations to meet the forecasted demand at minimum cost. In particular, analytical models for decision support, based on queuing theory, discrete-event simulation, and integer linear programming were presented. Computational experiments have been done on real data from the city of Milan, Italy.

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

    PubMed

    Nikić-Sovilj, Ljiljana

    2009-01-01

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

  6. [Antenatal emergency call. Indications. Role of the SAMU (Medical Emergency Care Services)].

    PubMed

    Lallemand, E; Drouet, N; Faudemay, C; Lacroute, J M; Menthonnex, P

    1989-01-01

    The increased incidence of antenatal distress calls to the SAMU (emergency medical squad) by pediatric obstetricians in maternity departments (6 times in 5 years) poses the problem of recognizing their indications. Based on case reports of 128 newborns who profited from antenatal assistance, the authors attempt to define the indications. The elimination of student physicians in training for anesthesiology-intensive care, additional participants during SAMU transportation of patients, makes it even more necessary to define these indications accurately so that a single language of communication and procedure may be instituted for all who are involved in this effort.

  7. Is acute dystonia an emergency? Sometimes, it really is!

    PubMed

    Kanburoglu, Mehmet Kenan; Derinoz, Oksan; Cizmeci, Mehmet Nevzat; Havali, Cengiz

    2013-03-01

    Most cases of acute dystonia are mild and easy to manage; nevertheless, some of them can be fatal because of the involvement of certain muscle groups such as the laryngeal muscles, thus requiring urgent intervention. In the literature, approach to life-threatening acute dystonia has not been investigated thoroughly, although the diagnosis is a challenge, and treatment should be offered immediately. Herein the management of life-threatening acute dystonia is discussed via 2 case reports.

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

    PubMed

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

    2016-10-01

    Short-term exposure to air pollution may be linked to negative health outcomes that require an emergency medical response. However, few studies have been undertaken on this phenomenon to date. The aim of this study therefore was to examine the association between short-term exposure to ambient suspended particulate matter (SPM) and emergency ambulance dispatches (EADs) for acute illness in Japan. Daily EAD data, daily mean SPM and meteorological data were obtained for four prefectures in the Kanto region of Japan for the period from 2007 to 2011. The area-specific association between daily EAD for acute illness and SPM was explored using generalized linear models while controlling for ambient temperature, relative humidity, seasonality, long-term trends, day of the week and public holidays. Stratified analyses were conducted to evaluate the modifying effects of age, sex and medical conditions. Area-specific estimates were combined using meta-analyses. For the total study period the mean level of SPM was 23.7μg/m(3). In general, higher SPM was associated with a significant increase in EAD for acute illness [estimated pooled relative risk (RR): 1.008, 95% CI: 1.007 to 1.010 per 10μg/m(3) increase in SPM at lag 0-1]. The effects of SPM on EAD for acute illness were significantly greater for moderate/mild medical conditions (e.g. cases that resulted in <3weeks hospitalization or no hospitalization) when compared to severe medical conditions (e.g. critical cases, and cases that led to >3weeks hospitalization or which resulted in death). Using EAD data, this study has shown the adverse health effects of ambient air pollution. This highlights the importance of reducing the level of air pollution in order to maintain population health and well-being.

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

    PubMed

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

    2012-09-01

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

  10. Factors Associated with Follow-Up Attendance among Rape Victims Seen in Acute Medical Care

    PubMed Central

    Darnell, Doyanne; Peterson, Roselyn; Berliner, Lucy; Stewart, Terri; Russo, Joan; Whiteside, Lauren; Zatzick, Douglas

    2016-01-01

    Objective Rape is associated with Posttraumatic Stress Disorder and related comorbidities. Most victims do not obtain treatment for these conditions. Acute care medical settings are well-positioned to link patients to services; however, difficulty engaging victims and low attendance at provided follow-up appointments is well documented. Identifying factors associated with follow-up can inform engagement and linkage strategies. Method Administrative, patient self-report, and provider observational data from Harborview Medical Center were combined for the analysis. Using logistic regression, we examined factors associated with follow-up health service utilization after seeking services for rape in the emergency department. Results Of the 521 diverse female (n=476) and male (n=45) rape victims, 28% attended the recommended medical/counseling follow-up appointment. In the final (adjusted) logistic regression model, having a developmental or other disability (OR=0.40, 95% CI=0.21-0.77), having a current mental illness (OR=0.25, 95% CI=0.13-0.49), and being assaulted in public (OR=0.50, 95% CI=0.28-0.87) were uniquely associated with reduced odds of attending the follow-up. Having a prior mental health condition (OR= 3.02 95% CI=1.86-4.91), a completed SANE examination (OR=2.97, 95% CI=1.84-4.81), and social support available to help cope with the assault (OR=3.54, 95% CI=1.76-7.11) were associated with an increased odds of attending the follow-up. Conclusions Findings point to relevant characteristics ascertained at the acute care medical visit for rape that may be used to identify victims less likely to obtain posttraumatic medical and mental health services. Efforts to improve service linkage among these patients is warranted and may require alternative models to engage these patients to support posttraumatic recovery. PMID:26168030

  11. Bioterrorism preparedness. II: The community and emergency medical services systems.

    PubMed

    Flowers, Lynn K; Mothershead, Jerry L; Blackwell, Thomas H

    2002-05-01

    Disaster planning is an arduous task. Perhaps no form of disaster is more difficult to prepare for than one resulting from the intentional, covert release of a biological pathogen or toxin. The complexities of response operations and the perils of inadequate preparation cannot be overemphasized. Even with detailed planning, deviations from anticipated emergency operations plans are likely to occur. Several federal programs have been initiated to assist communities in enhancing their preparedness for events involving biological and other agents of mass destruction. Many of these, such as the Metropolitan Medical Response Systems (MMRS) Program [37,38], will be discussed elsewhere. Community preparedness will be enhanced by: 1. Implementing a real-time public health disease surveillance program linking local healthcare, emergency care, EMS, the CDC, local law enforcement, and the FBI 2. Improved real-time regional patient and healthcare capacity status management 3. Development of affordable, accurate biological agent detection systems 4. Incorporation of standardized education and training curricula (appropriate for audience) on terrorism and biological agents into healthcare training programs 5. Expansion of federal and state programs to assist communities in system development 6. Increased public awareness and education programs.

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

  13. Emergency Medical Technician-Ambulance: National Standard Curriculum. Student Study Guide (Third Edition).

    ERIC Educational Resources Information Center

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

    This student study guide is one of three documents prepared for the Emergency Medical Technician (EMT), National Standard Curriculum. The course is designed to develop skills in symptom recognition and in all emergency care procedures and techniques currently considered to be within the responsibilities of an EMT providing emergency medical care…

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

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ....271 Helicopter hospital emergency medical evacuation service (HEMES). (a) No certificate holder may... assignment, for hospital emergency medical evacuation service helicopter operations unless that assignment... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Helicopter hospital emergency...

  15. 14 CFR 135.271 - Helicopter hospital emergency medical evacuation service (HEMES).

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ....271 Helicopter hospital emergency medical evacuation service (HEMES). (a) No certificate holder may... assignment, for hospital emergency medical evacuation service helicopter operations unless that assignment... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Helicopter hospital emergency...

  16. 14 CFR 135.271 - Helicopter hospital emergency medical evacuation service (HEMES).

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ....271 Helicopter hospital emergency medical evacuation service (HEMES). (a) No certificate holder may... assignment, for hospital emergency medical evacuation service helicopter operations unless that assignment... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Helicopter hospital emergency...

  17. 14 CFR 135.271 - Helicopter hospital emergency medical evacuation service (HEMES).

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ....271 Helicopter hospital emergency medical evacuation service (HEMES). (a) No certificate holder may... assignment, for hospital emergency medical evacuation service helicopter operations unless that assignment... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Helicopter hospital emergency...

  18. 14 CFR 135.271 - Helicopter hospital emergency medical evacuation service (HEMES).

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ....271 Helicopter hospital emergency medical evacuation service (HEMES). (a) No certificate holder may... assignment, for hospital emergency medical evacuation service helicopter operations unless that assignment... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Helicopter hospital emergency...

  19. [Training of endotracheal intubation for an emergency medical technician and three cases of endotracheal intubation during emergency situation].

    PubMed

    Kaneda, Toru; Suzuki, Toshiyasu

    2007-05-01

    It is said that airway management is an important part of lifesaving at the prehospital care for a seriously ill emergency patient. We performed the training of endotracheal intubation for an emergency medical technician, and in this report we discussed the results of trainings and examined 3 cases of endotracheal intubation in the emergency situation after training. Various kinds of problem arose through this training, for example, difficulty to get the consent from patients, overlap of a case for clinical resident and emergency medical technician, large responsibility of the anesthesiologist as a teaching staff. In addition, there may be no useful case for lifesaving at the emergency situation in 3 cases of endotracheal intubation. We consider that it may be difficult, but possibility cannot deny if endotracheal intubation by emergency medical technicians contribute to lifesaving rate improvement from viewpoint of prehospital care.

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

    PubMed Central

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

    2016-01-01

    Introduction Emergency medical services (EMS) agencies transport a significant majority of patients with low acuity and non-emergent conditions to local emergency departments (ED), affecting the entire emergency care system’s capacity and performance. Opportunities exist for alternative models that integrate technology, telehealth, and more appropriately aligned patient navigation. While a limited number of programs have evolved recently, no empirical evidence exists for their efficacy. This research describes the development and comparative effectiveness of one large urban program. Methods The Houston Fire Department initiated the Emergency Telehealth and Navigation (ETHAN) program in 2014. ETHAN combines telehealth, social services, and alternative transportation to navigate primary care-related patients away from the ED where possible. Using a case-control study design, we describe the program and compare differences in effectiveness measures relative to the control group. Results During the first 12 months, 5,570 patients participated in the telehealth-enabled program, which were compared against the same size control group. We found a 56% absolute reduction in ambulance transports to the ED with the intervention compared to the control group (18% vs. 74%, P<.001). EMS productivity (median time from EMS notification to unit back in service) was 44 minutes faster for the ETHAN group (39 vs. 83 minutes, median). There were no statistically significant differences in mortality or patient satisfaction. Conclusion We found that mobile technology-driven delivery models are effective at reducing unnecessary ED ambulance transports and increasing EMS unit productivity. This provides support for broader EMS mobile integrated health programs in other regions. PMID:27833678

  1. Use of medications in the treatment of acute low back pain.

    PubMed

    Malanga, Gerard A; Dennis, Robin L

    2006-01-01

    The prescription of medications continues to be one of the mainstays of treatment of acute low back pain episodes. The goals of the pharmacologic treatment for acute low back are reduction of pain and return of normal function. Often, nociception is a result of secondary inflammation and muscle spasm after acute injury of a structure of the spine, which may include muscle, tendon, ligament, disc, or bone. An understanding of the appropriate use of medications to address the underlying pain generator and the current evidence for using these medications is essential for any physician who sees and treats patients with acute low back pain.

  2. Acute migraine in the Emergency Department: extending European principles of management.

    PubMed

    Martelletti, Paolo; Farinelli, Ivano; Steiner, Timothy J

    2008-10-01

    The World Health Organization (WHO) placed migraine 19th among all causes of disability (12th in women) measured in years of healthy life lost to disability (YLD). The importance of headache disorders, particularly of the primary forms, is established by their distribution worldwide, their duration (the majority being life-long conditions) and their imposition of both disability and life-style restrictions among large numbers of people. For these reasons, headache disorders should represent a public-health priority. In the Emergency Department (ED), as elsewhere, migraine is often under-diagnosed-and under-treated when it is diagnosed. The result is likely to be failure of treatment. Particular attention to diagnosis is needed in ED patients with acute headache, since there is a higher probability of secondary headache due to underlying pathologies. According to European principles of management, acute migraine treatment generally is stepwise. Of the two main steps, the first relies on symptomatic medication, preferably NSAIDs with or without antiemetics. The second step uses specific therapies, usually triptans. Modifications to routine practice are appropriate in the ED. Parenteral administration of symptomatic therapies is a preferred first choice, whilst immediate resort to triptans may be appropriate, and achieve better outcomes, in patients with severe headache and diagnostic confirmation of migraine.

  3. The use of mobile phones for acute wound care: attitudes and opinions of emergency department patients.

    PubMed

    Sikka, Neal; Carlin, Katrina N; Pines, Jesse; Pirri, Michael; Strauss, Ryan; Rahimi, Faisil

    2012-01-01

    There are a significant number of emergency department (ED) visits for lacerations each year. When individuals experience skin, soft tissue, or laceration symptoms, the decision to go to the ED is not always easy on the basis of the level of severity. For such cases, it may be feasible to use a mobile phone camera to submit images of their wound to a remote medical provider who can review and help guide their care choice decisions. The authors aimed to assess patient attitudes toward the use of mobile phone technology for laceration management. Patients presenting to an urban ED for initial care and follow-up visits for lacerations were prospectively enrolled. A total of 194 patients were enrolled over 8 months. Enrolled patients answered a series of questions about their injury and a survey on attitudes about the acceptability of making management decisions using mobile phone images only. A majority of those surveyed agreed that it was acceptable to send a mobile phone picture to a physician for a recommendation and diagnosis. Patients also reported few concerns regarding privacy and security and believe that this technology could be cost effective and convenient. In this study, the majority of patients had favorable opinions of using mobile phones for laceration care. Mobile phone camera images (a) may provide a useful modality for assessment of some acute wound care needs and (b) may decrease ED visits for a high-volume complaint such as acute wounds.

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

    PubMed Central

    Bashir, Talha

    2014-01-01

    An estimated 1 in 600 commercial flights will have an onboard medical emergency and approximately half of the time a passenger physician will provide medical assistance. A medical emergency on an aircraft can be a daunting task for even the most seasoned physician. This article is a narrative case report from a physician passenger who found himself in the midst of such an emergency on a 15-hour international flight. PMID:25147640

  5. Risks to emergency medical responders at terrorist incidents: a narrative review of the medical literature.

    PubMed

    Thompson, Julian; Rehn, Marius; Lossius, Hans Morten; Lockey, David

    2014-09-24

    As the threat of international terrorism rises, there is an increasing requirement to provide evidence-based information and training for the emergency personnel who will respond to terrorist incidents. Current major incident training advises that emergency responders prioritize their own personal safety above that of the 'scene and survivors'. However, there is limited information available on the nature of these threats and how they may be accurately evaluated. This study reviews the published medical literature to identify the hazards experienced by emergency responders who have attended previous terrorist incidents. A PubMed literature search identified 10,894 articles on the subject of 'terrorism', and there was a dramatic increase in publications after the 9/11 attacks in 2001. There is heterogeneity in the focus and quality of this literature, and 307 articles addressing the subject of scene safety were assessed for information regarding the threats encountered at terrorist incidents. These articles demonstrate that emergency responders have been exposed to both direct terrorist threats and environmental scene hazards, including airborne particles, structural collapse, fire, and psychological stress. The emphasis of training and preparedness for terrorist incidents has been primarily on the direct threats, but the published literature suggests that the dominant causes of mortality and morbidity in responders after such incidents are the indirect environmental hazards. If the medical response to terrorist incidents is to be based on evidence rather than anecdote, analysis of the current literature should be incorporated into major incident training, and consistent collection of key data from future incidents is required.

  6. 78 FR 50136 - Notice of Information Collection Under Emergency Review: Medical History and Examination for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-16

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF STATE Notice of Information Collection Under Emergency Review: Medical History and Examination for Foreign Service... of Information Collection: Medical History and Examination for Foreign Service. OMB Control...

  7. Medical identity theft: an emerging problem for informatics.

    PubMed

    Gillette, William; Patrick, Timothy B

    2007-10-11

    This poster reports a preliminary review of medical identity theft. Financial identity theft has received a great deal of media attention. Medical identity theft is a particular kind of identity theft that has received little attention. There are two main subtypes of medical identity theft. In the first type the stolen medical identity is used to receive medical services, and in the second type the stolen medical identity is used to commit healthcare fraud.

  8. Emergency Department Patients’ Perceptions of Radiation from Medical Imaging

    PubMed Central

    Repplinger, Michael D.; Li, Annabel J.; Svenson, James E.; Ehlehbach, William J.; Westergaard, Ryan P.; Reeder, Scott B.; Jacobs, Elizabeth A.

    2016-01-01

    Objective To evaluate emergency department patients’ knowledge of radiation exposure and subsequent risks from CT and MRI scans. Methods This is a cross-sectional survey study of adult, English-speaking patients from 6/2011-8/2011 at two emergency departments, one academic and one community-based, in the upper Midwest. The survey consisted of two sets of three questions evaluating patients’ knowledge of radiation exposure from medical imaging and subsequent radiation-induced malignancies, and was based on a previously published survey. The question sets paralleled each other, but one pertained to CT and the other to MRI. Questions in the survey ascertained patients’ understanding of: 1) the relative amount of radiation exposed from CT/MRI compared with a single chest x-ray, 2) the relative amount of radiation exposed from CT/MRI compared with a nuclear power plant accident, and 3) the possibility of radiation-induced malignancies from CT/MRI. Sociodemographic data were also gathered. The primary outcome measure was the proportion of correct answers to each question of the survey. Multiple logistic regression was then used to examine the relationship between the percentage correct for each question and sociodemographic variables, using odds ratios with 95% confidence intervals. P-values less than 0.05 were considered statistically significant. Results There were 500 participants in this study, 315 from the academic center and 185 from the community hospital. Overall, 14.1% (95% CI 11.0%-17.2%) of participants understood the relative radiation exposure of a CT scan compared with a chest x-ray while 22.8% (95% CI 18.9%-26.7%) of respondents understood the lack of ionizing radiation use with MRI. 25.6% (95% CI 21.8%-29.4%) believed that there was an increased risk of developing cancer from repeated abdominal CTs while 55.6% (95% CI 51.1%-60.1%) believed this to be true of abdominal MRI. Higher educational level and identification as a healthcare professional were

  9. [A device to facilitate training of intubation by emergency medical technician].

    PubMed

    Fujita, Yasuaki; Takahashi, Ayako; Yamada, Aya; Kobayashi, Kazuhiko; Nakata, Jun; Teramoto, Yuzo

    2012-06-01

    In our hospital, the average duration of training in intubation by the emergency medical technician training intubation was 17.9 days. Compared to other reports, our training period is shorter. Short training period has reduced burden of hospital and fire station. One of the important contributions to the society for anesthesiologists is to increase the number of emergency medical technicians who can intubate. But long training period has been increasing the burden of anesthesiologists and emergency medical technicians. We report a practical method of intubation by emergency medical technician in our hospital.

  10. Outcomes of Basic Versus Advanced Life Support for Out-of-Hospital Medical Emergencies

    PubMed Central

    Sanghavi, Prachi; Jena, Anupam B.; Newhouse, Joseph P.; Zaslavsky, Alan M.

    2016-01-01

    Background Most Medicare patients seeking emergency medical transport are treated by ambulance providers trained in advanced life support (ALS). Evidence supporting the superiority of ALS over basic life support (BLS) is limited, but some studies suggest ALS may harm patients. Objective To compare outcomes after ALS and BLS in out-of-hospital medical emergencies. Design Observational study with adjustment for propensity score weights and instrumental variable analyses based on county-level variations in ALS use. Setting Traditional Medicare. Patients 20% random sample of Medicare beneficiaries from nonrural counties between 2006 and 2011 with major trauma, stroke, acute myocardial infarction (AMI), or respiratory failure. Measurements Neurologic functioning and survival to 30 days, 90 days, 1 year, and 2 years. Results Except in cases of AMI, patients showed superior unadjusted outcomes with BLS despite being older and having more comorbidities. In propensity score analyses, survival to 90 days among patients with trauma, stroke, and respiratory failure was higher with BLS than ALS (6.1 percentage points [95% CI, 5.4 to 6.8 percentage points] for trauma; 7.0 percentage points [CI, 6.2 to 7.7 percentage points] for stroke; and 3.7 percentage points [CI, 2.5 to 4.8 percentage points] for respiratory failure). Patients with AMI did not exhibit differences in survival at 30 days but had better survival at 90 days with ALS (1.0 percentage point [CI, 0.1 to 1.9 percentage points]). Neurologic functioning favored BLS for all diagnoses. Results from instrumental variable analyses were broadly consistent with propensity score analyses for trauma and stroke, showed no survival differences between BLS and ALS for respiratory failure, and showed better survival at all time points with BLS than ALS for patients with AMI. Limitation Only Medicare beneficiaries from nonrural counties were studied. Conclusion Advanced life support is associated with substantially higher mortality

  11. Nystagmus Assessments Documented by Emergency Physicians in Acute Dizziness Presentations: A Target for Decision Support?

    PubMed Central

    Kerber, Kevin A.; Morgenstern, Lewis B.; Meurer, William J.; McLaughlin, Thomas; Hall, Pamela A.; Forman, Jane; Fendrick, A. Mark; Newman-Toker, David E.

    2011-01-01

    Objectives Dizziness is a common presenting complaint to the emergency department (ED), and emergency physicians (EPs) consider these presentations a priority for decision support. Assessing for nystagmus and defining its features are important steps for any acute dizziness decision algorithm. The authors sought to describe nystagmus documentation in routine ED care to determine if nystagmus assessments might be an important target in decision support efforts. Methods Medical records from ED visits for dizziness were captured as part of a surveillance study embedded within an ongoing population-based cohort study. Visits with documentation of a nystagmus assessment were reviewed and coded for presence or absence of nystagmus, ability to draw a meaningful inference from the description, and coherence with the final EP diagnosis when a peripheral vestibular diagnosis was made. Results Of 1,091 visits for dizziness, 887 (81.3%) documented a nystagmus assessment. Nystagmus was present in 185 out of 887 (20.9%) visits. When nystagmus was present, no further characteristics were recorded in 48 of the 185 visits (26%). The documentation of nystagmus (including all descriptors recorded) enabled a meaningful inference about the localization or cause in only 10 of the 185 (5.4%) visits. The nystagmus description conflicted with the EP diagnosis in 113 (80.7%) of the 140 visits that received a peripheral vestibular diagnosis. Conclusions Nystagmus assessments are frequently documented in acute dizziness presentations, but details do not generally enable a meaningful inference. Recorded descriptions usually conflict with the diagnosis when a peripheral vestibular diagnosis is rendered. Nystagmus assessments might be an important target in developing decision support for dizziness presentations. PMID:21676060

  12. Medical emergencies in the dermatology office: incidence and options for crisis preparedness.

    PubMed

    Hazen, Paul G; Daoud, Shaza; Hazen, Brent P; Engstrom, Conley W; Turgeon, Karen L; Reep, Michael D; Tanphaichitr, Arthapol; Styron, Brandie T

    2014-05-01

    Medical emergencies may occur in any setting, including dermatology offices. We examined the incidence of medical emergencies in a survey of 34 dermatologists northeast Ohio. Fifty-five events occurred over 565 combined years of clinical practice, an incidence of 1 episode every 10.3 years. We also review options for better preparedness for medical emergencies in dermatology practices, ranging from an emergency action plan for emergency personnel, basic life support (BLS) certification, advanced cardiac life support (ACLS) certification, and on-site automatic electronic defibrillators (AEDs).

  13. [Surgical treatment in severe acute pancreatitis. Last 15 years of experience in Emergency County Hospital of Baia Mare].

    PubMed

    Leşe, Mihaela; Tămăşan, Anca; Stoicescu, B; Brânduşe, M; Puia, Ioana; Mare, C; Lazăr, C

    2005-01-01

    The aim of this study is to investigate the particular course of the patients operated for severe acute pancreatitis in a period of 15 years in surgical department of Emergency County Hospital of Baia Mare. Medical records of 202 patients admitted and operated for severe acute pancreatitis, were studied. Follow-up parameters were: age, gender, etiology, moment of operation, the type of operations and postoperative evolution of this patients. In the group of deceased patients alcoholic etiology of pancreatitis was prevailing. Almost a half of patients were operated in the first day of admission. A high number of patients were operated for diagnosis of acute abdomen with intention of exploratory laparotomy. In the last years, besides the usual closed drainage, open drainage and planning drainage were performed. Postoperative mortality is still high. The diagnose of severe acute pancreatitis is difficult in emergency. Global mortality in pancreatitis remains high, especially in the period of enzymatic shock, and is correlated with masculine gender, alcoholic etiology and somewhat with precocity of operation.

  14. 22 CFR 71.10 - Emergency medical assistance.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...) Medications and related medical supplies and equipment required on a routine basis to sustain life; (5) Preventive or protective medications and medical supplies and equipment (vaccinations, inoculations, etc... verify the alleged abuse of a U.S. national prisoner by arresting or confining authorities; or...

  15. 22 CFR 71.10 - Emergency medical assistance.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...) Medications and related medical supplies and equipment required on a routine basis to sustain life; (5) Preventive or protective medications and medical supplies and equipment (vaccinations, inoculations, etc... verify the alleged abuse of a U.S. national prisoner by arresting or confining authorities; or...

  16. 22 CFR 71.10 - Emergency medical assistance.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...) Medications and related medical supplies and equipment required on a routine basis to sustain life; (5) Preventive or protective medications and medical supplies and equipment (vaccinations, inoculations, etc... verify the alleged abuse of a U.S. national prisoner by arresting or confining authorities; or...

  17. The 2012 derecho: emergency medical services and hospital response.

    PubMed

    Kearns, Randy D; Wigal, Mark S; Fernandez, Antonio; Tucker, March A; Zuidgeest, Ginger R; Mills, Michael R; Cairns, Bruce A; Cairns, Charles B

    2014-10-01

    During the early afternoon of June 29, 2012, a line of destructive thunderstorms producing straight line winds known as a derecho developed near Chicago (Illinois, USA). The storm moved southeast with wind speeds recorded from 100 to 160 kilometers per hour (kph, 60 to 100 miles per hour [mph]). The storm swept across much of West Virginia (USA) later that evening. Power outage was substantial as an estimated 1,300,000 West Virginians (more than half) were without power in the aftermath of the storm and approximately 600,000 citizens were still without power a week later. This was one of the worst storms to strike this area and occurred as residents were enduring a prolonged heat wave. The wind damage left much of the community without electricity and the crippling effect compromised or destroyed critical infrastructure including communications, air conditioning, refrigeration, and water and sewer pumps. This report describes utilization of Emergency Medical Services (EMS) and hospital resources in West Virginia in response to the storm. Also reported is a review of the weather phenomena and the findings and discussion of the disaster and implications.

  18. Hand Washing Practices Among Emergency Medical Services Providers

    PubMed Central

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

    2015-01-01

    Introduction Hand hygiene is an important component of infection control efforts. Our primary and secondary goals were to determine the reported rates of hand washing and stethoscope cleaning in emergency medical services (EMS) workers, respectively. Methods We designed a survey about hand hygiene practices. The survey was distributed to various national EMS organizations through e-mail. Descriptive statistics were calculated for survey items (responses on a Likert scale) and subpopulations of survey respondents to identify relationships between variables. We used analysis of variance to test differences in means between the subgroups. Results There were 1,494 responses. Overall, reported hand hygiene practices were poor among pre-hospital providers in all clinical situations. Women reported that they washed their hands more frequently than men overall, although the differences were unlikely to be clinically significant. Hygiene after invasive procedures was reported to be poor. The presence of available hand sanitizer in the ambulance did not improve reported hygiene rates but improved reported rates of cleaning the stethoscope (absolute difference 0.4, p=0.0003). Providers who brought their own sanitizer were more likely to clean their hands. Conclusion Reported hand hygiene is poor amongst pre-hospital providers. There is a need for future intervention to improve reported performance in pre-hospital provider hand washing. PMID:26587098

  19. Medical Management of Acute Radiation Syndromes : Immunoprophylaxis by Antiradiation Vaccine

    NASA Astrophysics Data System (ADS)

    Popov, Dmitri; Maliev, Vecheslav; Jones, Jeffrey; Casey, Rachael; Kedar, Prasad

    Introduction: Traditionally, the treatment of Acute Radiation Syndrome (ARS) includes supportive therapy, cytokine therapy, blood component transfusions and even stem cell transplantation. Recommendations for ARS treatment are based on clinical symptoms, laboratory results, radiation exposure doses and information received from medical examinations. However, the current medical management of ARS does not include immune prophylaxis based on antiradiation vaccines or immune therapy with hyperimmune antiradiation serum. Immuneprophylaxis of ARS could result from stimulating the immune system via immunization with small doses of radiation toxins (Specific Radiation Determinants-SRD) that possess significant immuno-stimulatory properties. Methods: Principles of immuno-toxicology were used to derive this method of immune prophylaxis. An antiradiation vaccine containing a mixture of Hematotoxic, Neurotoxic and Non-bacterial (GI) radiation toxins, underwent modification into a toxoid forms of the original SRD radiation toxins. The vaccine was administered to animals at different times prior to irradiation. The animals were subjected to lethal doses of radiation that induced different forms of ARS at LD 100/30. Survival rates and clinical symptoms were observed in both control and vaccine-treated animals. Results: Vaccination with non-toxic doses of Radiation toxoids induced immunity from the elaborated Specific Radiation Determinant (SRD) toxins. Neutralization of radiation toxins by specific antiradiation antibodies resulted in significantly improved clinical symptoms in the severe forms of ARS and observed survival rates of 60-80% in animals subjected to lethal doses of radiation expected to induce different forms of ARS at LD 100/30. The most effective vaccination schedule for the antiradiation vaccine consisted of repeated injections 24 and 34 days before irradiation. The vaccine remained effective for the next two years, although the specific immune memory probably

  20. Feasibility study to assess the use of the Cincinnati stroke scale by emergency medical dispatchers: a pilot study

    PubMed Central

    Govindarajan, Prasanthi; DeSouza, Natalie T.; Pierog, Jessica; Ghilarducci, David; Johnston, S. Claiborne

    2015-01-01

    The Emergency Medical Dispatcher (EMD) receiving a call via 911 is the first point of contact within the acute care system and plays an important role in early stroke recognition. Published studies show that EMDs' diagnostic accuracy of stroke need to be improved. Therefore, the National Association of Emergency Medical Dispatchers (NAEMD) implemented a stroke diagnostic tool modelled after the Cincinnati Stroke Scale across 3000 cities world-wide. This is the first time a diagnostic tool that requires callers to test physical findings and report those back to the EMD has been implemented. However, the ability of EMDs and 911 callers to use this in real time has not been reported. Our goal in this pilot study was to determine the feasibility of an EMD applying the Cincinnati Stroke Scale tool during a 911 call, and to report the time required to administer the tool. PMID:21849337

  1. Adolescents and young adults on the acute medical unit: how might we do it better?

    PubMed

    Albon, Lorraine; Vaughan, Louella

    2014-12-01

    It is a common perception that young people do not become ill and do not pose a challenge in the unscheduled healthcare setting. The research, however, increasingly suggests that young adults and adolescents (YAAs) are a highly vulnerable group, with poorer outcomes than either older adults or children, and distinct healthcare needs. The acute medical unit (AMU) setting poses particular challenges to the care of this patient group. To improve care and patient experience, adult clinicians need to look critically at their services and seek to adapt them to meet the needs of YAAs. This requires cooperation and linkage with local paediatric and emergency services, as well as the input of other relevant stakeholder groups. Staff on AMUs also need to develop the knowledge, skills and attitudes to communicate effectively and address the developmental and health needs of YAAs and their parents/carers at times of high risk and stress.

  2. Contemporary sex differences among patients with acute coronary syndrome treated by emergency percutaneous coronary intervention.

    PubMed

    Wada, Hideki; Ogita, Manabu; Miyauchi, Katsumi; Tsuboi, Shuta; Konishi, Hirokazu; Shitara, Jun; Kunimoto, Mitsuhiro; Sonoda, Taketo; Iso, Takashi; Ebina, Hideki; Aoki, Eriko; Kitamura, Kenichi; Tamura, Hiroshi; Suwa, Satoru; Daida, Hiroyuki

    2016-08-08

    Acute coronary syndrome (ACS) is an important cause of mortality and morbidity in the general population. Recent advances in percutaneous coronary intervention (PCI) and optimal medical treatment have helped to improve the prognosis of patients with ACS. The previous reports indicated that women with ACS have a higher risk of adverse outcomes. However, sex differences in clinical outcomes with contemporary coronary revascularization and medical therapy for ACS have not been elucidated. We analyzed data from 676 consecutive patients with ACS (female, n = 166; male, n = 510) who were treated by emergency PCI between 2011 and 2014 at Juntendo Shizuoka Hospital. The patients were grouped according to sex. We defined major adverse cardiovascular events as a composite of all-cause death and ACS recurrence at 1 year and compared rates of major adverse cardiac events (MACE) between the groups. Women were older (75.4 ± 11.0 vs. 66.2 ± 12.2 years) and had a higher rate of multi-vessel disease, chronic kidney disease, and Killip IV at presentation. The cumulative rate of MACE at 1 year was significantly higher among women than men (17.5 vs. 10.2 %, p = 0.02, log-rank test). However, the association between women and a higher risk of MACE was attenuated after adjusting for age (HR 1.25, 95 % CI 0.77-2.00, p = 0.36) and other variables (HR 0.93, 95 % CI 0.36-2.44, p = 0.88). Adjustment for age and other risk factors attenuated sex differences in mid-term clinical outcomes among patients with ACS after emergency PCI.

  3. Delivering quality care: what can emergency gynaecology learn from acute obstetrics?

    PubMed

    Bika, O H; Edozien, L C

    2014-08-01

    Emergency obstetric care in the UK has been systematically developed over the years to high quality standards. More recently, advances have been made in the organisation and delivery of care for women presenting with acute gynaecological problems, but a lot remains to be done, and emergency gynaecology has a lot to learn from the evolution of its sister special interest area: acute obstetric care. This paper highlights areas such as consultant presence, risk management, patient flow pathways, out-of-hours care, clinical guidelines and protocols, education and training and facilities, where lessons from obstetrics are transferrable to emergency gynaecology.

  4. An alternative for rapid administration of medication and fluids in the emergency setting using a novel device.

    PubMed

    Lyons, Neal; Nejak, Daniel; Lomotan, Nadine; Mokszycki, Robert; Jamieson, Stephen; McDowell, Marc; Kulstad, Erik

    2015-08-01

    Routes of administration for medications and fluids in the acute care setting have primarily focused on oral, intravenous, or intraosseous routes, but, in many patients, none of these routes is optimal. A novel device (Macy Catheter; Hospi Corp) that offers an easy route for administration of medications or fluids via rectal mucosal absorption (proctoclysis) has recently become available in the palliative care market; we describe here the first known uses of this device in the emergency setting. Three patients presenting to the hospital with conditions limiting more typical routes of medication or fluid administration were treated with this new device; patients were administered water for hydration, lorazepam for treatment of alcohol withdrawal, ondansetron for nausea, acetaminophen for fever, aspirin for antiplatelet effect, and methimazole for hyperthyroidism. Placement of the device was straightforward, absorption of administered medications (judged by immediacy of effects, where observable) was rapid, and use of the device was well tolerated by patients, suggesting that this device may be an appealing alternative route to medication and fluid administration for a variety of indications in acute and critical care settings.

  5. Acute mountain sickness: medical problems associated with acute and subacute exposure to hypobaric hypoxia

    PubMed Central

    Clarke, C

    2006-01-01

    This article summarises the medical problems of travel to altitudes above 3000 m. These are caused by chronic hypoxia. Acute mountain sickness (AMS), a self limiting common illness is almost part of normal acclimatisation—a transient condition lasting for several days. However, in <2% of people staying above 4000 m, serious illnesses related to hypoxia develop – high altitude pulmonary oedema and cerebral oedema. These are potentially fatal but can be largely avoided by gradual ascent. Short vacations, pressure from travel companies and peer groups often encourage ascent to 4000 m more rapidly than is prudent. Sensible guidelines for ascent are outlined, clinical features, management and treatment of these conditions. PMID:17099095

  6. Medication Overdoses at a Public Emergency Department in Santiago, Chile

    PubMed Central

    Aguilera, Pablo; Garrido, Marcela; Lessard, Eli; Swanson, Julian; Mallon, William K.; Saldias, Fernando; Basaure, Carlos; Lara, Barbara; Swadron, Stuart P.

    2016-01-01

    Introduction While a nationwide poison control registry exists in Chile, reporting to the center is sporadic and happens at the discretion of the treating physician or by patients’ self-report. Moreover, individual hospitals do not monitor accidental or intentional poisoning in a systematic manner. The goal of this study was to identify all cases of intentional medication overdose (MO) that occurred over two years at a large public hospital in Santiago, Chile, and examine its epidemiologic profile. Methods This study is a retrospective, explicit chart review conducted at Hospital Sótero del Rio from July 2008 until June 2010. We included all cases of identified intentional MO. Alcohol and recreational drugs were included only when they were ingested with other medications. Results We identified 1,557 cases of intentional MO and analyzed a total of 1,197 cases, corresponding to 0.51% of all emergency department (ED) presentations between July 2008 and June 2010. The median patient age was 25 years. The majority was female (67.6%). Two peaks were identified, corresponding to the spring of each year sampled. The rate of hospital admission was 22.2%. Benzodiazepines, selective serotonin reuptake inhibitors, and tricyclic antidepressants (TCA) were the causative agents most commonly found, comprising 1,044 (87.2%) of all analyzed cases. Acetaminophen was involved in 81 (6.8%) cases. More than one active substance was involved in 35% of cases. In 7.3% there was ethanol co-ingestion and in 1.0% co-ingestion of some other recreational drug (primarily cocaine). Of 1,557 cases, six (0.39%) patients died. TCA were involved in two of these deaths. Conclusion Similar to other developed and developing nations, intentional MO accounts for a significant number of ED presentations in Chile. Chile is unique in the region, however, in that its spectrum of intentional overdoses includes an excess burden of tricyclic antidepressant and benzodiazepine overdoses, a relatively low rate

  7. [Replantation and revascularization in acute upper limb amputation--the Sheba Medical Center experience].

    PubMed

    Oron, Amir; Yaffe, Batia

    2008-01-01

    Replantation and revascularization in acute upper-limb amputations are well-accepted surgical techniques in hand surgery. All medical staff members treating patients in emergency settings should be familiar with the indications, timetable, setup and transportation of patients rendered suitable for such surgery. While replantation surgery is not considered a simple surgical procedure by any means, viability rates approach ninety percent. The amputated part should be wrapped with gauze soaked in saline, placed in a sterile plastic bag and then put in an ice-filled container. The patient should be transferred to a medical center with a team dedicated to performing replantation procedures, following notification in advance. Time from the initial insult to the initiation of treatment should be minimized. Combined efforts employed by the primary caregivers and the microsurgical team will lead to optimization of patient treatment and improve the final outcome. During the years 1991-2007 a total of 383 upper limb replantation or revascularization procedures were performed at the Sheba Medical Center and are presented in this article.

  8. Investigation of the degree of organisational influence on patient experience scores in acute medical admission units in all acute hospitals in England using multilevel hierarchical regression modelling

    PubMed Central

    Sullivan, Paul

    2017-01-01

    Objectives Previous studies found that hospital and specialty have limited influence on patient experience scores, and patient level factors are more important. This could be due to heterogeneity of experience delivery across subunits within organisations. We aimed to determine whether organisation level factors have greater impact if scores for the same subspecialty microsystem are analysed in each hospital. Setting Acute medical admission units in all NHS Acute Trusts in England. Participants We analysed patient experience data from the English Adult Inpatient Survey which is administered to 850 patients annually in each acute NHS Trusts in England. We selected all 8753 patients who returned the survey and who were emergency medical admissions and stayed in their admission unit for 1–2 nights, so as to isolate the experience delivered during the acute admission process. Primary and secondary outcome measures We used multilevel logistic regression to determine the apportioned influence of host organisation and of organisation level factors (size and teaching status), and patient level factors (demographics, presence of long-term conditions and disabilities). We selected ‘being treated with respect and dignity’ and ‘pain control’ as primary outcome parameters. Other Picker Domain question scores were analysed as secondary parameters. Results The proportion of overall variance attributable at organisational level was small; 0.5% (NS) for respect and dignity, 0.4% (NS) for pain control. Long-standing conditions and consequent disabilities were associated with low scores. Other item scores also showed that most influence was from patient level factors. Conclusions When a single microsystem, the acute medical admission process, is isolated, variance in experience scores is mainly explainable by patient level factors with limited organisational level influence. This has implications for the use of generic patient experience surveys for comparison between

  9. 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.…

  10. Emergency Medical Technician-Ambulance: National Standard Curriculum. Instructor's Lesson Plans (Third Edition).

    ERIC Educational Resources Information Center

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

    This set of instructor's lesson plans is one of three documents prepared for the Emergency Medical Technician (EMT) National Standard Curriculum. It contains detailed outlines of course content and guidance for teaching each course lesson. The training course contains 33 lessons covering all emergency medical techniques currently considered to be…

  11. National Training Course. Emergency Medical Technician. Paramedic. Instructor's Lesson Plans. Module XV. Telemetry and Communications.

    ERIC Educational Resources Information Center

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

    This instructor's lesson plan guide on telemetry and communications is one of fifteen modules designed for use in the training of emergency medical technicians (paramedics). Two units of study are presented: (1) emergency medical services communications systems (items of equipment and such radio communications concepts as frequency allocation,…

  12. Correlates of Intent to Leave Job and Profession for Emergency Medical Technicians and Paramedics

    ERIC Educational Resources Information Center

    Chapman, Susan A.; Blau, Gary; Pred, Robert; Lopez, Andrea B.

    2009-01-01

    Purpose: A very limited number of studies have explored factors related to emergency medical services (EMS) workers leaving their jobs and the profession. This paper aims to investigate the correlates of intent to leave EMS jobs and the profession and compared two types of workers: emergency medical technicians (EMTs) and paramedics.…

  13. National Training Course. Emergency Medical Technician. Paramedic. Instructor's Lesson Plans. Module Course Guide.

    ERIC Educational Resources Information Center

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

    Designed to help administrators plan and implement an emergency medical technician (EMT) training program, this course guide is intended for use with a series of fifteen instructor lesson plan modules. (The EMT-Paramedic is described as a professional in emergency medical care who has successfully completed a training program that includes formal…

  14. Instructor Quality Affecting Emergency Medical Technician (EMT) Preparedness: A LEADS Project

    ERIC Educational Resources Information Center

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

    2005-01-01

    This represents one of a series of studies of the Longitudinal Emergency Medical Technician Attributes and Demographics Study (LEADS) being undertaken by the National Registry of Emergency Medical Technicians and the National Highway Traffic Safety Administration (NHTSA). This secondary analysis of the LEADS database, which provides a…

  15. 30 CFR 75.1713 - Emergency medical assistance; first-aid.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Emergency medical assistance; first-aid. 75... Emergency medical assistance; first-aid. Each operator shall make arrangements in advance for obtaining... provided to the nearest point of assistance. Selected agents of the operator shall be trained in...

  16. 30 CFR 75.1713 - Emergency medical assistance; first-aid.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Emergency medical assistance; first-aid. 75... Emergency medical assistance; first-aid. Each operator shall make arrangements in advance for obtaining... provided to the nearest point of assistance. Selected agents of the operator shall be trained in...

  17. 30 CFR 75.1713 - Emergency medical assistance; first-aid.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Emergency medical assistance; first-aid. 75... Emergency medical assistance; first-aid. Each operator shall make arrangements in advance for obtaining... provided to the nearest point of assistance. Selected agents of the operator shall be trained in...

  18. 30 CFR 75.1713 - Emergency medical assistance; first-aid.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Emergency medical assistance; first-aid. 75... Emergency medical assistance; first-aid. Each operator shall make arrangements in advance for obtaining... provided to the nearest point of assistance. Selected agents of the operator shall be trained in...

  19. 30 CFR 75.1713 - Emergency medical assistance; first-aid.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Emergency medical assistance; first-aid. 75... Emergency medical assistance; first-aid. Each operator shall make arrangements in advance for obtaining... provided to the nearest point of assistance. Selected agents of the operator shall be trained in...

  20. Emergency Medical Care. A Manual for the Paramedic in the Field.

    ERIC Educational Resources Information Center

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

    This document is a textbook of emergency medical procedures to be used for training emergency medical technicians. The book is organized into 15 modules, each containing 1 to 10 units. Each module contains information illustrated with line drawings, a glossary, and references. The modules cover the following topics: the role of the emergency…

  1. 3 CFR 8383 - Proclamation 8383 of May 20, 2009. Emergency Medical Services Week, 2009

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... the United States of America, by virtue of the authority vested in me by the Constitution and the laws of the United States, do hereby proclaim May 17 through May 23, 2009, as Emergency Medical Services..., 2009 Proc. 8383 Emergency Medical Services Week, 2009By the President of the United States of America...

  2. Emergency Medical Science (T-139). Curriculum Models, Guidelines, and Outcome-Competencies.

    ERIC Educational Resources Information Center

    Lovin, Barbara Keelor

    Developed for use by curriculum planners in Emergency Medical Science (EMS) programs throughout the North Carolina Community College System (NCCCS), and by evaluators in their reviews of existing programs, this manual provides a model set of guidelines for the education and training of the Emergency Medical Technician-Paramedic (EMT-P) in…

  3. [Is a more efficient operative strategy feasible for the emergency management of the patient with acute chest pain?].

    PubMed

    Cassin, M; Badano, L P; Solinas, L; Macor, F; Burelli, C; Antonini-Canterin, F; Cappelletti, P; Rubin, D; Tropeano, P; Deganuto, L; Nicolosi, G L

    2000-02-01

    Patients with acute chest pain are a common problem and a difficult challenge for clinicians. In the United States more than 5 million patients are examined in the emergency department on a yearly basis, at a cost of 6 billion dollars. In the CHEPER registry the prevalence of patients with chest pain in the Emergency Department was 5.3%. Similarly, in 1997 at our institution the prevalence was 4.8%. Only 50% of the patients are subsequently found to have cardiac ischemia as the cause of their symptoms and 50-60% of them showed a non-diagnostic electrocardiogram (ECG). Twenty-five-50% of chest pain patients are not appropriately admitted to the hospital and despite this conservative approach, acute myocardial infarction is misdiagnosed up to 8% of patients with acute chest pain who are released from the emergency department without further evaluation, accounting for approximately 20% of emergency department malpractice in the United States. Important diagnostic information is covered by the patient's medical history, physical examination, and ECG, but often this approach is inadequate for a definitive diagnosis. Creatine kinase (CK) and CK isoenzyme--cardiac muscle subunit (CK-MB)--are traditionally obtained in the emergency department in patients admitted for suspected acute coronary syndrome. Mass measurements of CK-MB have improved sensitivity and specificity, and to date this is the gold standard test for diagnosis of acute myocardial infarction. CK-MB, however, is not a perfect marker because it is not totally cardiac specific and does not identify patients with unstable angina and minimal myocardial damage. There are no controlled clinical impact trials showing that these tests are effective in deciding whether to discharge or to appropriately admit the patient with suspected acute coronary syndrome. Relevant investigative interest has recently been focused on new markers for myocardial injury, including myoglobin, cardiac troponins T and I. Myoglobin, a

  4. The critical incident inventory: characteristics of incidents which affect emergency medical technicians and paramedics

    PubMed Central

    2012-01-01

    Background Emergency medical technicians (EMTs) and paramedics experience critical incidents which evoke distress and impaired functioning but it is unknown which aspects of incidents contribute to their impact. We sought to determine these specific characteristics by developing an inventory of critical incident characteristics and testing their relationship to protracted recovery from acute stress, and subsequent emotional symptoms. Methods EMT/paramedics (n = 223) completed a retrospective survey of reactions to an index critical incident, and current depressive, posttraumatic and burnout symptoms. Thirty-six potential event characteristics were evaluated; 22 were associated with peritraumatic distress and were retained. We assigned inventory items to one of three domains: situational, systemic or personal characteristics. We tested the relationships between (a) endorsing any domain item and (b) outcomes of the critical incident (peritraumatic dissociation, recovery from components of the Acute Stress Reaction and depressive, posttraumatic, and burnout symptoms). Analyses were repeated for the number of items endorsed. Results Personal and situational characteristics were most frequently endorsed. The personal domain had the strongest associations, particularly with peritraumatic dissociation, prolonged distressing feelings, and current posttraumatic symptoms. The situational domain was associated with peritraumatic dissociation, prolonged social withdrawal, and current posttraumatic symptoms. The systemic domain was associated with peritraumatic dissociation and prolonged irritability. Endorsing multiple characteristics was related to peritraumatic, acute stress, and current posttraumatic symptoms. Relationships with outcome variables were as strong for a 14-item inventory (situational and personal characteristics only) as the 22-item inventory. Conclusions Emotional sequelae are associated most strongly with EMT/paramedics’ personal experience, and least

  5. 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.

  6. Dispensing medications at the hospital upon discharge from an emergency department.

    PubMed

    Yamamoto, Loren G; Manzi, Shannon; Shaw, Kathy N; Ackerman, Alice D; Chun, Thomas H; Conners, Gregory P; Dudley, Nanette C; Fein, Joel A; Fuchs, Susan M; Moore, Brian R; Selbst, Steven M; Wright, Joseph L

    2012-02-01

    Although most health care services can and should be provided by their medical home, children will be referred or require visits to the emergency department (ED) for emergent clinical conditions or injuries. Continuation of medical care after discharge from an ED is dependent on parents or caregivers' understanding of and compliance with follow-up instructions and on adherence to medication recommendations. ED visits often occur at times when the majority of pharmacies are not open and caregivers are concerned with getting their ill or injured child directly home. Approximately one-third of patients fail to obtain priority medications from a pharmacy after discharge from an ED. The option of judiciously dispensing ED discharge medications from the ED's outpatient pharmacy within the facility is a major convenience that overcomes this obstacle, improving the likelihood of medication adherence. Emergency care encounters should be routinely followed up with primary care provider medical homes to ensure complete and comprehensive care.

  7. 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...

  8. 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...

  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...

  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...

  11. 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...

  12. 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...

  13. 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...

  14. 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...

  15. 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...

  16. Military Medical Decision Support for Homeland Defense During Emergency

    DTIC Science & Technology

    2004-12-01

    Integrated Decision Support ( MERMAIDS ) developed for training of emergency response teams using heterogeneous resources under a unified command and control...The MERMAIDS has been designed to contain a decision-centric interface, which is not only useful for emergency information management, but has...decision models to support response planning during emergency conditions. An expert heuristic evaluation of the MERMAIDS is encouraging. The expert

  17. How are emergencies different from other medical situations?

    PubMed

    Gert, Heather J

    2005-07-01

    Three criteria are necessary for an event to be an emergency: (a) there must be an expectation of serious harm; (b) there must be an expectation that someone can do something to prevent or reduce that harm; and (c) there must be time pressure. Because emergencies are unique in having this set of criteria, standard moral principles, when applied to emergency situations, can require actions that are prohibited in other situations. This can give the impression that there are different moral principles at work in emergencies. This paper argues that this impression is illusory.

  18. The Clinical Course of a Drug-induced Acute Dystonic Reaction in the Emergency Room

    PubMed Central

    Marano, Massimo; di Biase, Lazzaro; Salomone, Gaetano; Di Santo, Alessandro; Montiroli, Annalisa; Di Lazzaro, Vincenzo

    2016-01-01

    Background Acute dystonic reactions following the administration of safe, reliable drugs can occur and must be promptly recognized and treated in the emergency room. Phenomenology Shown The entire clinical course of an acute dystonic reaction due to metoclopramide, from early motor signs to full-blown clinical symptoms and resolution. Educational Value Providing elements for early recognition of a drug-induced movement disorder phenomenology. PMID:28105387

  19. Acute rectal ischaemia following emergency abdominal aortic aneurysm surgery

    PubMed Central

    Mosley, Frances R.; Akhtar, Sobia; George, Rina; Pillay, Woolagasen R.

    2016-01-01

    We present a case of isolated rectal ischaemia, a rare complication after emergency surgery for a ruptured abdominal aneurysm. We discuss the possible aetiology of this condition and how this rare condition may be missed unless care is taken at the time of reoperation. PMID:28344761

  20. Medicine for Somewhere: The Emergence of Place in Medical Education

    ERIC Educational Resources Information Center

    Ross, Brian M.; Daynard, Kim; Greenwood, David

    2014-01-01

    Until recently medical education has been largely silent on those aspects of the physician's life, both professional and unprofessional, that differ from place to place. This has contributed to health inequity through an undersupply of health care workers to many communities. A growing movement for social accountability in medical education has…

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

    NASA Astrophysics Data System (ADS)

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

    2014-02-01

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

  2. Prognostic markers of acute decompensated heart failure: the emerging roles of cardiac biomarkers and prognostic scores.

    PubMed

    Cohen-Solal, Alain; Laribi, Said; Ishihara, Shiro; Vergaro, Giuseppe; Baudet, Mathilde; Logeart, Damien; Mebazaa, Alexandre; Gayat, Etienne; Vodovar, Nicolas; Pascual-Figal, Domingo A; Seronde, Marie-France

    2015-01-01

    Rapidly assessing outcome in patients with acute decompensated heart failure is important but prognostic factors may differ from those used routinely for stable chronic heart failure. Multiple plasma biomarkers, besides the classic natriuretic peptides, have recently emerged as potential prognosticators. Furthermore, prognostic scores that combine clinical and biochemical data may also be useful. However, compared with the scores used in chronic heart failure, scores for acute decompensated heart failure have not been validated. This article reviews potential biomarkers, with a special focus on biochemical biomarkers, and possible prognostic scores that could be used by the clinician when assessing outcome in patients with acute heart failure.

  3. [Exceptional medical circumstances: interest of an interhospital support strategy within the North Alps emergency trauma network].

    PubMed

    Incagnoli, P; Hacini, R; Gros, I; Rancurel, E; Jacquot, C

    2011-12-01

    The Northern French Alps Emergency Network (RENAU) has a main objective the improvement of the quality of the care in the field of the emergency medical treatment. With this French medical system, we developed a procedure allowing the detachment of a medical-surgical team of the university hospital to help general hospital team in the event of immediate vital emergency situation with untransportable patient. We reported the successful implementation of this support strategy for a 51-year-old patient arrived in a hospital of the network in extremely serious hemodynamic shock due to an important hemorrhagic pericardial effusion with tamponnade 1 day after percutaneous closure of the patent foramen ovale (PFO).

  4. Emergency medical kit for commercial airlines: an update.

    PubMed

    Thibeault, Claude; Evans, Anthony

    2007-12-01

    In 1998, the Air Transport Medicine (ATM) Committee of the Aerospace Medical Association (AsMA) made its first recommendations concerning medical kits for commercial airlines. These were updated in 2002 and the ATM has continued to monitor medical kit usage, as well as pharmaceutical developments, and a further revision is now needed. This has taken into account ongoing work of the International Civil Aviation Organization and recommendations of the International Air Transport Association in the field of passenger and crew health. Based on the above, the Committee proposes the following update to its 2002 recommendations.

  5. Evaluation of self-perception of mechanical ventilation knowledge among Brazilian final-year medical students, residents and emergency physicians

    PubMed Central

    Tallo, Fernando Sabia; de Campos Vieira Abib, Simone; de Andrade Negri, Alexandre Jorgi; Filho, Paulo Cesar; Lopes, Renato Delascio; Lopes, Antônio Carlos

    2017-01-01

    OBJECTIVE: To present self-assessments of knowledge about mechanical ventilation made by final-year medical students, residents, and physicians taking qualifying courses at the Brazilian Society of Internal Medicine who work in urgent and emergency settings. METHODS: A 34-item questionnaire comprising different areas of knowledge and training in mechanical ventilation was given to 806 medical students, residents, and participants in qualifying courses at 11 medical schools in Brazil. The questionnaire’s self-assessment items for knowledge were transformed into scores. RESULTS: The average score among all participants was 21% (0-100%). Of the total, 85% respondents felt they did not receive sufficient information about mechanical ventilation during medical training. Additionally, 77% of the group reported that they would not know when to start noninvasive ventilation in a patient, and 81%, 81%, and 89% would not know how to start volume control, pressure control and pressure support ventilation modes, respectively. Furthermore, 86.4% and 94% of the participants believed they would not identify the basic principles of mechanical ventilation in patients with obstructive pulmonary disease and acute respiratory distress syndrome, respectively, and would feel insecure beginning ventilation. Finally, 77% said they would fear for the safety of a patient requiring invasive mechanical ventilation under their care. CONCLUSION: Self-assessment of knowledge and self-perception of safety for managing mechanical ventilation were deficient among residents, students and emergency physicians from a sample in Brazil. PMID:28273238

  6. 30 CFR 47.83 - Disclosure in a medical emergency.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... TRAINING HAZARD COMMUNICATION (HazCom) Trade Secret Hazardous Chemical § 47.83 Disclosure in a medical... confidentiality agreement, the operator must immediately disclose the identity of a trade secret chemical to...

  7. 30 CFR 47.83 - Disclosure in a medical emergency.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... TRAINING HAZARD COMMUNICATION (HazCom) Trade Secret Hazardous Chemical § 47.83 Disclosure in a medical... confidentiality agreement, the operator must immediately disclose the identity of a trade secret chemical to...

  8. 30 CFR 47.83 - Disclosure in a medical emergency.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... TRAINING HAZARD COMMUNICATION (HazCom) Trade Secret Hazardous Chemical § 47.83 Disclosure in a medical... confidentiality agreement, the operator must immediately disclose the identity of a trade secret chemical to...

  9. 30 CFR 47.83 - Disclosure in a medical emergency.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... TRAINING HAZARD COMMUNICATION (HazCom) Trade Secret Hazardous Chemical § 47.83 Disclosure in a medical... confidentiality agreement, the operator must immediately disclose the identity of a trade secret chemical to...

  10. Emerging trends in the outsourcing of medical and surgical care.

    PubMed

    Boyd, Jennifer B; McGrath, Mary H; Maa, John

    2011-01-01

    As total health care expenditures are expected to constitute an increasing portion of the US gross domestic product during the coming years, the US health care system is anticipating a historic spike in the need for care. Outsourcing medical and surgical care to other nations has expanded rapidly, and several ethical, legal, and financial considerations require careful evaluation. Ultimately, the balance between cost savings, quality, and patient satisfaction will be the key determinant in the future of medical outsourcing.

  11. Work-Related Psychosocial Hazards Among Emergency Medical Responders (EMRs) in Mansoura City

    PubMed Central

    Khashaba, Eman Omar; El-Sherif, Mona Abdel Fattah; Ibrahim, Adel Al-Wehedy; Neatmatallah, Mostafa Ahmed

    2014-01-01

    Purpose: This research was done to assess levels of psychosocial stress and related hazards [(burnout, depression, and posttraumatic stress disorder (PTSD)] among emergency medical responders (EMRs). Materials and Methods: A comparative cross-sectional study was conducted upon (140) EMRs and a comparative group composed of (140) nonemergency workers. The groups studied were subjected to semistructured questionnaire including demographic data, survey for job stressors, Maslach burn out inventory (MBI), Beck depression inventory (BDI), and Davidson Trauma scale for PTSD. Results: The most severe acute stressors among EMRs were dealing with traumatic events (88.57%), followed by dealing with serious accidents (87.8%) and young victims (87.14%). Chronic stressors were more commonly reported among EMRs with statistically significant differences (P < 0.05) except for social support with colleagues and supervisors. EMRs had statistically significant higher levels of emotional exhaustion (EE) (20%) and depersonalization (DP) (9.3%) compared with comparative group (4.3%, 1.4% respectively). Also, there was no statistically significant difference between two groups as regards lower personal achievement or depression symptoms (P > 0.05). There was increased risk of PTSD for those who had higher stress levels from death of colleagues [odds ratio (OR) [95% confidence interval (CI)] = 2.2 (0.7-7.6), exposure to verbal or physical assault OR (95% CI) = 1.6 (0.5-4.4) and dealing with psychiatric OR (95% CI) 1.4 (0.53.7) (P > 0.05) Conclusion: EMRs group had more frequent exposure to both acute and chronic work-related stressors than comparative group. Also, EMRs had higher levels of EE, DP, and PTSD compared with comparative group. EMRs are in need for stress management program for prevention these of stress related hazards on health and work performance. PMID:24963227

  12. Voluntary Medical Incident Reporting Tool to Improve Physician Reporting of Medical Errors in an Emergency Department

    PubMed Central

    Okafor, Nnaemeka G.; Doshi, Pratik B.; Miller, Sara K.; McCarthy, James J.; Hoot, Nathan R.; Darger, Bryan F.; Benitez, Roberto C.; Chathampally, Yashwant G.

    2015-01-01

    Introduction Medical errors are frequently under-reported, yet their appropriate analysis, coupled with remediation, is essential for continuous quality improvement. The emergency department (ED) is recognized as a complex and chaotic environment prone to errors. In this paper, we describe the design and implementation of a web-based ED-specific incident reporting system using an iterative process. Methods A web-based, password-protected tool was developed by members of a quality assurance committee for ED providers to report incidents that they believe could impact patient safety. Results The utilization of this system in one residency program with two academic sites resulted in an increase from 81 reported incidents in 2009, the first year of use, to 561 reported incidents in 2012. This is an increase in rate of reported events from 0.07% of all ED visits to 0.44% of all ED visits. In 2012, faculty reported 60% of all incidents, while residents and midlevel providers reported 24% and 16% respectively. The most commonly reported incidents were delays in care and management concerns. Conclusion Error reporting frequency can be dramatically improved by using a web-based, user-friendly, voluntary, and non-punitive reporting system. PMID:26759657

  13. Prospects for emerging infections in East and southeast Asia 10 years after severe acute respiratory syndrome.

    PubMed

    Horby, Peter W; Pfeiffer, Dirk; Oshitani, Hitoshi

    2013-06-01

    It is 10 years since severe acute respiratory syndrome (SARS) emerged, and East and Southeast Asia retain a reputation as a hot spot of emerging infectious diseases. The region is certainly a hot spot of socioeconomic and environmental change, and although some changes (e.g., urbanization and agricultural intensification) may reduce the probability of emerging infectious diseases, the effect of any individual emergence event may be increased by the greater concentration and connectivity of livestock, persons, and products. The region is now better able to detect and respond to emerging infectious diseases than it was a decade ago, but the tools and methods to produce sufficiently refined assessments of the risks of disease emergence are still lacking. Given the continued scale and pace of change in East and Southeast Asia, it is vital that capabilities for predicting, identifying, and controlling biologic threats do not stagnate as the memory of SARS fades.

  14. Prospects for Emerging Infections in East and Southeast Asia 10 Years after Severe Acute Respiratory Syndrome

    PubMed Central

    Pfeiffer, Dirk; Oshitani, Hitoshi

    2013-01-01

    It is 10 years since severe acute respiratory syndrome (SARS) emerged, and East and Southeast Asia retain a reputation as a hot spot of emerging infectious diseases. The region is certainly a hot spot of socioeconomic and environmental change, and although some changes (e.g., urbanization and agricultural intensification) may reduce the probability of emerging infectious diseases, the effect of any individual emergence event may be increased by the greater concentration and connectivity of livestock, persons, and products. The region is now better able to detect and respond to emerging infectious diseases than it was a decade ago, but the tools and methods to produce sufficiently refined assessments of the risks of disease emergence are still lacking. Given the continued scale and pace of change in East and Southeast Asia, it is vital that capabilities for predicting, identifying, and controlling biologic threats do not stagnate as the memory of SARS fades. PMID:23738977

  15. Non-Medical Use of Prescription Pain Medications and Increased Emergency Department Utilization: Results of a National Survey

    PubMed Central

    Frank, Joseph W.; Binswanger, Ingrid A.; Calcaterra, Susan L.; Brenner, Lisa A.; Levy, Cari

    2015-01-01

    Background There are no population-based studies of emergency department (ED) utilization by individuals using prescription pain medications non-medically. We examined whether non-medical use of prescription pain medications was independently associated with increased ED utilization. Methods We conducted a retrospective analysis of a nationally representative sample of the non-institutionalized, civilian U.S. population in the National Survey on Drug Use and Health, 2008–2013. We used multivariable logistic regression to examine the association between past year ED utilization and non-medical use of prescription pain medications, defined as use of medications “not prescribed for you or that you took only for the experience or feeling they caused”. Results An estimated 10.5 million adults annually reported past year non-medical use (NMU) of prescription pain medications, and 39%, or 4.1 million adults annually, also reported one or more past year ED visits. After adjustment for sociodemographic and clinical characteristics, adults with past year NMU of prescription pain medications had increased odds of past year ED utilization (adjusted odds ratio 1.32; 95% confidence interval 1.24–1.41). In secondary analyses, individuals with more frequent NMU had increased odds of ED utilization in unadjusted analyses, but this association was attenuated with adjustment for the source of prescription pain medication (i.e., physician, friend/family, other source). Conclusions Non-medical use of prescription pain medications is associated with increased ED utilization. Further work is needed to identify the optimal role of ED settings in providing screening, education, and treatment referral for individuals using prescription pain medications non-medically. PMID:26564754

  16. Woods and Russell, Hill, and the emergence of medical statistics

    PubMed Central

    Farewell, Vern; Johnson, Tony

    2010-01-01

    In 1937, Austin Bradford Hill wrote Principles of Medical Statistics (Lancet: London, 1937) that became renowned throughout the world and is widely associated with the birth of modern medical statistics. Some 6 years earlier Hilda Mary Woods and William Thomas Russell, colleagues of Hill at the London School of Hygiene and Tropical Medicine, wrote a similar book An Introduction to Medical Statistics (PS King and Son: London, 1931) that is little known today. We trace the origins of these two books from the foundations of early demography and vital statistics, and make a detailed examination of some of their chapters. It is clear that these texts mark a watershed in the history of medical statistics that demarcates the vital statistics of the nineteenth and early twentieth centuries from the modern discipline. Moreover, we consider that the book by Woods and Russell is of some importance in the development of medical statistics and we describe and acknowledge their place in the history of this discipline. Copyright © 2010 John Wiley & Sons, Ltd. PMID:20535761

  17. Woods and Russell, Hill, and the emergence of medical statistics.

    PubMed

    Farewell, Vern; Johnson, Tony

    2010-06-30

    In 1937, Austin Bradford Hill wrote Principles of Medical Statistics (Lancet: London, 1937) that became renowned throughout the world and is widely associated with the birth of modern medical statistics. Some 6 years earlier Hilda Mary Woods and William Thomas Russell, colleagues of Hill at the London School of Hygiene and Tropical Medicine, wrote a similar book An Introduction to Medical Statistics (PS King and Son: London, 1931) that is little known today. We trace the origins of these two books from the foundations of early demography and vital statistics, and make a detailed examination of some of their chapters. It is clear that these texts mark a watershed in the history of medical statistics that demarcates the vital statistics of the nineteenth and early twentieth centuries from the modern discipline. Moreover, we consider that the book by Woods and Russell is of some importance in the development of medical statistics and we describe and acknowledge their place in the history of this discipline.

  18. Implementing the EQUiPPED Medication Management Program at 5 VA Emergency Departments.

    PubMed

    Vandenberg, Ann E; Stevens, Melissa; Echt, Katharina V; Hastings, S Nicole; Powers, James; Markland, Alayne; Hwang, Ula; Hung, William; Belbis, Stephanie; Vaughan, Camille P

    2016-04-01

    The Enhancing Quality of Prescribing Practices for Older Veterans Discharged From the Emergency Department (EQUiPPED) program aimed to reduce potentially inappropriate medication prescribing to older adults at 5 VAMCs.

  19. 14 CFR Appendix A to Part 121 - First Aid Kits and Emergency Medical Kits

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... appropriately maintained contents in the specified quantities: Contents Quantity Adhesive bandage compresses, 1... contain at least the following appropriately maintained contents in the specified quantities: Contents... emergency medical kit that must contain at least the following appropriately maintained contents in...

  20. 14 CFR Appendix A to Part 121 - First Aid Kits and Emergency Medical Kits

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... appropriately maintained contents in the specified quantities: Contents Quantity Adhesive bandage compresses, 1... contain at least the following appropriately maintained contents in the specified quantities: Contents... emergency medical kit that must contain at least the following appropriately maintained contents in...