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Sample records for acute medical services

  1. 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.

  2. 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 ...

  3. Medical Services: Ophthalmic Services

    DTIC Science & Technology

    2007-11-02

    optometrist may be employed according to Service regulations. Such examinations will include fitting and adjusting of spectacles. All prescriptions...below. a. An ophthalmologist or optometrist competent in contact lens fitting must be available. b. Adequate diagnostic, inspection, and modification...the prescribing officer. Enter name, grade, and title of the prescribing officer (oph- thalmologist or optometrist ). DD Form 577 (Signature Card) will

  4. The Identification of Seniors at Risk (ISAR) score to predict clinical outcomes and health service costs in older people discharged from UK acute medical units

    PubMed Central

    Edmans, Judi; Bradshaw, Lucy; Gladman, John R. F.; Franklin, Matthew; Berdunov, Vladislav; Elliott, Rachel; Conroy, Simon P.

    2013-01-01

    Background: tools are required to identify high-risk older people in acute emergency settings so that appropriate services can be directed towards them. Objective: to evaluate whether the Identification of Seniors At Risk (ISAR) predicts the clinical outcomes and health and social services costs of older people discharged from acute medical units. Design: an observational cohort study using receiver–operator curve analysis to compare baseline ISAR to an adverse clinical outcome at 90 days (where an adverse outcome was any of death, institutionalisation, hospital readmission, increased dependency in activities of daily living (decrease of 2 or more points on the Barthel ADL Index), reduced mental well-being (increase of 2 or more points on the 12-point General Health Questionnaire) or reduced quality of life (reduction in the EuroQol-5D) and high health and social services costs over 90 days estimated from routine electronic service records. Setting: two acute medical units in the East Midlands, UK. Participants: a total of 667 patients aged ≥70 discharged from acute medical units. Results: an adverse outcome at 90 days was observed in 76% of participants. The ISAR was poor at predicting adverse outcomes (AUC: 0.60, 95% CI: 0.54–0.65) and fair for health and social care costs (AUC: 0.70, 95% CI: 0.59–0.81). Conclusions: adverse outcomes are common in older people discharged from acute medical units in the UK; the poor predictive ability of the ISAR in older people discharged from acute medical units makes it unsuitable as a sole tool in clinical decision-making. PMID:23666405

  5. Medical Services Assistant Curriculum.

    ERIC Educational Resources Information Center

    Leeman, Phyllis A.

    Designed to develop 12th-grade multiple competencies courses, this curriculum prepares the student to assist a physician, dentist, or other health professional with the management of a medical office and to perform basic health services procedures. Course descriptions are provided for the two courses in the curriculum: medical services assistant…

  6. 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

  7. 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.

  8. Setting up an acute pain management service.

    PubMed

    Schwenk, Eric S; Baratta, Jaime L; Gandhi, Kishor; Viscusi, Eugene R

    2014-12-01

    Successful implementation of an acute pain management service involves a team approach in which team members have clearly defined roles. Clinical protocols are designed to help address common problems and prevent errors. As the complexity of surgery and patients' diseases continues to increase, current knowledge of new analgesic medications, acute pain literature, and skills in regional anesthesia techniques is imperative. Emphasizing a multimodal approach can improve analgesia and decrease opioid-related side effects.

  9. 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:…

  10. 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

  11. Medical Services: Veterinary Health Services

    DTIC Science & Technology

    2007-11-02

    Chapter 5 Government-Owned Animal Program, page 5 Duties of the veterinarian • 5–1, page 5 Death or euthanasia of Government-owned animals • 5–2, page 6...provision of veterinary services. b. The installation veterinarian will— (1) Coordinate the provision of veterinary services in support of all DOD component...c. Veterinarians supporting MWD procurement and training facil- ities will perform the duties listed in paragraph 5–1. 1AR 40–905/SECNAVINST 6401.1A

  12. Factors Affecting Medical Service Quality

    PubMed Central

    MOSADEGHRAD, Ali Mohammad

    2014-01-01

    Abstract Background A better understanding of factors influencing quality of medical service can pinpoint better strategies for quality assurance in medical services. This study aimed to identify factors affecting the quality of medical services provided by Iranian physicians. Methods Exploratory in-depth individual interviews were conducted with sixty-four physicians working in various medical institutions in Iran. Results Individual, organizational and environmental factors enhance or inhibit the quality of medical services. Quality of medical services depends on the personal factors of the physician and patient, and factors pertaining to the healthcare setting and the broader environment. Conclusion Differences in internal and external factors such as availability of resources, patient cooperation and collaboration among providers affect the quality of medical services and patient outcomes. Supportive leadership, proper planning, education and training and effective management of resources and processes improve the quality of medical services. This article contributes to healthcare theory and practice by developing a conceptual framework for understanding factors that influence medical services quality. PMID:26060745

  13. 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

  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. Medical Services: The Disputed Related Service.

    ERIC Educational Resources Information Center

    Bartlett, Larry

    2000-01-01

    This article analyzes the 1999 Supreme Court decision, Cedar Rapids Community School District v. Garret F., which affirmed the school district's responsibility to provide medical services to a student with disabilities. It traces the legal history of the issue, examines lines of case law underlying the decision, and discusses the likely…

  16. Medical Services: Preventive Dentistry

    DTIC Science & Technology

    2007-11-02

    hygienist b. DENTAC— dental activity c. DFO— dental fitness officer d. DODDS—Department of Defense Dependent Schools e. HSC—U.S. Army Health Services Command f...community health dental hygienist (CHDH) in implementing these programs. (3) Coordinate with the preventive medicine activity and post or installation...aspects of preven- tive dentistry and dental public health programs. j. The community health dental hygienist , where assigned, will assist the DFO as

  17. Medical Services: Preventive Medicine

    DTIC Science & Technology

    2007-11-02

    and non - ionizing radiation, to include licensing and authorizations, personal protective measures, radiation detection and measuring equipment, control...located at and providing OH services primarily for non -DA(such as the Defense Logistics Agency (DLA)) installations. (2) The DA Form 3076 will be...failure. Hepatitis A and non -A non -B hepa- titis are transmitted by the fecal-oral route, while hepatitis B is transmitted through the exchange of

  18. [Medical Service of the Lithuanian Armed Forces].

    PubMed

    Golota, A S; Ivanov, V V; Krassii, A B; Mironov, V G; Soldatov, E A; Shalakhin A A

    2016-01-01

    The article is a brief description of the current state of Lithuanian Armed Forces medical service and is based on the study of the open access foreign sources. At the beginning, the general information about Lithuania, its Armed Forces, and their, medical service is presented. Then the medical service particular features are described, with more detail, namely, the organization of the inpatient and outpatient treatment, medical supply, scientific research, combat medicine, medical staff education and training, medical service personnel income.

  19. 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,…

  20. Consumer Perception of Inpatient Medical Services

    PubMed Central

    Takase, Kozo

    2016-01-01

    Although it is currently popular to reflect consumers’ perspectives to medical service management, insufficient attempts have been made to understand detailed perception of the consumer side of medical services to promote medical services’ evaluation from the consumer viewpoint. The aim of this study was to descriptively reveal how consumers perceive medical services that they receive, focusing on inpatient medical services. We conducted semi-structured interviews with 10 adults who experienced hospitalization of five or more days. Constant comparative analysis was performed on the obtained descriptive data. We identified 1) medical procedures, 2) explanations from medical professionals, 3) behavior of medical service providers, 4) somatic sensations, and 5) self-perceived physical conditions as target factors that medical service consumers perceived during hospitalization. The response to the perceived target factors, “compared with the expectation that the consumer had before the hospitalization,” suggests that it is an important medical service consumer reaction to check if the service met their expectations for perceived factors. The response to the medical services perception targets suggested that medical service consumers are involved in medical services and interested in various perception targets. The expectations that medical service consumers have prior to hospitalization can largely influence inpatient medical services evaluation. PMID:27832165

  1. [Medical Service of the Norwegian Armed Forces].

    PubMed

    Golota, A S; Krassiĭ, A B; Morovikova, T V; Soldatov, E A

    2014-09-01

    The article is a brief description of the current state of the Norwegian Armed Forces medical service and is based on the study of the open access foreign sources. At the beginning, the general information about Norway, the Norwegian Armed Forces, and their medical service is presented: Then some particular features are described with more detail, namely, the organization of the inpatient and outpatient treatment, medical supply, scientific research, combat medicine, medical staff education and training, medical service personnel income.

  2. 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…

  3. 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

  4. 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

  5. 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.

  6. 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…

  7. Medical Services: Medical, Dental, and Veterinary Care

    DTIC Science & Technology

    2007-11-02

    Form 7397-R will be locally reproduced on 8 1/2- by 11-inch paper unless available electronically. A copy for reproduction purposes is located at the...Antihistamines c. Narcotic analgesics 2. a. Hypnotics and sedatives Avoid taking alcohol with this medication unless advised by physician. b. Oral hypoglycemic

  8. 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

  9. Medical Services: Armed Forces Medical Examiner System

    DTIC Science & Technology

    2007-11-02

    Armed Forces Medical Examiner system Procedural Guide. 3–4. Forensic dental identification The Forensic Dentistry Section of the Department of Oral...Pathology at AFIP and special consultants in forensic dentistry to the surgeons general of the Armed Forces will serve as the principal advisers to the...a. Courses and programs. (1) Forensic dentistry /odontology. (2) Aerospace pathology. (3) Basic forensic pathology. (4) Advanced forensic pathology

  10. Strategic management of Public Hospitals' medical services.

    PubMed

    Hao, Aimin; Yi, Tao; Li, Xia; Wei, Lei; Huang, Pei; Xu, Xinzhou; Yi, Lihua

    2016-01-01

    Purpose: The quality of medical services provided by competing public hospitals is the primary consideration of the public in determining the selection of a specific hospital for treatment. The main objective of strategic planning is to improve the quality of public hospital medical services. This paper provides an introduction to the history, significance, principles and practices of public hospital medical service strategy, as well as advancing the opinion that public hospital service strategy must not merely aim to produce but actually result in the highest possible level of quality, convenience, efficiency and patient satisfaction.

  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. 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…

  13. Advanced medical video services through context-aware medical networks.

    PubMed

    Doukas, Charalampos N; Maglogiannis, Ilias; Pliakas, Thomas

    2007-01-01

    The aim of this paper is to present a framework for advanced medical video delivery services, through network and patient-state awareness. Under this scope a context-aware medical networking platform is described. The developed platform enables proper medical video data coding and transmission according to both a) network availability and/or quality and b) patient status, optimizing thus network performance and telediagnosis. An evaluation platform has been developed based on scalable H.264 coding of medical videos. Corresponding results of video transmission over a WiMax network have proved the effectiveness and efficiency of the platform providing proper video content delivery.

  14. Medical Services: Veterinary/Medical Food Inspection and Laboratory Service

    DTIC Science & Technology

    2007-11-02

    or civilian equivalents will conduct sanitary inspections of commercial ice manufacturing estab- lishments and bottled water establishments in...establishments other than those of prime contractors Normally, veterinary/medical personnel inspect only the establish- ments that manufacture , process, store...through the manufacturing process. ( 2 ) T h e p r i m e c o n t r a c t o r d o e s n o t h a v e c o n t r o l p r o c e d u r e s 5AR 40–657/NAVSUPINST

  15. 48 CFR 871.201-3 - Medical services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Medical services. 871.201... Rehabilitation and Employment Service 871.201-3 Medical services. The medical services provided trainees under... any other medical service under the jurisdiction of the Veterans Health Administration to which...

  16. 48 CFR 871.201-3 - Medical services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Medical services. 871.201... Rehabilitation and Employment Service 871.201-3 Medical services. The medical services provided trainees under... any other medical service under the jurisdiction of the Veterans Health Administration to which...

  17. Ethics in the marketing of medical services.

    PubMed

    Latham, Stephen R

    2004-09-01

    This paper deals with the ethics of marketing medical services by physicians, medical groups, hospitals and other mainstream medical caregivers in the United States. It does not deal with pharmaceutical marketing, since that raises a number of special issues, some of them legal and some having to do with the unique culture of pharmaceutical marketing, which really ought to be dealt with separately. Nor does it touch on the little-explored field of marketing alternative and complementary medicine. It begins with a general description of what is included in "the marketing process." It then briefly tours some of the difficulties faced by those who would market medical services ethically, and ends with some comments on the relevance of professionalism to ethical marketing.

  18. Battered wives--measures by the social and medical services.

    PubMed Central

    Bergman, B.; Brismar, B.

    1990-01-01

    The social files and medical records of 98 acutely battered wives who attended a surgical emergency department were studied. Although all women had been hospitalized during the decade preceding the present incident, wife battering was documented in the records in only 18%. The majority of the women (73%) were also known to the social services, but battering was documented in less than half of the cases in the social service files. The measures taken by the social services to help the battered women consisted mainly of economic support and psychotherapy. The cooperation between the medical and social services and the police in cases of wife battering was very limited or non-existent. It is concluded that support given to battered women by the formal sources of aid is insufficient. The documentation of the cases is poor, there is a lack of practical measures and the cooperation between the authorities is limited. This study indicates that the social and medical services underestimate the importance of informal help sources like women's groups or shelters which often are the most valued resources by the battered women themselves. With improved cooperation between authorities and between formal and informal sources of aid the battered wives could be helped more effectively. PMID:2349163

  19. 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.

  20. Calibration services for medical applications of radiation

    SciTech Connect

    DeWerd, L.A.

    1993-12-31

    Calibration services for the medical community applications of radiation involve measuring radiation precisely and having traceability to the National Institute of Standards and Technology (NIST). Radiation therapy applications involve the use of ionization chambers and electrometers for external beams and well-type ionization chamber systems as well as radioactive sources for brachytherapy. Diagnostic x-ray applications involve ionization chamber systems and devices to measure other parameters of the x-ray machine, such as non-invasive kVp meters. Calibration laboratories have been established to provide radiation calibration services while maintaining traceability to NIST. New radiation applications of the medical community spur investigation to provide the future calibration needs.

  1. Short message service (SMS) texting as a method of communication during on call: prevalence and experience of medical staff in a large acute NHS Trust in the UK.

    PubMed

    Matharu, J; Hale, B; Ammar, M; Brennan, P A

    2016-10-01

    With the widespread use of smartphones, text messaging has become an accepted form of communication for both social and professional use in medicine. To our knowledge no published studies have assessed the prevalence and use of short message service (SMS) texting by doctors on call. We have used an online questionnaire to seek information from doctors in a large NHS Trust in the UK about their use of texting while on call, what they use it for, and whether they send images relevant to patients' care. We received 302 responses (43% response rate), of whom 166 (55%) used SMS while on call. There was a significant association between SMS and age group (p=0.005), with the 20-30-year-old group using it much more than the other age groups. Doctors in the surgical specialties used it significantly less than those in other speciality groups (p<0 .001). Texting while on call was deemed to be safe and reliable (p<0.001). Eighteen clinicians (11%) admitted to routinely sending images of patients by text, despite some being identifiable. Texting was mainly used to update colleagues on patients' progress and give information about times of ward rounds and meetings. With the increasing use of texting in healthcare, much of which seems to be unregulated, further work and detailed guidance is required on what information may be given to ensure confidentiality and that SMS is a safe and acceptable method of communication to use when on call.

  2. [Medical Service of the Latvian National Armed Forces].

    PubMed

    Aleinikov, S I; Golota, A S; Krassii, A B; Soldatov, E A; Shalakhin, R A

    2015-08-01

    The article is a brief description of the current state of the Latvian National Armed Forces medical service and is based on the study of the open access foreign sources. At the beginning, the general information about Latvia, its Armed Forces, and their medical service is presented. Then the medical service particular features are described with more detail, namely, the organization of inpatient and outpatient treatment, medical supply, scientific research, combat medicine, medical staff education and training, medical service personnel income.

  3. 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…

  4. 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…

  5. 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.

  6. Medication therapy management services: definitions and outcomes.

    PubMed

    Pellegrino, Annette N; Martin, Michelle T; Tilton, Jessica J; Touchette, Daniel R

    2009-01-01

    In the US, the Medicare Modernization Act of 2003 required that Medicare Part D insurers provide medication therapy management (MTM) services (MTMS) to selected beneficiaries, with the goals of providing education, improving adherence, or detecting adverse drug events and medication misuse. These broad goals and variety in MTM programmes available make assessment of these programmes difficult. The objectives of this article are to review the definitions of MTMS proposed by various stakeholders, and to summarize and evaluate the outcomes of MTMS consistent with those that may be offered in Medicare Part D or reimbursed by State Medicaid programmes. MTM programmes are approved by the Centers for Medicare and Medicaid Services (CMS). Pharmacy, medical and insurance organizations have provided guidelines and definitions for MTM programmes, distinguishing them from other types of community pharmacy activities. MTM has been distinguished from disease state management because of the focus on medications and multiple conditions. It differs from patient counselling because it is delivered independent of dispensing and involves collaboration with patients and providers. There is no consensus on the recommended mode of delivery (i.e. face-to-face or by telephone) for MTM. A MEDLINE search was conducted to identify articles published after 2000 using the search terms 'medication therapy management' and 'medication management'. Studies with outcomes evaluating community-based programmes consistent with MTMS, regardless of MTMS reimbursement source, were included in the review. Seven publications describing four MTMS were identified. For each of the identified articles, we describe the study design, service setting, inclusion criteria and outcomes. An additional three surveys describing multiple MTMS were identified and are summarized. Finally, ongoing efforts by CMS to evaluate the success of MTMS in the US are described. To date, there are limited outcomes available for MTMS

  7. Medical Services: Nutrition Standards and Education

    DTIC Science & Technology

    2001-06-15

    Army Regulation 40–25 BUMEDINST 10110.6 AFI 44-141 Medical Services Nutrition Standards and Education Headquarters Departments of the Army, Navy, and...YYYY) 15-06-2001 2. REPORT TYPE 3. DATES COVERED (FROM - TO) xx-xx-2001 to xx-xx-2001 4. TITLE AND SUBTITLE Nutrition Standards and Education...AFI 44–141 Nutrition Standards and Education This revision-- o Renames the recommended nutrient standards, changing the term from Military Recommended

  8. 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

  9. 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....

  10. 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...

  11. 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...

  12. 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...

  13. 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...

  14. 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...

  15. 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...

  16. 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...

  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. 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...

  19. 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...

  20. 29 CFR 1915.87 - Medical services and first aid.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Working Conditions § 1915.87 Medical services and first aid. (a) General requirement. The employer shall ensure that emergency medical services and first aid are readily accessible. (b) Advice and consultation... 29 Labor 7 2012-07-01 2012-07-01 false Medical services and first aid. 1915.87 Section...

  1. 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...

  2. 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...

  3. 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...

  4. 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...

  5. 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...

  6. 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...

  7. 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...

  8. 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...

  9. 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...

  10. 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...

  11. 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...

  12. 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...

  13. 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...

  14. 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...

  15. 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...

  16. 29 CFR 1915.87 - Medical services and first aid.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Working Conditions § 1915.87 Medical services and first aid. (a) General requirement. The employer shall ensure that emergency medical services and first aid are readily accessible. (b) Advice and consultation... 29 Labor 7 2014-07-01 2014-07-01 false Medical services and first aid. 1915.87 Section...

  17. 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...

  18. 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...

  19. 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...

  20. Collaborative social and medical service application.

    PubMed

    Petermann, C A; Buffone, G J; Bobroff, R B; Moore, D M; Dargahi, R; Moreau, D R; Gilson, H S; Li, Y; Fowler, J; Beck, J R

    1995-01-01

    Baylor College of Medicine has five Teen Health Clinics (THC) dispersed throughout Harris county. The population served by the clinics includes inner-city adolescent boys and girls 19 years of age and under. Patients receive services such as family planning, sexually transmitted disease screening and treatment, perinatal care, counseling, and support services. Adolescents may receive services at any one of the clinics at no cost to the adolescent or their dependents. Given the geographical distribution of the clinics and the reliance on paper-based records, client services cannot be provided efficiently or expeditiously. According to the statistics developed by Clinic staff, ineffective coordination of service needs and client schedules undermine the follow-up needed for effective care. For example, a counselor will often need to balance a school schedule, clinic visits, well baby follow-up, and the Best Friends Program for a new mother. In addition, the lack of ready access to patient information impairs the ability of clinical and social service staff to provide continuity of care. In fact, some cases of client dropout are attributable to these difficulties. We have developed the Collaborative Social and Medical Service Application (CSMSA) to facilitate the provision of social and medical services to this population. The CSMSA is a domain-specific application based on a robust infrastructure known as the Ambulatory Services Architecture (ASA). This system is designed to support integrated social and ambulatory care. The ASA is a Baylor developed application framework and architecture for the computerization of the patient medical record in the ambulatory care setting. The working environment for the CSMSA user is an integrated desktop which provides an operating environment for both third-party applications and the CSMSA, as well as a fundamental set of services. The integrated desktop services include a mechanism for object organization or grouping, a facility

  1. 29 CFR 1910.151 - Medical services and first aid.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 5 2013-07-01 2013-07-01 false Medical services and first aid. 1910.151 Section 1910.151..., DEPARTMENT OF LABOR OCCUPATIONAL SAFETY AND HEALTH STANDARDS Medical and First Aid § 1910.151 Medical services and first aid. (a) The employer shall ensure the ready availability of medical personnel...

  2. 29 CFR 1910.151 - Medical services and first aid.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 5 2011-07-01 2011-07-01 false Medical services and first aid. 1910.151 Section 1910.151..., DEPARTMENT OF LABOR OCCUPATIONAL SAFETY AND HEALTH STANDARDS Medical and First Aid § 1910.151 Medical services and first aid. (a) The employer shall ensure the ready availability of medical personnel...

  3. 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

  4. 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

  5. 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.

  6. 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

  7. 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.

  8. 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

  9. 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.

  10. Delinquent Medical Service Accounts at Naval Medical Center Portsmouth Need Additional Management Oversight

    DTIC Science & Technology

    2015-03-04

    and Surgery CAC Common Access Card CRS Centralized Receivables Service DoD FMR DoD Financial Management Regulation MSA Medical Service Account MTF...H 4 , 2 0 1 5 Delinquent Medical Service Accounts at Naval Medical Center Portsmouth Need Additional Management Oversight Report No. DODIG-2015...04 MAR 2015 2. REPORT TYPE 3. DATES COVERED 00-00-2015 to 00-00-2015 4. TITLE AND SUBTITLE Delinquent Medical Service Accounts at Naval

  11. Integrating traditional nursing service orientation content with electronic medical record orientation.

    PubMed

    Harton, Brenda B; Borrelli, Larry; Knupp, Ann; Rogers, Necolen; West, Vickie R

    2009-01-01

    Traditional nursing service orientation classes at an acute care hospital were integrated with orientation to the electronic medical record to blend the two components in a user-friendly format so that the learner is introduced to the culture, processes, and documentation methods of the organization, with an opportunity to document online in a practice domain while lecture and discussion information is fresh.

  12. 31 CFR 597.511 - In-kind donations of medicine, medical devices, and medical services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false In-kind donations of medicine... Licensing Policy § 597.511 In-kind donations of medicine, medical devices, and medical services. (a... medicine, medical devices, and medical services to the Palestinian Authority Ministry of Health,...

  13. Chat reference service in medical libraries: part 2--Trends in medical school libraries.

    PubMed

    Dee, Cheryl R

    2003-01-01

    An increasing number of medical school libraries offer chat service to provide immediate, high quality information at the time and point of need to students, faculty, staff, and health care professionals. Part 2 of Chat Reference Service in Medical Libraries presents a snapshot of the current trends in chat reference service in medical school libraries. In late 2002, 25 (21%) medical school libraries provided chat reference. Trends in chat reference services in medical school libraries were compiled from an exploration of medical school library Web sites and informal correspondence from medical school library personnel. Many medical libraries are actively investigating and planning new chat reference services, while others have decided not to pursue chat reference at this time. Anecdotal comments from medical school library staff provide insights into chat reference service.

  14. 48 CFR 752.228-70 - Medical Evacuation (MEDEVAC) Services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Medical Evacuation... Clauses 752.228-70 Medical Evacuation (MEDEVAC) Services. As prescribed in 728.307-70, for use in all contracts requiring performance overseas: Medical Evacuation (MEDEVAC) Services (JUL 2007) (a)...

  15. 10 CFR 35.2080 - Records of mobile medical services.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 1 2014-01-01 2014-01-01 false Records of mobile medical services. 35.2080 Section 35.2080 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Records § 35.2080 Records of mobile medical services. (a) A licensee shall retain a copy of each letter that permits the use...

  16. 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...

  17. 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...

  18. 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...

  19. Insurance and the utilization of medical services.

    PubMed

    Meer, Jonathan; Rosen, Harvey S

    2004-05-01

    Most data sets indicate a positive correlation between having health insurance and utilizing health care services. Yet the direction of causality is not at all clear. If we observe a positive correlation between the utilization of health care services and insurance status, we do not know if this is because people who anticipate poor health buy more insurance (or take jobs with generous medical coverage), or because insurance lowers the cost of health care, increasing the quantity demanded. While a few attempts have been made to implement an instrumental variables (IV) strategy to deal with endogeneity, the instruments chosen have not been entirely convincing. In this paper we revisit the IV estimation of the reduced form relationships between insurance and health care utilization taking advantage of what we argue is a good instrument-the individual's self-employment status. Our main finding is that a positive and statistically significant effect of insurance continues to obtain even after instrumenting. Indeed, instrumental variables estimates of the impact of insurance on utilization of a variety of health care services are larger than their non-instrumented counterparts. The validity of this exercise depends on the extent to which self-employment status is a suitable instrument. To argue this case, we analyze panel data on transitions from wage-earning into self-employment and show that individuals who select into self-employment do not differ systematically from those who remain wage-earners with respect to either the utilization of health care or health status. While this finding does not prove that self-employment status is an appropriate instrument, it is encouraging that there appear to be no underlying differences that might lead to self-employment per se affecting health services utilization.

  20. Service Learning in Medical Education: Project Description and Evaluation

    ERIC Educational Resources Information Center

    Borges, Nicole J.; Hartung, Paul J.

    2007-01-01

    Although medical education has long recognized the importance of community service, most medical schools have not formally nor fully incorporated service learning into their curricula. To address this problem, we describe the initial design, development, implementation, and evaluation of a service-learning project within a first-year medical…

  1. 76 FR 37201 - Reimbursement Offsets for Medical Care or Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-24

    ... Care or Services; Final Rule #0;#0;Federal Register / Vol. 76, No. 122 / Friday, June 24, 2011 / Rules... Offsets for Medical Care or Services AGENCY: Department of Veterans Affairs. ACTION: Final rule. SUMMARY... reimbursement of medical care and services delivered to veterans for nonservice-connected conditions. This...

  2. [Quality of German medical services: a review].

    PubMed

    Braun, J; Robbers, J; Lakomek, H-J

    2016-02-01

    In the current draft of the law on the reform of the support structures of hospital provision (German Hospital Structure Law) the future quality of provision is highly significant. Quality assurance measures are mandatory for hospitals. The Federal General Committee was legally charged with developing the relevant quality indicators for structural, procedural and outcome quality that are designed to form the criteria and the basis for planning decisions in the federal states. This involves a paradigm shift in quality assurance measures in hospitals. In the future, subject to the verified quality, this should have an influence on hospital planning, and the funding or regulation of hospital departments should also adhere to this prescribed quality. This review reveals the course of quality or quality assurance measures in medical services in Germany. The status of the institutions responsible for the quality of care in hospitals and the significance of quality indicators are explained.

  3. 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.

  4. 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.

  5. 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.

  6. 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

  7. [Current problems of information technologies application for forces medical service].

    PubMed

    Ivanov, V V; Korneenkov, A A; Bogomolov, V D; Borisov, D N; Rezvantsev, M V

    2013-06-01

    The modern information technologies are the key factors for the upgrading of forces medical service. The aim of this article is the analysis of prospective information technologies application for the upgrading of forces medical service. The authors suggested 3 concepts of information support of Russian military health care on the basis of data about information technologies application in the foreign armed forces, analysis of the regulatory background, prospects of military-medical service and gathered experience of specialists. These three concepts are: development of united telecommunication network of the medical service of the Armed Forces of the Russian Federation medical service, working out and implementation of standard medical information systems for medical units and establishments, monitoring the military personnel health state and military medical service resources. It is noted that on the assumption of sufficient centralized financing and industrial implementation of the military medical service prospective information technologies, by the year 2020 the united information space of the military medical service will be created and the target information support effectiveness will be achieved.

  8. 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

  9. 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.

  10. 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.

  11. Service-Oriented Security Framework for Remote Medical Services in the Internet of Things Environment

    PubMed Central

    Lee, Jae Dong; Yoon, Tae Sik; Chung, Seung Hyun

    2015-01-01

    Objectives Remote medical services have been expanding globally, and this is expansion is steadily increasing. It has had many positive effects, including medical access convenience, timeliness of service, and cost reduction. The speed of research and development in remote medical technology has been gradually accelerating. Therefore, it is expected to expand to enable various high-tech information and communications technology (ICT)-based remote medical services. However, the current state lacks an appropriate security framework that can resolve security issues centered on the Internet of things (IoT) environment that will be utilized significantly in telemedicine. Methods This study developed a medical service-oriented frame work for secure remote medical services, possessing flexibility regarding new service and security elements through its service-oriented structure. First, the common architecture of remote medical services is defined. Next medical-oriented secu rity threats and requirements within the IoT environment are identified. Finally, we propose a "service-oriented security frame work for remote medical services" based on previous work and requirements for secure remote medical services in the IoT. Results The proposed framework is a secure framework based on service-oriented cases in the medical environment. A com parative analysis focusing on the security elements (confidentiality, integrity, availability, privacy) was conducted, and the analysis results demonstrate the security of the proposed framework for remote medical services with IoT. Conclusions The proposed framework is service-oriented structure. It can support dynamic security elements in accordance with demands related to new remote medical services which will be diversely generated in the IoT environment. We anticipate that it will enable secure services to be provided that can guarantee confidentiality, integrity, and availability for all, including patients, non-patients, and medical

  12. 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.

  13. 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

  14. 42 CFR 440.50 - Physicians' services and medical and surgical services of a dentist.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Definitions § 440.50 Physicians' services and medical and surgical services of a dentist. (a) “Physicians... 42 Public Health 4 2010-10-01 2010-10-01 false Physicians' services and medical and surgical services of a dentist. 440.50 Section 440.50 Public Health CENTERS FOR MEDICARE & MEDICAID...

  15. 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).

  16. Biomedical equipment and medical services in India.

    PubMed

    Sahay, K B; Saxena, R K

    Varieties of Biomedical Equipment (BME) are now used for quick diagnosis, flawless surgery and therapeutics etc. Use of a malfunctioning BME could result in faulty diagnosis and wrong treatment and can lead to damaging or even devastating aftermath. Modern Biomedical Equipments inevitably employ highly sophisticated technology and use complex systems and instrumentation for best results. To the best of our knowledge the medical education in India does not impart any knowledge on the theory and design of BME and it is perhaps not possible also. Hence there is need for a permanent mechanism which can maintain and repair the biomedical equipments routinely before use and this can be done only with the help of qualified Clinical Engineers. Thus there is a genuine need for well organized cadre of Clinical Engineers who would be persons with engineering background with specialization in medical instrumentation. These Clinical engineers should be made responsible for the maintenance and proper functioning of BME. Every hospital or group of hospitals in the advanced countries has a clinical engineering unit that takes care of the biomedical equipments and systems in the hospital by undertaking routine and preventive maintenance, regular calibration of equipments and their timely repairs. Clinical engineers should be thus made an essential part of modern health care system and services. Unfortunately such facilities and mechanism do not exist in India. To make BME maintenance efficient and flawless in India, study suggests following measures and remedies: (i) design and development of comprehensive computerized database for BME (ii) cadre of Clinical engineers (iii) online maintenance facility and (iv) farsighted managerial skill to maximize accuracy, functioning and cost effectiveness.

  17. 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.

  18. 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

  19. Chat reference service in medical libraries: part 1--An introduction.

    PubMed

    Dee, Cheryl R

    2003-01-01

    Chat reference services offer the opportunity to provide immediate access to quality information to meet the medical information needs of students, faculty, staff, physicians, nurses, and allied health care professionals. Part 1 of this two-part article on chat reference service in medical libraries is an introduction to the management of chat reference services and to features available for chat reference. The management of chat reference services raises issues of planning, staffing, selecting, and marketing. Planning issues focus on the identification of the users, the users' medical information needs, and the users' information-seeking behavior. Staffing issues relate to the selection of chat hours, the location of the chat service, and participation in collaborative agreements. Selecting chat software weighs the sophistication of the chat features against the related cost. Marketing uses techniques similar to traditional reference services and often begins slowly as chat expertise develops. Part 2 of the article discusses trends in chat reference services in medical libraries.

  20. 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.

  1. 31 CFR 595.513 - In-kind donations of medicine, medical devices, and medical services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false In-kind donations of medicine, medical... donations of medicine, medical devices, and medical services. (a) Effective July 6, 2006, nongovernmental organizations that are U.S. persons are authorized to provide in-kind donations of medicine, medical...

  2. 31 CFR 595.513 - In-kind donations of medicine, medical devices, and medical services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false In-kind donations of medicine, medical... donations of medicine, medical devices, and medical services. (a) Effective July 6, 2006, nongovernmental organizations that are U.S. persons are authorized to provide in-kind donations of medicine, medical...

  3. 31 CFR 595.513 - In-kind donations of medicine, medical devices, and medical services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false In-kind donations of medicine, medical... donations of medicine, medical devices, and medical services. (a) Effective July 6, 2006, nongovernmental organizations that are U.S. persons are authorized to provide in-kind donations of medicine, medical...

  4. 31 CFR 595.513 - In-kind donations of medicine, medical devices, and medical services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false In-kind donations of medicine, medical... donations of medicine, medical devices, and medical services. (a) Effective July 6, 2006, nongovernmental organizations that are U.S. persons are authorized to provide in-kind donations of medicine, medical...

  5. 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...

  6. 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...

  7. [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.

  8. 29 CFR 1926.50 - Medical services and first aid.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 8 2014-07-01 2014-07-01 false Medical services and first aid. 1926.50 Section 1926.50... Environmental Controls § 1926.50 Medical services and first aid. (a) The employer shall insure the availability... employees, a person who has a valid certificate in first-aid training from the U.S. Bureau of Mines,...

  9. 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...

  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. 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 ...

  1. 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...

  2. 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...

  3. 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...

  4. 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...

  5. 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...

  6. 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...

  7. 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...

  8. 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...

  9. 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...

  10. 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...

  11. 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.

  12. [SOROKA UNIVERSITY MEDICAL CENTER: THE ROAD TO LEADERSHIP IN QUALITY OF MEDICAL CARE, SERVICE AND RESEARCH].

    PubMed

    Davidson, Ehud; Sheiner, Eyal

    2016-02-01

    Soroka University Medical Center is a tertiary hospital, and the sole medical center in the Negev, the southern part of Israel. Soroka has invested in quality, service and research. The region has developed joint programs in order to advance the quality of medical care whilst optimizing the utilization of available resources. In this editorial we describe the path to leadership in quality of medical care, service and research.

  13. A service-oriented medical framework for fast and adaptive information delivery in mobile environment.

    PubMed

    Park, Eunjeong; Nam, Hyo Suk

    2009-11-01

    The need for fast treatment of patients in critical conditions motivates the use of mobile devices to provide prompt and consistent communication between hospitals and physicians. We propose a framework that supports ubiquitous access to medical systems using personalized mobile services and integrated medical systems. The proposed service-oriented medical framework provides dynamically composed services that are adapted to contextual variables such as the user's role, the network bandwidth, and resources available at mobile devices while supporting task allocation in distributed servers for massive resource-consuming services. It also manages accurate patient data by integrating local medical systems using medical information standards such as Digital Imaging and Communications in Medicine and Health Level 7. We have demonstrated the effectiveness of our framework by building a prototype of context-based adaptation of computerized tomography image retrieval for acute stroke treatments, which allows images to be viewed on mobile devices with WiMax wireless network. The proposed medical framework reduces hospital delays of patients and facilitates treatments in the absence of medical specialists.

  14. 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.

  15. 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."

  16. [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.

  17. [Medical services at Paris-Charles-de-Gaulle airport].

    PubMed

    Bargain, Philippe

    2015-01-01

    Charles-de-Gaulle airport in Roissy, a 3 400 hectare citadel, contains a multitude of airlines, service companies, businesses, retailers and public services, including firefighters, police officers, customs officers, ministers and medical teams. This article presents its missions, notably with regard to health services.

  18. Medicare's bundling pilot: including post-acute care services.

    PubMed

    Dummit, Laura A

    2011-03-28

    Fee-for-service Medicare, in which a separate payment is made for each service, rewards health care providers for delivering more services, but not necessarily coordinating those services over time or across settings. To help address these concerns, the Patient Protection and Affordable Care Act of 2010 requires Medicare to experiment with making a bundled payment for a hospitalization plus post-acute care, that is, the recuperative or rehabilitative care following a hospital discharge. This bundled payment approach is intended to promote more efficient care across the acute/post-acute episode because the entity that receives the payment has financial incentives to keep episode costs below the payment. Although the entity is expected to control costs through improved care coordination and efficiency, it could stint on care or avoid expensive patients instead. This issue brief focuses on the unique challenges posed by the inclusion of post-acute care services in a payment bundle and special considerations in implementing and evaluating the episode payment approach.

  19. Acute forensic medical procedures used following a sexual assault among treatment-seeking women.

    PubMed

    Dunlap, Hester; Brazeau, Paulette; Stermac, Lana; Addison, Mary

    2004-01-01

    Despite the negative physical and mental health outcomes of sexual assault, a minority of sexually assaulted women seek immediate post-assault medical and legal services. This study identified the number and types of acute forensic medical procedures used by women presenting at a hospital-based urgent care centre between 1997 and 2001 within 72 hours following a reported sexual assault. The study also examined assault and non-assault factors associated with the use of procedures. It was hypothesized that assault characteristics resembling the stereotype of rape would be associated with the use of more procedures. The multiple regression indicated that injury severity, coercion severity, homelessness, and delay in presentation were significantly associated with the number of procedures received. Findings provide partial support for the hypothesis that post-assault procedures would be associated with the stereotype of rape, and highlight homeless women as a group particularly at risk for not receiving adequate medical treatment following a sexual assault.

  20. Linking radiology equipment service and medical physics survey databases.

    PubMed

    David, George; Burnett, Lou Ann; Schenkel, Robert

    2004-01-01

    During the performance of medical physics surveys on diagnostic imaging equipment, it is not unusual to find problems requiring service. In the work described in this article, two existing and separate databases, one for radiology equipment maintenance and the other for medical physics surveys were linked. By linking the two databases we have closed the loop in our documentation. The two databases are integrated so that when logging a survey, a single mouse click will allow the user to initiate a service call and link it to the survey. In addition, any survey linked to a service call permits the user to view the service record with a single mouse click. This allows us within the medical physics database to document the resolution of problems as well as to keep track of the status of service calls initiated as a result of medical physics surveys.

  1. Abortion Services and Military Medical Facilities

    DTIC Science & Technology

    2010-07-08

    payments prohibited for drugs or devices to prevent implantation of the fertilized ovum , or for medical procedures necessary for the termination of an...fertilized ovum , or for medical procedures necessary for the termination of an ectopic pregnancy: Provided, however, That the several States are and

  2. Abortion Services and Military Medical Facilities

    DTIC Science & Technology

    2010-12-16

    are payments prohibited for drugs or devices to prevent implantation of the fertilized ovum , or for medical procedures necessary for the termination...the fertilized ovum , or for medical procedures necessary for the termination of an ectopic pregnancy: Provided, however, That the several States are

  3. Randomised controlled trial of a transprofessional healthcare role intervention in an acute medical setting.

    PubMed

    Kaltner, Melissa; Murtagh, Doug; Bennetts, Marguerite; Pighills, Alison; James, Julie; Scott, Annette

    2017-03-01

    As demand for health services increases, attention has turned to the development of alternate models of service delivery that maximise efficiency. These include skill sharing models, in which cross-professional skills are delivered by appropriately trained professionals. The usage of skill sharing models is increasing in some professions, but little evidence on efficacy currently exists. This article reports on an intervention of the use of a transprofessional role, which involved delivery of services from a range of health providers, including physiotherapy, occupational therapy, dietetics, speech pathology, podiatry, social work, and psychology, by a trained professional, developed and trialled in the acute medical setting in Toowoomba Hospital, Queensland, Australia. A single-blind randomised controlled trial examined the clinical efficacy of this skill shared service. Participants were allocated at random to either standard care (n = 29) or the new model of care (n = 29) groups and compared on a range of patient and service provision outcome measures. Descriptive outcomes indicated that patients receiving the new model of care underwent more comprehensive and prompt assessments in the health domains included than those in standard care, and demonstrated more positive health and functional outcomes at 1-, 3-, and 6-month follow-up. Given the paucity of research on skill sharing, this study provides preliminary evidence of the effectiveness of skill shared roles in acute settings.

  4. 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.

  5. Medical Services: Nursing Records and Reports

    DTIC Science & Technology

    2007-11-02

    Record—Nursing Discharge Summary) • 2–11, page 5 SF 511 (Clinical Record—Vital Signs Record) • 2–12, page 6 SF 536 (Clinical Record— Pediatric Nursing...Notes) • 2–13, page 6 SF 537 (Medical Record— Pediatric Graphic Chart) • 2–14, page 6 SF 539 (Medical Record—Abbreviated Medical Record) • 2–15, page 6...the 24–hour total of the patient’s intake and output. 2–13. SF 536 (Clinical Record— Pediatric Nursing Notes) This form may be used for pediatric

  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. 31 CFR 594.515 - In-kind donations of medicine, medical devices, and medical services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false In-kind donations of medicine, medical...-kind donations of medicine, medical devices, and medical services. (a) Effective July 6, 2006, nongovernmental organizations that are U.S. persons are authorized to provide in-kind donations of...

  9. 31 CFR 597.511 - In-kind donations of medicine, medical devices, and medical services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false In-kind donations of medicine, medical... § 597.511 In-kind donations of medicine, medical devices, and medical services. (a) Effective July 6... provision by nongovernmental organizations that are U.S. persons of in-kind donations of medicine,...

  10. 31 CFR 594.515 - In-kind donations of medicine, medical devices, and medical services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false In-kind donations of medicine, medical...-kind donations of medicine, medical devices, and medical services. (a) Effective July 6, 2006, nongovernmental organizations that are U.S. persons are authorized to provide in-kind donations of...

  11. 31 CFR 597.511 - In-kind donations of medicine, medical devices, and medical services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false In-kind donations of medicine, medical... § 597.511 In-kind donations of medicine, medical devices, and medical services. (a) Effective July 6... provision by nongovernmental organizations that are U.S. persons of in-kind donations of medicine,...

  12. 31 CFR 597.511 - In-kind donations of medicine, medical devices, and medical services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false In-kind donations of medicine, medical... § 597.511 In-kind donations of medicine, medical devices, and medical services. (a) Effective July 6... provision by nongovernmental organizations that are U.S. persons of in-kind donations of medicine,...

  13. 31 CFR 594.515 - In-kind donations of medicine, medical devices, and medical services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false In-kind donations of medicine, medical...-kind donations of medicine, medical devices, and medical services. (a) Effective July 6, 2006, nongovernmental organizations that are U.S. persons are authorized to provide in-kind donations of...

  14. 31 CFR 597.511 - In-kind donations of medicine, medical devices, and medical services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false In-kind donations of medicine, medical... § 597.511 In-kind donations of medicine, medical devices, and medical services. (a) Effective July 6... provision by nongovernmental organizations that are U.S. persons of in-kind donations of medicine,...

  15. 31 CFR 594.515 - In-kind donations of medicine, medical devices, and medical services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false In-kind donations of medicine, medical...-kind donations of medicine, medical devices, and medical services. (a) Effective July 6, 2006, nongovernmental organizations that are U.S. persons are authorized to provide in-kind donations of...

  16. Would Older Medical Patients Use Psychological Services?

    ERIC Educational Resources Information Center

    Arean, Patricia A.; Alvidrez, Jennifer; Barrera, Alinne; Robinson, Gia S.; Hicks, Scotia

    2002-01-01

    Surveyed patients (N=183) aged 55 and older on their current level of psychiatric distress and preferences for psychological services. Seventy-nine percent stated they would use any psychological services presented to them. Few said they would attend group psychotherapy but more than half said they would attend psychoeducational classes. Discusses…

  17. 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

  18. Medical Services: Medical Record Administration and Health Care Documentation

    DTIC Science & Technology

    2013-01-31

    liter lab laboratory lac laceration lap laparotomy laser ; LASER light amplification by stimulated emission of radiation lat lateral lb pound L/B live...Social Work Service sx signs; symptoms sys system T temperature T&A tonsillectomy and adenoidectomy tab tablet TAH total abdominal hysterectomy TB

  19. 42 CFR 409.24 - Medical social services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... PROGRAM HOSPITAL INSURANCE BENEFITS Posthospital SNF Care § 409.24 Medical social services. Medicare pays... emotional factors related to the beneficiary's illness, need for care, response to treatment, and...

  20. [The digital information platform after-sale service of medical equipment].

    PubMed

    Cao, Shaoping; Li, Bin

    2015-01-01

    This paper describes the after-sale service of medical equipment information management platform, with large data sharing resources to further enhance customer service in the whole management process of medical service, to strengthen quality management, to control medical risk.

  1. 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...

  2. 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...

  3. 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,...

  4. 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,...

  5. 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....

  6. 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...

  7. 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...

  8. 10 CFR 35.2080 - Records of mobile medical services.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Records of mobile medical services. 35.2080 Section 35.2080 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Records § 35.2080 Records... instrument used to make the survey, and the name of the individual who performed the survey....

  9. 10 CFR 35.80 - Provision of mobile medical service.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 1 2012-01-01 2012-01-01 false Provision of mobile medical service. 35.80 Section 35.80 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL General Technical Requirements... use of byproduct material at the client's address and clearly delineates the authority...

  10. 10 CFR 35.80 - Provision of mobile medical service.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 1 2014-01-01 2014-01-01 false Provision of mobile medical service. 35.80 Section 35.80 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL General Technical Requirements... use of byproduct material at the client's address and clearly delineates the authority...

  11. 10 CFR 35.80 - Provision of mobile medical service.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 1 2013-01-01 2013-01-01 false Provision of mobile medical service. 35.80 Section 35.80 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL General Technical Requirements... use of byproduct material at the client's address and clearly delineates the authority...

  12. 10 CFR 35.80 - Provision of mobile medical service.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 1 2011-01-01 2011-01-01 false Provision of mobile medical service. 35.80 Section 35.80 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL General Technical Requirements... use of byproduct material at the client's address and clearly delineates the authority...

  13. 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…

  14. Tele-pharmacy in remote medical practice: the Royal Flying Doctor Service Medical Chest Program.

    PubMed

    Margolis, S A; Ypinazar, V A

    2008-01-01

    In recent times remote medical practice has been developed into a unique discipline in its own right with telehealth one of the eight defining key features. Since 1942, the telemedicine consultation service provided by the Royal Flying Doctor Service in Australia has been supported by a tele-pharmacy program known as the Medical Chest Program. The contents of the chest comprise more than 85 items, including medications and equipment which can be prescribed during a telehealth consultation to cover both emergency care and definitive treatment for less serious conditions. By 2006 there were 3500 medical chests placed throughout Australia. Specifically, the state of Queensland had 21 470 telehealth consultations from 1 July 2005 to 30 June 2006, resulting in the prescription of at least one medical chest item in 2938 (13.7%) consultations. Queensland data regarding medication indicate that antibiotics (26%), analgesics (23%) and gastrointestinal medications (12%) were the most common categories of dispensed medications, and that the most common clinical diagnostic categories for the consultation resulting in dispensed medications were respiratory (17%), skin (15%) and abdominal conditions (13%). In summary, the RFDS medical chest program continues to be a successful large scale provider of medications to those living in remote Australia, enabling early access to medications for both emergencies and definitive care, while minimising the need for mail-order pharmacy or patient travel. This model of care may provide an important template for those designing service delivery models in other remote jurisdictions.

  15. 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.

  16. 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.

  17. The contribution of hospital library services to continuing medical education.

    PubMed

    Gluck, Jeannine Cyr

    2004-01-01

    Much of the literature relating to continuing medical education programs laments the lack of effectiveness of traditional lecture-based format, the most often used method of presentation in hospitals. A gap exists between the content taught in lectures and the application of that knowledge in actual patient care. The services of the medical librarian, already employed in most hospitals, can help ameliorate this problem. Further, libraries help to support quality improvement efforts. These three functions (library services, continuing medical education, and quality improvement) are interdependent. Each lends strength to the other, and, ideally, all are coordinated within the hospital structure.

  18. Medical students' attitudes toward abortion and other reproductive health services.

    PubMed

    Rosenblatt, R A; Robinson, K B; Larson, E H; Dobie, S A

    1999-03-01

    This paper investigated the attitude toward abortion and other reproductive health services of first- and second-year medical students at the Seattle campus of the University of Washington, a large regional primary care-oriented medical school, in 1996-97. A total of 219 (76.6%) students responded. The majority of the students support the availability of a broad range of reproductive health services including abortion; 58.1% felt that first-trimester abortions should be available to patients under most circumstances. Of the 43.4% of students who anticipated a career in family practice, most expected to provide abortions in their future practices. Moreover, older students and women were more likely to support the provision of abortion services. This study concludes that despite the continuing pressure on abortion providers, most first- and second-year medical students at a fairly state-supported medical school intend to incorporate this procedure into their future practices.

  19. Family Medicine/Northern Medical Services Involvement in Northern Saskatchewan

    PubMed Central

    Irvine, James

    1988-01-01

    To address the problems of recruitment and retention of family physicians in various remote locations in northern Saskatchewan, the University of Saskatchewan became involved through Northern Medical Services, a division of the Department of Family Medicine. The University's involvement consists of the provision of resident family-physician services, visiting consultant services, family-practise resident training, research, and a consulting role of the Medical Health Officer. This paper reviews the context in which this program was created, its role in health care in the area, and its involvement with the communities in health promotion and research. PMID:21253032

  20. Content-based management service for medical videos.

    PubMed

    Mendi, Engin; Bayrak, Coskun; Cecen, Songul; Ermisoglu, Emre

    2013-01-01

    Development of health information technology has had a dramatic impact to improve the efficiency and quality of medical care. Developing interoperable health information systems for healthcare providers has the potential to improve the quality and equitability of patient-centered healthcare. In this article, we describe an automated content-based medical video analysis and management service that provides convenience and ease in accessing the relevant medical video content without sequential scanning. The system facilitates effective temporal video segmentation and content-based visual information retrieval that enable a more reliable understanding of medical video content. The system is implemented as a Web- and mobile-based service and has the potential to offer a knowledge-sharing platform for the purpose of efficient medical video content access.

  1. Experiences of parenting a child with medical complexity in need of acute hospital care.

    PubMed

    Hagvall, Monica; Ehnfors, Margareta; Anderzén-Carlsson, Agneta

    2016-03-01

    Parents of children with medical complexity have described being responsible for providing advanced care for the child. When the child is acutely ill, they must rely on the health-care services during short or long periods of hospitalization. The purpose of this study was to describe parental experiences of caring for their child with medical complexity during hospitalization for acute deterioration, specifically focussing on parental needs and their experiences of the attitudes of staff. Data were gathered through individual interviews and analyzed using qualitative content analysis. The care period can be interpreted as a balancing act between acting as a caregiver and being in need of care. The parents needed skilled staff who could relieve them of medical responsibility, but they wanted to be involved in the care and in the decisions taken. They needed support, including relief, in order to meet their own needs and to be able to take care of their children. It was important that the child was treated with respect in order for the parent to trust the staff. An approach where staff view parents and children as a single unit, as recipients of care, would probably make the situation easier for these parents and children.

  2. Real-time medical collaboration services over the web.

    PubMed

    Andrikos, Christos; Rassias, Georgios; Tsanakas, Panayiotis; Maglogiannis, Ilias

    2015-08-01

    The gradual shift in modern medical practice, from working alone clinical doctors to MDTs (Multi-Disciplinary Teams), raises the need of online real-time collaboration among geographically distributed medical personnel. The paper presents a Web-based platform, featuring an efficient medical data management and exchange, for hosting real-time collaborative services. The presented work leverages state-of-the-art features of the web (technologies and APIs) to support client-side medical data processing. Moreover, to address the typical bandwidth bottleneck and known scalability issues of centralized data sharing, an indirect RPC (Remote Process Call) scheme is introduced through object synchronization over the WebRTC paradigm.

  3. 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…

  4. An overview of infusing service-learning in medical education

    PubMed Central

    Wubbena, Zane

    2014-01-01

    Objectives To identify and review existing empirical research about service-learning and medical education and then to develop a framework for infusing service-learning in Doctor of Medicine or Doctor of Osteopathic Medicine curricula. Methods We selected literature on service-learning and medical education. Articles were screened with a protocol for inclusion or exclusion at two separate stages. At stage one, articles were screened according to their titles, abstracts, and keywords. The second stage involved a full-text review. Finally, a thematic analysis using focused and selective coding was conducted. Results Eighteen studies were analyzed spanning the years 1998 to 2012. The results from our analysis informed the development of a four-stage service-learning framework: 1) planning and preparation, 2) action, 3) reflection and demonstration, and 4) assessment and celebration. Conclusions The presented service-learning framework can be used to develop curricula for the infusion of service-learning in medical school. Service-learning curricula in medical education have the potential to provide myriad benefits to faculty, students, community members, and university-community partnerships. PMID:25341224

  5. 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.

  6. [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.

  7. 3D Medical Volume Reconstruction Using Web Services

    PubMed Central

    Kooper, Rob; Shirk, Andrew; Lee, Sang-Chul; Lin, Amy; Folberg, Robert; Bajcsy, Peter

    2008-01-01

    We address the problem of 3D medical volume reconstruction using web services. The use of proposed web services is motivated by the fact that the problem of 3D medical volume reconstruction requires significant computer resources and human expertise in medical and computer science areas. Web services are implemented as an additional layer to a dataflow framework called Data to Knowledge. In the collaboration between UIC and NCSA, pre-processed input images at NCSA are made accessible to medical collaborators for registration. Every time UIC medical collaborators inspected images and selected corresponding features for registration, the web service at NCSA is contacted and the registration processing query is executed using the Image to Knowledge library of registration methods. Co-registered frames are returned for verification by medical collaborators in a new window. In this paper, we present 3D volume reconstruction problem requirements and the architecture of the developed prototype system at http://isda.ncsa.uiuc.edu/MedVolume. We also explain the tradeoffs of our system design and provide experimental data to support our system implementation. The prototype system has been used for multiple 3D volume reconstructions of blood vessels and vasculogenic mimicry patterns in histological sections of uveal melanoma studied by fluorescent confocal laser scanning microscope. PMID:18336808

  8. 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.

  9. 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

  10. 31 CFR 594.515 - In-kind donations of medicine, medical devices, and medical services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false In-kind donations of medicine....515 In-kind donations of medicine, medical devices, and medical services. (a) Effective July 6, 2006, nongovernmental organizations that are U.S. persons are authorized to provide in-kind donations of...

  11. 31 CFR 595.513 - In-kind donations of medicine, medical devices, and medical services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false In-kind donations of medicine...-kind donations of medicine, medical devices, and medical services. (a) Effective July 6, 2006, nongovernmental organizations that are U.S. persons are authorized to provide in-kind donations of...

  12. Twenty-first-century medical microbiology services in the UK.

    PubMed

    Duerden, Brian

    2005-12-01

    With infection once again a high priority for the UK National Health Service (NHS), the medical microbiology and infection-control services require increased technology resources and more multidisciplinary staff. Clinical care and health protection need a coordinated network of microbiology services working to consistent standards, provided locally by NHS Trusts and supported by the regional expertise and national reference laboratories of the new Health Protection Agency. Here, I outline my thoughts on the need for these new resources and the ways in which clinical microbiology services in the UK can best meet the demands of the twenty-first century.

  13. Medical relief activities conducted by Nippon Medical School in the acute phase of the Great East Japan Earthquake 2011.

    PubMed

    Fuse, Akira; Shuto, Yuki; Ando, Fumihiko; Shibata, Masafumi; Watanabe, Akihiro; Onda, Hidetaka; Masuno, Tomohiko; Yokota, Hiroyuki

    2011-01-01

    At 14:46 on March 11, 2011, the Great East Japan Earthquake and tsunami occurred off the coast of Honshu, Japan. In the acute phase of this catastrophe, one of our teams was deployed as a Tokyo Disaster Medical Assistance Team (DMAT) to Kudan Kaikan in Tokyo, where the ceiling of a large hall had partially collapsed as the result of the earthquake, to conduct triage at the scene: 6 casualties were assigned to the red category (immediate), which included 1 case of cardiopulmonary arrest and 1 of flail chest; 8 casualties in the yellow category (delayed); and 22 casualties in the green category (minor). One severely injured person was transported to our hospital. Separately, our medical team was deployed to Miyagi 2 hours after the earthquake in our multipurpose medical vehicle as part of Japan DMAT (J-DMAT). We were the first DMAT from the metropolitan area to arrive, but we were unable to start medical relief activities because the information infrastructure had been destroyed and no specific information had yet reached the local headquarters. Early next morning, J-DMAT decided to support Sendai Medical Center and search and rescue efforts in the affected area and to establish a staging care unit at Camp Kasuminome of the Japan Self-Defense Force. Our team joined others to establish the staging care unit. Because information was still confused until day 3 of the disaster and we could not adequately grasp onsite medical needs, our J-DMAT decided to provide onsite support at Ishinomaki Red Cross Hospital, a disaster base hospital, and relay information about its needs to the local J-DMAT headquarters. Although our medical relief teams were deployed as quickly as possible, we could not begin medical relief activities immediately owing to the severely damaged information infrastructure. Only satellite mobile phones could be operated, and information on the number of casualties and the severity of shortages of lifeline services could be obtained only through a "go and

  14. Bibliometric study of Medical Reference Services Quarterly, 1982-2009.

    PubMed

    Kenefick, Colleen; Werner, Susan E

    2011-01-01

    Medical Reference Services Quarterly began publication in 1982, covering topics of current interest and practical value to public services librarians in medical and related specialties. Since then, it has expanded in scope to include more aspects of health sciences librarianship. This article is a systematic study of all 428 peer-reviewed articles published from 1982 through 2009, with a comprehensive description of content and a citation analysis. Content is extensively analyzed for article subject, and cited references are examined for subject, type of cited material, and average age. In addition, author, institutional, and regional productivity is determined and ranked.

  15. [Improvement of medical equipment setting for the hospital link of the medical service during wartime].

    PubMed

    Miroshnichenko, Yu V; Goryachev, A B; Popov, A A; Rodionov, E O

    2016-04-01

    One of the priorities of the military health care is to improve the system of rationing medical equipment for the hospital unit of the medical service of the Armed Forces in wartime. This is determined the fact that the effectiveness of measures to provide military field hospitals with medical supplies depends on the quality of medical care for the wounded and sick, as well as the level of their return to duty. The article presents the characteristics of modern standards medical supplies procurement of military field hospitals included in the new regulatory legal act of the Russian Federation Ministry of Defence--"Standards of supplies medical supplies medical and pharmaceutical organizations (units) of the Russian Federation on the wartime armed forces", approved and put into effect in 2015 by order of the Minister of Defence of the Russian Federation.

  16. The Defence Medical Library Service and military medicine.

    PubMed

    Walker, S B

    2005-01-01

    The Defence Medical Library Service (DMLS) supports the clinical practice and career development of military health professionals across the world. Clinical governance and the need for medical knowledge to be evidence-based means the DMLS has a central role to play in support of defence medicine. The DMLS is important for enabling health professionals to make sense of the evidence-based pyramid and the hierarchy of medical knowledge. The Royal Centre for Defence Medicine (RCDM) in Birmingham is recognised as an international centre of excellence. The information, knowledge and research requirements of the RCDM will provide opportunities for the DMLS to support and engage with the academic community.

  17. 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...

  18. 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...

  19. Multiobjective location planning for primary medical services in rural Iowa

    SciTech Connect

    Hillsman, E. L.

    1980-01-01

    Developing location plans for primary medical services is a multiobjective location problem. In rural regions, plans must consider both the ability of a location to retain needed health care professionals and the accessibility of service center locations to the rural population. Using township level population data and a model of physician attrition, these objectives were incorporated into a location-allocation model and applied to rural Iowa.

  20. 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

  1. 42 CFR 409.12 - Nursing and related services, medical social services; use of hospital or CAH facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... services; use of hospital or CAH facilities. 409.12 Section 409.12 Public Health CENTERS FOR MEDICARE... services, medical social services; use of hospital or CAH facilities. (a) Except as provided in paragraph... facilities, and medical social services as inpatient hospital or inpatient CAH services only if...

  2. Service quality, trust, and patient satisfaction in interpersonal-based medical service encounters

    PubMed Central

    2013-01-01

    Background Interaction between service provider and customer is the primary core of service businesses of different natures, and the influence of trust on service quality and customer satisfaction could not be ignored in interpersonal-based service encounters. However, lack of existing literature on the correlation between service quality, patient trust, and satisfaction from the prospect of interpersonal-based medical service encounters has created a research gap in previous studies. Therefore, this study attempts to bridge such a gap with an evidence-based practice study. Methods We adopted a cross-sectional design using a questionnaire survey of outpatients in seven medical centers of Taiwan. Three hundred and fifty copies of questionnaire were distributed, and 285 valid copies were retrieved, with a valid response rate of 81.43%. The SPSS 14.0 and AMOS 14.0 (structural equation modeling) statistical software packages were used for analysis. Structural equation modeling clarifies the extent of relationships between variables as well as the chain of cause and effect. Restated, SEM results do not merely show empirical relationships between variables when defining the practical situation. For this reason, SEM was used to test the hypotheses. Results Perception of interpersonal-based medical service encounters positively influences service quality and patient satisfaction. Perception of service quality among patients positively influences their trust. Perception of trust among patients positively influences their satisfaction. Conclusions According to the findings, as interpersonal-based medical service encounters will positively influence service quality and patient satisfaction, and the differences for patients’ perceptions of the professional skill and communication attitude of personnel in interpersonal-based medical service encounters will influence patients’ overall satisfaction in two ways: (A) interpersonal-based medical service encounter directly

  3. 38 CFR 17.101 - Collection or recovery by VA for medical care or services provided or furnished to a veteran for...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... section, the charges billed will include the following types of charges, as appropriate: Acute inpatient... plan or insurance policies, provider agreements, medical evidence, proof of payment to other providers... identifier DRG code has been assigned to a particular type of medical care or service and a charge cannot...

  4. 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...

  5. Optimizing medical data quality based on multiagent web service framework.

    PubMed

    Wu, Ching-Seh; Khoury, Ibrahim; Shah, Hemant

    2012-07-01

    One of the most important issues in e-healthcare information systems is to optimize the medical data quality extracted from distributed and heterogeneous environments, which can extremely improve diagnostic and treatment decision making. This paper proposes a multiagent web service framework based on service-oriented architecture for the optimization of medical data quality in the e-healthcare information system. Based on the design of the multiagent web service framework, an evolutionary algorithm (EA) for the dynamic optimization of the medical data quality is proposed. The framework consists of two main components; first, an EA will be used to dynamically optimize the composition of medical processes into optimal task sequence according to specific quality attributes. Second, a multiagent framework will be proposed to discover, monitor, and report any inconstancy between the optimized task sequence and the actual medical records. To demonstrate the proposed framework, experimental results for a breast cancer case study are provided. Furthermore, to show the unique performance of our algorithm, a comparison with other works in the literature review will be presented.

  6. 20 CFR 725.706 - Authorization to provide medical services.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Authorization to provide medical services... require prior approval of the Office or the responsible operator. (b) Except where emergency treatment is required, prior approval of the Office or the responsible operator shall be obtained before...

  7. 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…

  8. The Economics of Air Force Medical Service Readiness

    DTIC Science & Technology

    2010-01-01

    50 Effects of Converting Inpatient Facilities to Stand -Alone Clinics...for Air Force Medical Service Stand -Alone Clinics in CONUS...Force bases were closed after the end of the Cold War) and to the conversion of many hospitals into stand -alone clinics or ASCs. The reasons for

  9. 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...

  10. 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...

  11. 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...

  12. 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...

  13. 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...

  14. 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;…

  15. 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...

  16. Factors Affecting Medical Services Utilization: A Behavioral Approach.

    ERIC Educational Resources Information Center

    Kelly, Terence F.; Schieber, George J.

    This study describes behavioral response--both its theoretical specification and its estimation--which relates health service utilization and expenditures to a number of variables: demographic, psychological, economic, medical, and policy-related. By incorporating these behavioral relations into a recently developed microsimulation model, national…

  17. Marketing physician services in an academic medical center.

    PubMed

    Eudes, J A; Divis, K L; Vaughan, D G; Fottler, M D

    1987-01-01

    As a result of recent environmental changes in the health care industry, marketing has become a vital necessity for the survival of most hospitals. Kotler's conceptual framework is used to study and evaluate an innovative program for marketing physician services in a large urban medical center. This program was quite successful in increasing admissions and referrals and won a national award in 1984.

  18. 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...

  19. 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...

  20. 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...

  1. 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...

  2. 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...

  3. 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…

  4. 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...

  5. 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...

  6. 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...

  7. 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 §...

  8. 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 §...

  9. 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...

  10. 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...

  11. 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 §...

  12. 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 §...

  13. 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...

  14. 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...

  15. 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...

  16. 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...

  17. 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...

  18. 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...

  19. 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...

  20. 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...

  1. 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...

  2. 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...

  3. 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...

  4. 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...

  5. 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...

  6. 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...

  7. 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...

  8. 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...

  9. 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 §...

  10. 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...

  11. 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...

  12. 20 CFR 416.1024 - Medical and other purchased services.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Medical and other purchased services. 416.1024 Section 416.1024 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Determinations of Disability Administrative Responsibilities...

  13. 20 CFR 404.1624 - Medical and other purchased services.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Medical and other purchased services. 404.1624 Section 404.1624 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Determinations of Disability Administrative Responsibilities and...

  14. Attitude Change As a Function of Field Medical Service School.

    ERIC Educational Resources Information Center

    Pishel, Robert Gordon

    Using a test retest design, this study investigated effects of Marine oriented Field Medical Service School training on the attitudes of 337 Navy corpsmen. Six issues pertaining to corpsmen and their work were created and administered as a survey instrument based on the Sherif Method of Ordered Alternatives. Attitude and ego involvement changes…

  15. 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...

  16. 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...

  17. 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...

  18. 20 CFR 725.706 - Authorization to provide medical services.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... hospitalization or surgery, or before ordering an apparatus for treatment where the purchase price exceeds $300. A request for approval of non-emergency hospitalization or surgery shall be acted upon expeditiously, and... surgery by telephone. (c) Payment for medical services, treatment, or an apparatus shall be made at...

  19. 20 CFR 725.706 - Authorization to provide medical services.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... hospitalization or surgery, or before ordering an apparatus for treatment where the purchase price exceeds $300. A request for approval of non-emergency hospitalization or surgery shall be acted upon expeditiously, and... surgery by telephone. (c) Payment for medical services, treatment, or an apparatus shall be made at...

  20. 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...

  1. 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...

  2. 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...

  3. 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...

  4. 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…

  5. 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...

  6. 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...

  7. 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...

  8. 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...

  9. 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...

  10. 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

  11. 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.

  12. Flexible medical image management using service-oriented architecture.

    PubMed

    Shaham, Oded; Melament, Alex; Barak-Corren, Yuval; Kostirev, Igor; Shmueli, Noam; Peres, Yardena

    2012-01-01

    Management of medical images increasingly involves the need for integration with a variety of information systems. To address this need, we developed Content Management Offering (CMO), a platform for medical image management supporting interoperability through compliance with standards. CMO is based on the principles of service-oriented architecture, implemented with emphasis on three areas: clarity of business process definition, consolidation of service configuration management, and system scalability. Owing to the flexibility of this platform, a small team is able to accommodate requirements of customers varying in scale and in business needs. We describe two deployments of CMO, highlighting the platform's value to customers. CMO represents a flexible approach to medical image management, which can be applied to a variety of information technology challenges in healthcare and life sciences organizations.

  13. 42 CFR 440.50 - Physicians' services and medical and surgical services of a dentist.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... dentist” means medical and surgical services furnished, on or after January 1, 1988, by a doctor of dental... either by a physician or by a doctor of dental medicine or dental surgery; and (3) Are furnished by a doctor of dental medicine or dental surgery who is authorized to furnish those services in the State...

  14. 42 CFR 440.50 - Physicians' services and medical and surgical services of a dentist.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... dentist” means medical and surgical services furnished, on or after January 1, 1988, by a doctor of dental... either by a physician or by a doctor of dental medicine or dental surgery; and (3) Are furnished by a doctor of dental medicine or dental surgery who is authorized to furnish those services in the State...

  15. 42 CFR 440.50 - Physicians' services and medical and surgical services of a dentist.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... dentist” means medical and surgical services furnished, on or after January 1, 1988, by a doctor of dental... either by a physician or by a doctor of dental medicine or dental surgery; and (3) Are furnished by a doctor of dental medicine or dental surgery who is authorized to furnish those services in the State...

  16. 42 CFR 440.50 - Physicians' services and medical and surgical services of a dentist.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... dentist” means medical and surgical services furnished, on or after January 1, 1988, by a doctor of dental... either by a physician or by a doctor of dental medicine or dental surgery; and (3) Are furnished by a doctor of dental medicine or dental surgery who is authorized to furnish those services in the State...

  17. Medical imaging equipment service in Kaiser Permanente, Northern California.

    PubMed

    Plasse, R J; Brooks, W G

    1993-01-01

    As the largest department in Biomedical Engineering, Medical Imaging Services (MIS) provides comprehensive equipment service for all imaging modalities in Kaiser Permanente, Northern California Region. MIS is customer-focused and committed to exploring better ways to deliver service, control costs and implement business strategies to meet customers' changing needs. Service extends beyond conventional preventive/corrective maintenance to include technology assessment, regulatory compliance, education and training, and managed vendor relationships. Program enhancements include film processor and solutions service, a second-source parts program, and a machine shop. In recent years, operations expanded to the Kaiser Permanente Northwest Region. Significant savings are available to any healthcare organization willing to embrace a new, expanded view of equipment management.

  18. Compression-based aggregation model for medical web services.

    PubMed

    Al-Shammary, Dhiah; Khalil, Ibrahim

    2010-01-01

    Many organizations such as hospitals have adopted Cloud Web services in applying their network services to avoid investing heavily computing infrastructure. SOAP (Simple Object Access Protocol) is the basic communication protocol of Cloud Web services that is XML based protocol. Generally,Web services often suffer congestions and bottlenecks as a result of the high network traffic that is caused by the large XML overhead size. At the same time, the massive load on Cloud Web services in terms of the large demand of client requests has resulted in the same problem. In this paper, two XML-aware aggregation techniques that are based on exploiting the compression concepts are proposed in order to aggregate the medical Web messages and achieve higher message size reduction.

  19. 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.

  20. 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…

  1. Delinquent Medical Service Accounts at Brooke Army Medical Center Need Additional Management Oversight

    DTIC Science & Technology

    2014-08-13

    collection. This is the first in a series of reports concerning medical service accounts ( MSAs ). This report provides the results of our review...performed at U.S. Army Brooke Army Medical Center (BAMC). We reviewed the 25 highest dollar delinquent MSAs valued at $11.0 million. Finding BAMC...Uniform Business Office (UBO) management did not effectively manage delinquent MSAs . As of May 29, 2013, BAMC UBO management had 15,106 outstanding

  2. The medical libraries of Vietnam--a service in transition.

    PubMed

    Brennen, P W

    1992-07-01

    The medical libraries of Vietnam maintain high profiles within their institutions and are recognized by health care professionals and administrators as an important part of the health care system. Despite the multitude of problems in providing even a minimal level of medical library services, librarians, clinicians, and researchers nevertheless are determined that enhanced services be made available. Currently, services can be described as basic and unsophisticated, yet viable and surprisingly well organized. The lack of hard western currency required to buy materials and the lack of library technology will be major obstacles to improving information services. Vietnam, like many developing nations, is about to enter a period of technological upheaval, which ultimately will result in a transition from the traditional library limited by walls to a national resource that will rely increasingly on electronic access to international knowledge networks. Technology such as CD-ROM, Integrated Services Digital Network (ISDN), and satellite telecommunication networks such as Internet can provide the technical backbone to provide access to remote and widely distributed electronic databases to support the information needs of the health care community. Over the long term, access to such databases likely will be cost-effective, in contrast to the assuredly astronomical cost of building a comparable domestic print collection. The advent of new, low-cost electronic technologies probably will revolutionize health care information services in developing nations. However, for the immediate future, the medical libraries of Vietnam will require ongoing sustained support from the international community, so that minimal levels of resources will be available to support the information needs of the health care community. It is remarkable, and a credit to the determination of Vietnam's librarians that, in a country with a legacy of war, economic deprivation, and international isolation

  3. [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.

  4. 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.

  5. [Medical services on an inspection ship in the north Atlantic].

    PubMed

    Kjaer, A

    1990-10-29

    The Danish Naval Inspection Ships sail in the North Atlantic waters with a doctor on board. The object of this investigation was to illustrate the medical services on board and to elucidate the significance of various factors to predict seeking medical advice. During a period of three months, all of the medical services and certain basic factors were registered. The crew was interviewed about consumption of alcohol and tobacco, previous life at sea and family background. A total of 305 consultations were used by the crew of 72 men. This figure is five times the anticipated figure in general practice. Low rank and low age were predictors for frequent medical consultations. The diagnosis groups of traumata/injuries, dermatological conditions and disease in the nervous system or organs of sense were relatively overrepresented. A series of factors may possibly have influenced the pattern of seeking medical help so that this differs from general practice. It is concluded that the dangerous working environment and poor possibilities for good hygiene are important factors whereas the mental stress is of lesser significance.

  6. Medical library service in a community-based medical school: a case study in South Dakota.

    PubMed Central

    Brennen, P W; Boilard, D W

    1981-01-01

    The historical background of community-based medical schools is described with emphasis on the experiences of the University of South Dakota Lommen Health Sciences Library. The steps undertaken by the library to meet Liaison Committee for Medical Education accreditation standards required for a full four-year, M.D.-degree granting institution are outlined. The governance structure of the participating Libraries of the Affiliated Teaching Hospitals Council is described. Special problems and their solutions are discussed in the context of providing service to a medical school which is decentralized on a statewide basis. PMID:7470677

  7. Medical library service in a community-based medical school: a case study in South Dakota.

    PubMed

    Brennen, P W; Boilard, D W

    1981-01-01

    The historical background of community-based medical schools is described with emphasis on the experiences of the University of South Dakota Lommen Health Sciences Library. The steps undertaken by the library to meet Liaison Committee for Medical Education accreditation standards required for a full four-year, M.D.-degree granting institution are outlined. The governance structure of the participating Libraries of the Affiliated Teaching Hospitals Council is described. Special problems and their solutions are discussed in the context of providing service to a medical school which is decentralized on a statewide basis.

  8. 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

  9. The Economics of Air Force Medical Service Readiness.

    PubMed

    Graser, John C; Blum, Daniel; Brancato, Kevin; Burks, James J; Chan, Edward W; Nicosia, Nancy; Neumann, Michael J; Ritschard, Hans V; Mundell, Benjamin F

    2012-01-01

    The prime mission of the Air Force Medical Service (AFMS), like those of the medical departments of its sister services, is to provide medical care during wartime. AFMS currently runs three successful in-theater hospitals that treat severely injured or wounded U.S. personnel from all four services. But this wartime mission depends on capabilities built at home, as critical-care specialists maintain their technical proficiency, as much as peacetime opportunities allow, by meeting health-care needs of Department of Defense beneficiaries at home. These patients have ranged from young, healthy active-duty personnel to aging retirees, historically presenting a broad range of injuries and illnesses for treatment. However, between the demands of deployments creating gaps in staff at home and changes in care plans, some beneficiaries now seek care in the civilian sector. In addition, several AFMS hospitals stateside have been closed, converted to clinics, or combined with those of other services for various reasons. All is problematic for two reasons: First, inpatient workloads in particular represent the best opportunities for critical care providers to prepare for their wartime missions. AFMS will need to increase these opportunities, perhaps working with other services, the Department of Veterans Affairs, or civilian hospitals. Second, AFMS's funding depends, in part, on the workload performed, but current measurement methods do not necessarily do a good job of accounting for the work AFMS practitioners accomplish outside their home stations. Some imminent changes may help resolve this situation, but AFMS should pursue opportunities to create additional workload for its medical personnel and to increase its budgets.

  10. 42 CFR 484.34 - Condition of participation: Medical social services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Medical social services....34 Condition of participation: Medical social services. If the agency furnishes medical social services, those services are given by a qualified social worker or by a qualified social work...

  11. 20 CFR 702.414 - Fees for medical services; unresolved disputes on prevailing charges.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... incorrectly identified by medical procedure code; (ii) that the presence of a severe or concomitant medical... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Fees for medical services; unresolved... ADMINISTRATION AND PROCEDURE Medical Care and Supervision § 702.414 Fees for medical services;...

  12. 20 CFR 702.414 - Fees for medical services; unresolved disputes on prevailing charges.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... incorrectly identified by medical procedure code; (ii) that the presence of a severe or concomitant medical... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Fees for medical services; unresolved... ADMINISTRATION AND PROCEDURE Medical Care and Supervision § 702.414 Fees for medical services;...

  13. Evidence for overuse of medical services around the world.

    PubMed

    Brownlee, Shannon; Chalkidou, Kalipso; Doust, Jenny; Elshaug, Adam G; Glasziou, Paul; Heath, Iona; Nagpal, Somil; Saini, Vikas; Srivastava, Divya; Chalmers, Kelsey; Korenstein, Deborah

    2017-01-06

    Overuse, which is defined as the provision of medical services that are more likely to cause harm than good, is a pervasive problem. Direct measurement of overuse through documentation of delivery of inappropriate services is challenging given the difficulty of defining appropriate care for patients with individual preferences and needs; overuse can also be measured indirectly through examination of unwarranted geographical variations in prevalence of procedures and care intensity. Despite the challenges, the high prevalence of overuse is well documented in high-income countries across a wide range of services and is increasingly recognised in low-income countries. Overuse of unneeded services can harm patients physically and psychologically, and can harm health systems by wasting resources and deflecting investments in both public health and social spending, which is known to contribute to health. Although harms from overuse have not been well quantified and trends have not been well described, overuse is likely to be increasing worldwide.

  14. Comprehensive medication management services influence medication adherence among Japanese older people

    PubMed Central

    Hirakawa, Yoshihisa; Hilawe, Esayas Haregot; Chiang, Chifa; Kawazoe, Nobuo; Aoyama, Atsuko

    2015-01-01

    Objective: Assistance from health professionals is very important to ensure medication adherence among older people. The present study aimed to assess the relationship between receipt of comprehensive medication management services by primary care physicians and medication adherence among community-dwelling older people in rural Japan. Methods: Data including medication adherence and whether or not a doctor knew all the kinds of medicines being taken were obtained from individuals aged 65 years or older who underwent an annual health checkup between February 2013 and March 2014 at a public clinic in Asakura. The subjects were divided into 2 groups: adherent (always) and non-adherent (not always). A logistic regression analysis was performed to assess the association between the presence of a doctor who was fully responsible for medication adherence and self-reported adherence. Predictors that exhibited significant association (p-value < 0.05) with medication adherence in a univariate analysis were entered in the model as possible confounding factors. The results were presented as odds ratios (OR) and 95% confidence intervals (CI). Results: Among four-hundred ninety-seven subjects in total, the adherent group included 430 subjects (86.5%), and its members were older than those of the non-adherent group. Significant predictors of good medication adherence included older age, no discomforting symptoms, eating regularly, diabetes mellitus and having a doctor who knew all the kinds of medicines being taken. After being adjusted for confounding variables, the subjects with a doctor who knew all the kinds of medicines they were taking were three times more likely to be adherent to medication (OR 3.01, 95% CI 1.44-6.99). Conclusion: Receipt of comprehensive medication management services for older people was associated with medication adherence. PMID:26705432

  15. Acute pain management services: a comparison between Air Force and U.S. hospitals.

    PubMed

    Rayos, C L; McDonough, J P

    1999-12-01

    The purpose of this descriptive study was to assess the prevalence of acute pain management services (APMS) in Air Force medical facilities. There are no published reports on the current status of Air Force pain programs. This study used a telephone survey to all facilities worldwide that house an anesthesia department. Anesthesia providers in charge of pain services or department chiefs were interviewed from December 1996 to May 1997. Respondents were asked questions related to the initiation of a formal APMS, components, and familiarity with the Agency for Health Care Policy and Research guidelines on pain management. Data analysis described current practices and used chi 2 analysis to compare results with a national study of U.S. hospitals. Air Force anesthesia departments (45%) had established as many acute pain services as U.S. hospitals (42%). Formal pain programs are becoming more prevalent in Air Force hospitals. These findings suggest an increased awareness of the need for pain management and future establishment of pain programs.

  16. [Models and practical games in training the medical service officers to control the medical care quality].

    PubMed

    Kartashov, V T; Romanovskiĭ, V V

    2006-02-01

    The 3-component structure of the model of medical service quality (MSQ) control is proposed. The model reflects the functional dependence of qualitative parameters of military treatment-and-prophylactic institutions' (TPI) activities: Qn = f(Rn, Mn), where the independent variables are the following: Rn is the provision of n-TPI with resources, Mn is the level of administrative activities and Qn function is MSQ. It allows transferring to information-and-analytical modeling of TPI as the triad of indices that reflect the resource quality (cadre, financial, material and technical), management and medical-and-statistical indices of medical service quality. For each of the model's component the information-and-analytical indices and criteria of their assessment are proposed. The scenario of practical games is based on abovementioned peculiarities of the model and consists of logically interconnected and successively solved situational problems. The methods and problems described can be used during medical service officers' training, for studying TPI physicians, in educational process of some departments of military medical higher schools. The specific feature of proposed models and methods is their applicability both in educational process and in practical work.

  17. Tri-Service Medical Transformation - Time for a Unified Military Medical Command (USMEDCOM)

    DTIC Science & Technology

    2007-11-02

    and Military Traffic Management Command ( MTMC ) into one functional combatant command with global reach. USTRANSCOM aptly fit the definition of a...Sealift Command MTMC Military Traffic Management Command NCA National Capital Area SASC Senate Armed Services Committee SIMLM Single Integrated Medical

  18. Summative service and stakeholder evaluation of an NHS-funded community Pharmacy Emergency Repeat Medication Supply Service (PERMSS)

    PubMed Central

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

    2016-01-01

    Objectives Service and stakeholder evaluation of an NHS-funded service providing out-ofhours (OOH) emergency repeat medications to patients self-presenting at community pharmacies. Setting Community pharmacies across the North East of England accredited to provide this service. Participants Patients self-presenting to community pharmacies during OOH periods with emergency repeat medication supply requests. Intervention Community pharmacists assessed each request for clinical appropriateness and when suitable provide an emergency repeat medication supply, with additional pharmaceutical advice and services if required. Primary outcomes Number of emergency repeat medication supplies, time of request, reason for access, medication(s), pharmaceutical advice and services provided. Secondary outcomes were community pharmacist and patient satisfaction. Results A total of 2485 patients were managed across 227 community pharmacies (15 December 2014 to 7 April 2015). Most patients presented on Saturdays, with increased activity over national holidays. Older age was associated with increased service use. Of the 3226 medications provided, 439 were classified as high risk. Patients found this service easy to access and were willing to access the community pharmacy in the future for medication-related issues. In the absence of this service, 50% of patients would have missed their medication(s) until they saw their doctor and a further 46% would have accessed an alternative service. The cost of National Health Service (NHS) service(s) for patients who would have accessed an alternative OOH service was estimated as 37 times that of the community pharmacy service provided. Community pharmacists were happy to provide this service despite increased consultation times and workload. Conclusions Community pharmacists were able to manage patients’ OOH requests for emergency repeat medication and patients were happy with the service provided. Since the service cost was favourable when

  19. [Organisation of scientific and research work of Navy medical service].

    PubMed

    Gavrilov, V V; Myznikov, I L; Kuz'minov, O V; Shmelev, S V; Oparin, M Iu

    2013-03-01

    The main issues of organization of scientific and research work of medical service in the North Fleet are considered in the present article. Analysis of some paragraphs of documents, regulating this work at army level is given. The authors give an example of successful experience of such work in the North Fleet, table some suggestions which allow to improve the administration of scientific and research work in the navy and also on the district scale.

  20. Civilian Health and Medical Program of the Uniformed Services (CHAMPUS)

    DTIC Science & Technology

    1991-07-01

    b,: manipulation and treatment of the structures of the human body, especially those of the spinal column. NOTE: Services of chiropractors are not...type patient. The unit is maintained on a continuing rather than an intermittent or temporary basis. It is n1’t a post operative rec1ver9v room nor a... post -delivery week), and also including treatment of the complications of pregnancy. Medicaid. Those medical benefits authorized under Title XIX of the

  1. 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.

  2. [The use of the new loads of expendable medical supplies by the medical service of the Armed Forces].

    PubMed

    Miroshnichenko, Iu V; Bunin, S A; Grebeniuk, A N; Kononov, V N; Sidorov, D A

    2014-09-01

    The new loads of expendable medical supplies adopted by the Armed Forces of the Russian Federation and included into regulating documents are the most important elements of the authorized equipment system. Nine loads of expendable medical supplies, combined into two classification groups, are provided for the medical service. The use of these loads improves the effectiveness of medical supply for all stages of medical evacuation, medical continuity during medical and evacuation procedures and allows to deliver medical aid to patients on the basis of modern and innovative medical technologies.

  3. 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

  4. 42 CFR 415.110 - Conditions for payment: Medically directed anesthesia services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... anesthesia services. 415.110 Section 415.110 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... payment: Medically directed anesthesia services. (a) General payment rule. Medicare pays for the physician's medical direction of anesthesia services for one service or two through four concurrent...

  5. 42 CFR 415.110 - Conditions for payment: Medically directed anesthesia services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... anesthesia services. 415.110 Section 415.110 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... payment: Medically directed anesthesia services. (a) General payment rule. Medicare pays for the physician's medical direction of anesthesia services for one service or two through four concurrent...

  6. 42 CFR 415.110 - Conditions for payment: Medically directed anesthesia services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... anesthesia services. 415.110 Section 415.110 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... payment: Medically directed anesthesia services. (a) General payment rule. Medicare pays for the physician's medical direction of anesthesia services for one service or two through four concurrent...

  7. 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...

  8. 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...

  9. 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...

  10. Medical training debt and service commitments: the rural consequences.

    PubMed

    Pathman, D E; Konrad, T R; King, T S; Spaulding, C; Taylor, D H

    2000-01-01

    This study assesses how student loan debt and scholarships, loan repayment and related programs with service requirements influence the incomes young physicians seek and attain, influence whether they choose to work in rural practice settings and affect the number of Medicaid-covered and uninsured patients they see. Data are from a 1999 mail survey of a national probability sample of 468 practicing family physicians, general internists and pediatricians who graduated from U.S. medical schools in 1988 and 1992. A majority of these generalist physicians recalled "moderate" or "great" concern for their financial situations before, during and after their training. Eighty percent financed all or part of their training with loans, and one-quarter received support from federal, state or community-sponsored scholarship, loan repayment and similar programs with service obligations. In their first job after residency, family physicians and pediatricians with greater debt reported caring for more patients insured under Medicaid and uninsured than did those with less debt. For no specialty was debt associated with physicians' income or likelihood of working in a rural area. Physicians serving commitments in exchange for training cost support, compared to those without obligations, were more likely to work in rural areas (33 vs. 7 percent, respectively, p < 0.001) and provided care to more Medicaid-covered and uninsured patients (53 vs. 29 percent, p < 0.001), but did not differ in their incomes ($99,600 vs. $93,800, p = 0.11). Thus, among physicians who train as generalists, the high costs of medical education appear to promote, not harm, national physician work force goals by prompting participation in service-requiring financial support programs and perhaps through increasing student borrowing. These positive outcomes for generalists should be weighed against other known and suspected negative consequences of the high costs of training, such as discouraging some poor

  11. Descriptions of Acute Transfusion Reactions in the Teaching Hospitals of Kermanshah University of Medical Sciences, Iran

    PubMed Central

    Payandeh, Mehrdad; Zare, Mohammad Erfan; Kansestani, Atefeh Nasir; Pakdel, Shirin Falah; Jahanpour, Firuzeh; Yousefi, Hoshang; Soleimanian, Farzaneh

    2013-01-01

    Background Transfusion services rely on transfusion reaction reporting to provide patient care and protect the blood supply. Unnecessary discontinuation of blood is a major wastage of scarce blood, as well as man, hours and funds. The aim of the present study was to describe the main characteristics of acute transfusion reactions reported in the 4 hospital of Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran. Material and Methods The study was carried out at 4 teaching hospital of Kermanshah University of Medical Sciences, Kermanshah, Iran, over18 months from April 2010. All adult patients on admission in the hospitals who required blood transfusion and had establish diagnosis and consented were included in the study. Results In the year 2010 until 2012, a total of 6238 units of blood components were transfused. A total of 59 (0.94%) cases of transfusion reaction were reported within this 3 years period. The commonest were allergic reactions which presented with various skin manifestations such as urticarial, rashes and pruritus (49.2%), followed by increase in body temperature of > 1°C from baseline which was reported as febrile non-hemolytic transfusion reaction (37.2%). pain at the transfusion site (6.8%) and hypotension (6.8%). Conclusion It is important that each transfusion of blood components to be monitor carefully. Many transfusion reactions are not recognized, because signs and symptoms mimic other clinical conditions. Any unexpected symptoms in a transfusion recipient should at least be considered as a possible transfusion reaction and be evaluated. Prompt recognition and treatment of acute transfusion reaction are crucial and would help in decreasing transfusion related morbidity and mortality, but prevention is preferable. PMID:24505522

  12. Global Budgets and Technology-Intensive Medical Services

    PubMed Central

    Song, Zirui; Fendrick, A. Mark; Safran, Dana Gelb; Landon, Bruce; Chernew, Michael E.

    2014-01-01

    Background In 2009-2010, Blue Cross Blue Shield of Massachusetts entered into global payment contracts (the Alternative Quality contract, AQC) with 11 provider organizations. We evaluated the impact of the AQC on spending and utilization of several categories of medical technologies, including one considered high value (colonoscopies) and three that include services that may be overused in some situations (cardiovascular, imaging, and orthopedic services). Methods Approximately 420,000 unique enrollees in 2009 and 180,000 in 2010 were linked to primary care physicians whose organizations joined the AQC. Using three years of pre-intervention data and a large control group, we analyzed changes in utilization and spending associated with the AQC with a propensity-weighted difference-in-differences approach adjusting for enrollee demographics, health status, secular trends, and cost-sharing. Results In the 2009 AQC cohort, total volume of colonoscopies increased 5.2 percent (p=0.04) in the first two years of the contract relative to control. The contract was associated with varied changes in volume for cardiovascular and imaging services, but total spending on cardiovascular services in the first two years decreased by 7.4% (p=0.02) while total spending on imaging services decreased by 6.1% (p<0.001) relative to control. In addition to lower utilization of higher-priced services, these decreases were also attributable to shifting care to lower-priced providers. No effect was found in orthopedics. Conclusions As one example of a large-scale global payment initiative, the AQC was associated with higher use of colonoscopies. Among several categories of services whose value may be controversial, the contract generally shifted volume to lower-priced facilities or services. PMID:24772385

  13. [Contemporary social medical problems of the family and issues in medical-social services].

    PubMed

    Grinina, O V

    1994-01-01

    Basing on her experience gained in comprehensive sociohygienic studies, the author analyzes present-day medicosocial programs of family health promotion. Theoretical conclusions are confirmed by findings of special sociohygienic studies. The priority problem of today is, to the author's mind, deterioration of the demographic situation caused by reduced reproductive function of a family, deterioration of the health status of mothers and their children resulting from inadequate performance of the medical function by the family, a higher number of induced abortions and divorces, etc. Among approaches to solution of the named problem are improvement of medical education of family members, promotion of the family principle in public health, development of social service, etc.

  14. 38 CFR 17.94 - Outpatient medical services for military retirees and other beneficiaries.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... services for military retirees and other beneficiaries. 17.94 Section 17.94 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Outpatient Treatment § 17.94 Outpatient medical services for military retirees and other beneficiaries. Outpatient medical services for military retirees...

  15. 42 CFR 412.87 - Additional payment for new medical services and technologies: General provisions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Additional payment for new medical services and... payment for new medical services and technologies: General provisions. (a) Basis. Sections 412.87 and 412... establish a mechanism to recognize the costs of new medical services and technologies under the...

  16. 76 FR 65216 - Beacon Medical Services, LLC, Aurora, CO; Notice of Negative Determination Regarding Application...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-20

    ... Employment and Training Administration Beacon Medical Services, LLC, Aurora, CO; Notice of Negative... apply for Trade Adjustment Assistance (TAA) applicable to workers and former workers of Beacon Medical Services, LLC, Aurora, Colorado (Beacon Medical Services). The negative determination was issued on June...

  17. 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...

  18. 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...

  19. 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...

  20. 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...

  1. 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...

  2. 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...

  3. 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...

  4. 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...

  5. 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......

  6. 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...

  7. 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.

  8. [Medical service of the Armed Forces of Great Britain (review of foreign internet-publications)].

    PubMed

    Agapitov, A A; Bolekhan, V N; Ivchenko, E V; Krassiĭ, A B; Nagibovich, O A; Petrov, S V; Rezvantsev, M V

    2012-07-01

    The present review is dedicated to organization and principles of operation of the Medical service of the Armed Forces of Great Britain. At the beginning of the review a brief description of British Armed Forces and their medical service is presented. Then the particular key elements of the medical service such as the medical services of the Armed Forces major components, inpatient care, medical supplies, research, medical care at an operation theater, medical personnel training are considered. The special attention is paid to the Joint Medical Command formed four years ago as a prototype for the future integration and centralization of the whole medical service. The cooperation with the civil health care has played an increasing role in the organization of British military medicine. That is why the review includes the short description of the major structure of the British civil health care system--the National Health Service.

  9. Delinquent Medical Service Accounts at David Grant Air Force Medical Center Need Additional Management Oversight

    DTIC Science & Technology

    2015-09-24

    facilities. DGMC provides a full spectrum of care to a prime service area of more than 106,000 Tricare-eligible patients in the San Francisco-Sacramento...area and 370,000 patients from the Department of Veterans Affairs Northern California Health Care System that covers more than 40,000 square miles and...members of the Military Services and others entitled to or eligible for DoD medical care and benefits. U.S. Treasury FedDebt FedDebt is an online

  10. Public Use of Mobile Medical Applications: A Case Study on Cloud-Based Medical Service of Taiwan.

    PubMed

    Lu, Chen-Luan; Yan, Yu-Hua

    2016-01-01

    The use of smart mobile devices has been getting increasingly popular. The focus of this study is an attempt to explore the development of mobile medical App by medical centers and regional hospitals of Taiwan and the function of the App for comparison. The results show indicated that many hospitals developed Apps for the public for mobile medical service, of which 26 medical centers (100%) and 72 regional hospitals (84.7%) availed appointment making service via Apps. The result indicated variance at significant level (p < 0.01). There are 23 medical centers (88.5%) and 74 regional hospitals (87.1%) availed Apps for checking service progress. The result indicated insignificant variance level (p > 0.01). We can see that mobile medical service is gradually emerging as a vital issue. Yet, this is a new domain in medical service. With the mushrooming of medical applications in smart mobile devices, the medical service system is expected to be installed in these devices to enhance interactive mode of operation and inquiry services, such as medication and inquiries into physical examination results. By then, people can learn the status of their health with this system.

  11. 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.

  12. Delinquent Medical Service Accounts at William Beaumont Army Medical Center Need Additional Management Oversight

    DTIC Science & Technology

    2014-09-16

    collection. This is the second in a series of reports concerning delinquent medical service accounts ( MSAs ). This report provides the results of our...review performed at WBAMC. We reviewed the 25 highest-dollar delinquent MSAs valued at $525,209. Finding WBAMC Uniform Business Office (UBO...management did not effectively manage delinquent MSAs . As of May 29, 2013, 1,688 of WBAMC MSAs , valued at $857,003, were more than 180 days delinquent

  13. An Audit of Changes in Outcomes of Acute Pain Service

    PubMed Central

    Low, Sheng Jia; Wong, Stanley Sau Ching; Qiu, Qiu; Lee, Yvonne; Chan, Timmy Chi Wing; Irwin, Michael G.; Cheung, Chi Wai

    2015-01-01

    Abstract Acute pain services (APS) have evolved over time. Strategies nowadays emphasize multimodal analgesic regimes using a combination of nonopioid adjuvant analgesic drugs, peripheral nerve blocks, and local anaesthetic wound infiltration where appropriate. APS should be assessed over time to evaluate changes in outcomes which form the basis for future development. In this audit, data of patients under APS care in Queen Mary hospital, Hong Kong, between 2009 and 2012 were analyzed and compared with data from a previous audit between 1992 and 1995. The use of patient-controlled analgesia (PCA) was increased (from 69.3% to 86.5%, P < 0.001), while the use of epidural analgesia reduced (from 25.3% to 8.3%, P < 0.001) significantly. Although postoperative pain scores did not improve, PCA opioid consumption and the incidence of analgesia-related side effects were significantly less (all P < 0.001). More patients graded their postoperative analgesic techniques used as good when the results from these 2 audit periods were compared (P < 0.001 and P = 0.001 for PCA and epidural analgesia, respectively). In conclusion, there has been a change in analgesic management techniques, but there has been no improvement in overall pain relief. While changes over time have led to improvement in important parameters such as the incidence of side effects and patient satisfaction, further and continuous efforts and improvements are warrant to reduce acute pain relief and suffering of the patients after the surgery. PMID:26448012

  14. [Effect of the change in the law of contract on the development of medical service units].

    PubMed

    Farnschläder, Josef; Stummer, Harald

    2012-01-01

    On January 1, 2004, the medical service unit was founded in Germany. However, one of the results of the reform in 2007 was that most of the advantages of medical service units were no longer idiosyncratic to this legal form, but granted to individual general practitioners as well. Since then, a decline in the foundation of medical service units by medical doctors can be observed. Today, the medical service unit rather seems to be a means for hospitals expanding in the intermediary medical sector and, maybe, a re-foundation of the former hospital-owned polyclinics.

  15. 42 CFR 415.110 - Conditions for payment: Medically directed anesthesia services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... anesthesia services. 415.110 Section 415.110 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... directed anesthesia services. (a) General payment rule. Medicare pays for the physician's medical direction of anesthesia services for one service or two through four concurrent anesthesia services...

  16. 42 CFR 415.110 - Conditions for payment: Medically directed anesthesia services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... anesthesia services. 415.110 Section 415.110 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... directed anesthesia services. (a) General payment rule. Medicare pays for the physician's medical direction of anesthesia services for one service or two through four concurrent anesthesia services...

  17. Behavioural antecedents to pro re nata psychotropic medication administration on acute psychiatric wards.

    PubMed

    Stewart, Duncan; Robson, Deborah; Chaplin, Robert; Quirk, Alan; Bowers, Len

    2012-12-01

    This study examined the antecedents to administration of pro re nata (PRN) psychotropic medication on acute psychiatric wards, with a particular focus on its use in response to patient aggression and other conflict behaviours. A sample of 522 adult in-patients was recruited from 84 acute psychiatric wards in England. Data were collected from nursing and medical records for the first 2  weeks of admission. Two-thirds of patients received PRN medication during this period, but only 30% of administrations were preceded by patient conflict (usually aggression). Instead, it was typically administered to prevent escalation of patient behaviour and to help patients sleep. Overall, no conflict behaviours or further staff intervention occurred after 61% of PRN administrations. However, a successful outcome was less likely when medication was administered in response to patient aggression. The study concludes that improved monitoring, review procedures, training for nursing staff, and guidelines for the administration of PRN medications are needed.

  18. A toolkit for incorporating genetics into mainstream medical services: Learning from service development pilots in England

    PubMed Central

    2010-01-01

    Background As advances in genetics are becoming increasingly relevant to mainstream healthcare, a major challenge is to ensure that these are integrated appropriately into mainstream medical services. In 2003, the Department of Health for England announced the availability of start-up funding for ten 'Mainstreaming Genetics' pilot services to develop models to achieve this. Methods Multiple methods were used to explore the pilots' experiences of incorporating genetics which might inform the development of new services in the future. A workshop with project staff, an email questionnaire, interviews and a thematic analysis of pilot final reports were carried out. Results Seven themes relating to the integration of genetics into mainstream medical services were identified: planning services to incorporate genetics; the involvement of genetics departments; the establishment of roles incorporating genetic activities; identifying and involving stakeholders; the challenges of working across specialty boundaries; working with multiple healthcare organisations; and the importance of cultural awareness of genetic conditions. Pilots found that the planning phase often included the need to raise awareness of genetic conditions and services and that early consideration of organisational issues such as clinic location was essential. The formal involvement of genetics departments was crucial to success; benefits included provision of clinical and educational support for staff in new roles. Recruitment and retention for new roles outside usual career pathways sometimes proved difficult. Differences in specialties' working practices and working with multiple healthcare organisations also brought challenges such as the 'genetic approach' of working with families, incompatible record systems and different approaches to health professionals' autonomous practice. 'Practice points' have been collated into a Toolkit which includes resources from the pilots, including job descriptions and

  19. Antiservice Within the Medical Service Encounter: Lessons for Radiologists Beyond Service Recovery.

    PubMed

    Hill, Paul Armstrong; Hill, Ronald Paul

    2015-12-01

    Recent modifications in the metrics for reimbursement have reinforced the importance of radiology service-delivery experiences of patients. Evaluating current radiology practices calls for reflection on the various touch points with patients, as well as their overall satisfaction. If problems occur during encounters, service failure, or lack of satisfactory medical experiences can be transformed through service recovery, whereby patients-as-customers are given chances to voice their concerns, and health care providers across the spectrum can work together to resolve problematic issues. This paper takes a systemic view of the patient experience as embedded in the care continuum, recognizing that different beliefs, attitudes, and behaviors of members of the health care team can negatively affect or sabotage patient satisfaction. Although radiologists are only one of many roles in the care continuum, recommendations are discussed for how they can integrate service satisfaction as a pervasive communal goal among all health care team members.

  20. Utility of a grief services program for medical examiners' offices.

    PubMed

    Berry, Ryan S; Aurelius, Michelle B; Barickman, Nancy; Lathrop, Sarah L

    2013-03-01

    Medical examiner/coroner's (ME/C) offices investigate sudden, violent, and unexpected deaths, leaving those close to the deceased suffering traumatic loss with little in terms of support and counseling. We investigated a grief services program (GSP) at the New Mexico Office of the Medical Investigator (OMI) to better understand the needs of bereaved individuals, identify the services provided, and propose our findings as a model for others. A total of 1085 contacts occurred over 1 year, with the majority occurring at OMI (60.5%), followed by telephone (23.1%). Support was primarily provided to those suffering a loss due to homicide (28.8%) and suicide (26.1%). The roles grief counselors play in the setting of a GSP and ME/C office are multiple. Given the frequent utilization of OMI's GSP and diverse reasons for visits, it is apparent there is a need for GSPs at ME/C offices, particularly given the traumatic nature of deaths investigated by ME/Cs.

  1. 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.

  2. 42 CFR 409.12 - Nursing and related services, medical social services; use of hospital or CAH facilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Nursing and related services, medical social... Inpatient Hospital Services and Inpatient Critical Access Hospital Services § 409.12 Nursing and related... (b) of this section, Medicare pays for nursing and related services, use of hospital or...

  3. 42 CFR 409.12 - Nursing and related services, medical social services; use of hospital or CAH facilities.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Nursing and related services, medical social... Inpatient Hospital Services and Inpatient Critical Access Hospital Services § 409.12 Nursing and related... (b) of this section, Medicare pays for nursing and related services, use of hospital or...

  4. 42 CFR 409.12 - Nursing and related services, medical social services; use of hospital or CAH facilities.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Nursing and related services, medical social... Inpatient Hospital Services and Inpatient Critical Access Hospital Services § 409.12 Nursing and related... (b) of this section, Medicare pays for nursing and related services, use of hospital or...

  5. 42 CFR 409.12 - Nursing and related services, medical social services; use of hospital or CAH facilities.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Nursing and related services, medical social... Inpatient Hospital Services and Inpatient Critical Access Hospital Services § 409.12 Nursing and related... (b) of this section, Medicare pays for nursing and related services, use of hospital or...

  6. 42 CFR 410.170 - Payment for home health services, for medical and other health services furnished by a provider...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... other health services furnished by a provider or an approved ESRD facility, and for comprehensive outpatient rehabilitation facility (CORF) services: Conditions. 410.170 Section 410.170 Public Health CENTERS... services, for medical and other health services furnished by a provider or an approved ESRD facility,...

  7. Development of an electronic database for Acute Pain Service outcomes

    PubMed Central

    Love, Brandy L; Jensen, Louise A; Schopflocher, Donald; Tsui, Ban CH

    2012-01-01

    BACKGROUND: Quality assurance is increasingly important in the current health care climate. An electronic database can be used for tracking patient information and as a research tool to provide quality assurance for patient care. OBJECTIVE: An electronic database was developed for the Acute Pain Service, University of Alberta Hospital (Edmonton, Alberta) to record patient characteristics, identify at-risk populations, compare treatment efficacies and guide practice decisions. METHOD: Steps in the database development involved identifying the goals for use, relevant variables to include, and a plan for data collection, entry and analysis. Protocols were also created for data cleaning quality control. The database was evaluated with a pilot test using existing data to assess data collection burden, accuracy and functionality of the database. RESULTS: A literature review resulted in an evidence-based list of demographic, clinical and pain management outcome variables to include. Time to assess patients and collect the data was 20 min to 30 min per patient. Limitations were primarily software related, although initial data collection completion was only 65% and accuracy of data entry was 96%. CONCLUSIONS: The electronic database was found to be relevant and functional for the identified goals of data storage and research. PMID:22518364

  8. Does a global budget superimposed on fee-for-service payments mitigate hospitals' medical claims in Taiwan?

    PubMed

    Hsu, Pi-Fem

    2014-12-01

    Taiwan's global budgeting for hospital health care, in comparison to other countries, assigns a regional budget cap for hospitals' medical benefits claimed on the basis of fee-for-service (FFS) payments. This study uses a stays-hospitals-years database comprising acute myocardial infarction inpatients to examine whether the reimbursement policy mitigates the medical benefits claimed to a third-payer party during 2000-2008. The estimated results of a nested random-effects model showed that hospitals attempted to increase their medical benefit claims under the influence of initial implementation of global budgeting. The magnitudes of hospitals' responses to global budgeting were significantly attributed to hospital ownership, accreditation status, and market competitiveness of a region. The results imply that the regional budget cap superimposed on FFS payments provides only blunt incentive to the hospitals to cooperate to contain medical resource utilization, unless a monitoring mechanism attached with the payment system.

  9. 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

  10. [The Russian Armed Forces Military Medical Service: condition and ways of improvement].

    PubMed

    Fisun, A Ia

    2014-01-01

    In 2013 the main efforts of the Medical Service were aimed at the following tasks: optimization of management system of military medical service, improvement of medical evacuation system, medical service security for military contingents, assigned according to territory principle to military-medical facilities of the Ministry of Defence of the Russian Federation, implementation of innovations at all stages of medical evacuation in peace- and wartime, security of combat and mobilization readiness of regulatory bodies of the Medical Service, medical military units and military medical facilities, medical service of troops battle training, improvement of material and technical resources, security of regular pharmacy and equipment supply, activation of research work in the Medical Service interests. Lines of military medicine development in 2014 are: transfer of treatment facilities that are not used by the Ministry of Defence into the Federal Biomedical Agency till the end of 2014, prevention of pneumonia and meningitis in military personnel, improvement of early diagnosis system, medical service for military contingents according to territory principle, improvement of diagnostic and treatment work in military-medical units and subunits and military-medical facilities by means of development of material and technical resources, monitor the implementation of innovative diagnostic and treatment technologies, completion of construction projects of central military hospitals and etc.

  11. Medicare Program; End-Stage Renal Disease Prospective Payment System, Coverage and Payment for Renal Dialysis Services Furnished to Individuals With Acute Kidney Injury, End-Stage Renal Disease Quality Incentive Program, Durable Medical Equipment, Prosthetics, Orthotics and Supplies Competitive Bidding Program Bid Surety Bonds, State Licensure and Appeals Process for Breach of Contract Actions, Durable Medical Equipment, Prosthetics, Orthotics and Supplies Competitive Bidding Program and Fee Schedule Adjustments, Access to Care Issues for Durable Medical Equipment; and the Comprehensive End-Stage Renal Disease Care Model. Final rule.

    PubMed

    2016-11-04

    This rule updates and makes revisions to the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for calendar year 2017. It also finalizes policies for coverage and payment for renal dialysis services furnished by an ESRD facility to individuals with acute kidney injury. This rule also sets forth requirements for the ESRD Quality Incentive Program, including the inclusion of new quality measures beginning with payment year (PY) 2020 and provides updates to programmatic policies for the PY 2018 and PY 2019 ESRD QIP. This rule also implements statutory requirements for bid surety bonds and state licensure for the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP). This rule also expands suppliers' appeal rights in the event of a breach of contract action taken by CMS, by revising the appeals regulation to extend the appeals process to all types of actions taken by CMS for a supplier's breach of contract, rather than limit an appeal for the termination of a competitive bidding contract. The rule also finalizes changes to the methodologies for adjusting fee schedule amounts for DMEPOS using information from CBPs and for submitting bids and establishing single payment amounts under the CBPs for certain groupings of similar items with different features to address price inversions. Final changes also are made to the method for establishing bid limits for items under the DMEPOS CBPs. In addition, this rule summarizes comments on the impacts of coordinating Medicare and Medicaid Durable Medical Equipment for dually eligible beneficiaries. Finally, this rule also summarizes comments received in response to a request for information related to the Comprehensive ESRD Care Model and future payment models affecting renal care.

  12. [About the improvement of communication system and information transmission in medical service control in airborne division].

    PubMed

    Korniushko, I G; Shelepov, A M; Zhidik, V V; Berezin, A I

    2007-03-01

    Frequent changes in tactical, rear and medical situations cause the medical service officials of airborne division (ABD) to obtain and transmit the data characterizing the medical service forces and means for a lot of times. It decreases the effectiveness of the control process. Equipping of ABD medical service staff with programming-and-technical systems (PTS), development of algorithm of official interaction, creation of report forms and selection of materials necessary for PTS database input will contribute to the effectiveness of ABD medical service control.

  13. Highly Developed Information-oriented Society and Humanity ; Medical Information Services and Library

    NASA Astrophysics Data System (ADS)

    Wakimoto, Atsuko

    Change in social circumstances caused by arrival of highly developed information-oriented society has altered what information services in medical libraries should be dramatically. Keeping with complication and diversification of needs by users such as medical doctors, researchers, medical technicians and so on medical librarians have been playing important role in the information activities, and are required to master more specialized knowledge. This paper outlines changes in circumstances surrounding medical libraries, discusses role of medical librarians in online information retrieval services, and introduces various curriculum for library education. The author proposes that humanity of librarian him or herself is still a key factor for library services regardless of advancement of computerization.

  14. [Medical entomology for the Armed services: preliminary results from the medical entomology unit].

    PubMed

    Pages, F; Girod, R

    2004-01-01

    Vector-borne diseases constitutes a threat to the operational capability of armed forces personnel operating outside or stationed overseas. To take this risk into account, the French armed forces medical corps created a medical entomology unit in 2003. The primary function of this unit is to monitor the entomological status of French military bases in sub-Saharan Africa (identification of vectors, study of vector behavior, and measurement of resistance to insecticides) as a means of maintaining an effective vector-control strategy. The French medical entomology unit takes part in the Impact Vector project aimed at evaluating the vector-borne disease risks for troops in combat situations, contributes its expertise to the investigation of epidemic disease, and participates in the development of a global strategy for vector-control for the armed services. To improve understanding and control of vector-borne disease risks, the unit provides basic training in medical entomology to army physicians, veterinarians, and pharmacists as well as to others involved in control programs. The purpose of this article is to present the results of the unit's first activities: investigation of a malaria epidemic that occurred in Ivory Coast in 2003, measurement of malaria exposure over a 4-month period in a combat group on duty in rural Africa, and initial evaluation of control techniques (spraying around living quarters and use of insecticide-impregnated battle dress).

  15. 20 CFR 702.415 - Fees for medical services; unresolved disputes on charges; procedure.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Fees for medical services; unresolved... ADMINISTRATION AND PROCEDURE Medical Care and Supervision § 702.415 Fees for medical services; unresolved... seek a hearing pursuant to section 556 of title 5, United States Code. Upon written request for such...

  16. 20 CFR 702.415 - Fees for medical services; unresolved disputes on charges; procedure.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Fees for medical services; unresolved... ADMINISTRATION AND PROCEDURE Medical Care and Supervision § 702.415 Fees for medical services; unresolved... seek a hearing pursuant to section 556 of title 5, United States Code. Upon written request for such...

  17. 20 CFR 702.415 - Fees for medical services; unresolved disputes on charges; procedure.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Fees for medical services; unresolved... ADMINISTRATION AND PROCEDURE Medical Care and Supervision § 702.415 Fees for medical services; unresolved... seek a hearing pursuant to section 556 of title 5, United States Code. Upon written request for such...

  18. 38 CFR 17.35 - Hospital care and medical services in foreign countries.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Hospital care and medical services in foreign countries. 17.35 Section 17.35 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Hospital Or Nursing Home Care and Medical Services in Foreign Countries §...

  19. 38 CFR 17.35 - Hospital care and medical services in foreign countries.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Hospital care and medical services in foreign countries. 17.35 Section 17.35 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Hospital Or Nursing Home Care and Medical Services in Foreign Countries §...

  20. 38 CFR 17.35 - Hospital care and medical services in foreign countries.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Hospital care and medical services in foreign countries. 17.35 Section 17.35 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Hospital Or Nursing Home Care and Medical Services in Foreign Countries §...

  1. 38 CFR 17.35 - Hospital care and medical services in foreign countries.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Hospital care and medical services in foreign countries. 17.35 Section 17.35 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Hospital Or Nursing Home Care and Medical Services in Foreign Countries §...

  2. 38 CFR 17.35 - Hospital care and medical services in foreign countries.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Hospital care and medical services in foreign countries. 17.35 Section 17.35 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Hospital Or Nursing Home Care and Medical Services in Foreign Countries §...

  3. 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...

  4. 78 FR 76064 - Authorization for Non-VA Medical Services; Withdrawal

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-16

    ... AFFAIRS 38 CFR Part 17 RIN 2900-AO47 Authorization for Non-VA Medical Services; Withdrawal AGENCY... amended its regulations regarding payment by VA for medical services under VA's statutory authority to provide non-VA medical care. VA sought to remove an outdated regulatory limitation on...

  5. 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...

  6. 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...

  7. 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...

  8. Effects of reduction of acute hospital services on district nursing services: implications for quality assurance.

    PubMed

    MacDonald, L D; Addington-Hall, J M; Hennessy, D A; Gould, T R

    1991-01-01

    Two questions of importance to those concerned with maintaining standards and increasing the efficiency of Community Nursing are: (1) does reducing hospital provision alter the number of patients referred for Community Nursing or the type of care provided; (2) are Community Nursing Services directed towards those who most require them? A base-line study was carried out in the first quarter of 1988, before the closure of one of two general hospitals in an inner London Health Authority and was replicated in the same quarter of 1989, after all acute inpatient services had been transferred to the other hospital. Comparison of patients discharged before and after closure showed no significant differences in patients' age, sex, proportion living alone, length of stay in hospital, readmissions or deaths within one month of discharge. There was some decline in general nursing care. Total discharges declined by 20% while the number of referrals remained the same, indicating that proportionately more patients were discharged with a referral. Comparing referred and unreferred patients showed that Community Nursing Services were already being directed towards those most in need both before and after hospital closure. Results suggest that Community Nursing helps to maintain patients in the community.

  9. 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.

  10. Medical and surgical management of acute disseminated encephalomyelitis.

    PubMed

    Ellis, B D; Kosmorsky, G S; Cohen, B H

    1994-12-01

    Two children with a recent history of viral illness developed visual loss secondary to optic neuritis. Clinical findings and neuroimaging were consistent with acute disseminated encephalomyelitis (ADEM). Markedly elevated opening pressures were noted on lumbar puncture. The patients demonstrated an initial favorable response to high-dose corticosteroid administration. Both had recurrence of symptoms after being tapered off oral corticosteroids. High-dose corticosteroids were reinstituted and a bilateral optic nerve sheath decompression was performed on one patient who developed profound visual loss. A second patient underwent a lumboperitoneal shunt. Both children had resolution of their symptoms and had a recovery of normal visual acuity.

  11. 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.

  12. 42 CFR 482.24 - Condition of participation: Medical record services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... anesthesia services. The medical history and physical examination must be placed in the patient's medical... anesthesia services. (B) An updated examination of the patient, including any changes in the patient's... anesthesia services. (ii) Admitting diagnosis. (iii) Results of all consultative evaluations of the...

  13. 42 CFR 482.24 - Condition of participation: Medical record services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... anesthesia services. The medical history and physical examination must be placed in the patient's medical... anesthesia services. (B) An updated examination of the patient, including any changes in the patient's... anesthesia services. (ii) Admitting diagnosis. (iii) Results of all consultative evaluations of the...

  14. 78 FR 31563 - Ryan White HIV/AIDS Program Core Medical Services Waiver; Application Requirements

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-24

    ... Administration Ryan White HIV/AIDS Program Core Medical Services Waiver; Application Requirements AGENCY: Health... XXVI of the Public Health Service Act, as amended by the Ryan White HIV/AIDS Treatment Extension Act of... on core medical services, including antiretroviral drugs, for individuals with HIV/AIDS...

  15. Marketing home health care medical services: the physician's view.

    PubMed

    Ryan, E J; Phelps, R A

    1993-01-01

    The authors surveyed physicians serving the Jackson, Mississippi home health care market. They identified problems and studied physician perceptions regarding services provided by home health care agencies, private duty nursing agencies, and durable medical equipment suppliers. Respondents perceived home health care as providing: (1) increased patient satisfaction, (2) greater patient convenience, (3) earlier discharge, and (4) lowered patient costs. They least liked: (1) lack of control and involvement in the patient caring process, (2) paperwork, (3) quality control potential, and the possibility that patient costs could increase. Two sets of implications for health care marketers are presented that involve both national and regional levels. Overall results indicate that a growing and profitable market segment exists and is being served in an effective and socially responsible manner.

  16. [Medical doctor in mountain rescue service - a profession's perspective].

    PubMed

    Putzke, Matthias

    2008-01-01

    Helicopter emergency services (HEMS) carrying doctors trained in emergency medicine represent a well established system for primary care with increasing professionalism since their implementation in the seventies until now. However, considerable differences persist in Europe concerning the structure as well as integration of the system in the entire organisation of area-wide demands. Based on the particular geographic conditions in the alps which are highly associated with challenges for man and material a dense network of helicopter airbases has been established. Hence, this system accounts for the social, economical and touristic requirements of this region in terms of providing sufficient emergency medical treatment. In addition to statutory and professional provisions qualification requirements for emergency doctors comprehend extensive alpine training. Primarily this provides personal safety as well as security for the entire team and the patient which particularly applies for technical rope rescue. Advanced all-season training is compulsory due to seasonal differences in casualties. Well harmonized training with cross-border validity is not available to-date. Hence, the development of obligatory standard operating procedures should be the major goal of medical associations and societies.

  17. 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.

  18. 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.

  19. Medical Acute Complications of Intracerebral Hemorrhage in Young Adults

    PubMed Central

    Koivunen, Riku-Jaakko; Haapaniemi, Elena; Satopää, Jarno; Niemelä, Mika; Tatlisumak, Turgut; Putaala, Jukka

    2015-01-01

    Background. Frequency and impact of medical complications on short-term mortality in young patients with intracerebral hemorrhage (ICH) have gone unstudied. Methods. We reviewed data of all first-ever nontraumatic ICH patients between 16 and 49 years of age treated in our hospital between January 2000 and March 2010 to identify medical complications suffered. Logistic regression adjusted for known ICH prognosticators was used to identify medical complications associated with mortality. Results. Among the 325 eligible patients (59% males, median age 42 [interquartile range 34–47] years), infections were discovered in 90 (28%), venous thrombotic events in 13 (4%), cardiac complications in 4 (1%), renal failure in 59 (18%), hypoglycemia in 15 (5%), hyperglycemia in 165 (51%), hyponatremia in 146 (45%), hypernatremia in 91 (28%), hypopotassemia in 104 (32%), and hyperpotassemia in 27 (8%). Adjusted for known ICH prognosticators and diabetes, the only independent complication associated with 3-month mortality was hyperglycemia (plasma glucose >8.0 mmol/L) (odds ratio: 5.90, 95% confidence interval: 2.25–15.48, P < 0.001). Three or more separate complications suffered also associated with increased mortality (7.76, 1.42–42.49, P = 0.018). Conclusions. Hyperglycemia is a frequent complication of ICH in young adults and is independently associated with increased mortality. However, multiple separate complications increase mortality even further. PMID:25722917

  20. Extended duration of thromboprophylaxis in acutely ill medical patients: optimizing therapy?

    PubMed

    Turpie, A G G

    2007-01-01

    Summary. Patients who are hospitalized for an acute medical illness are at risk of venous thromboembolism (VTE). Current evidence-based guidelines recommend prophylaxis with unfractionated heparin or low-molecular-weight heparin in acutely ill medical patients who are admitted to hospital with congestive heart failure, severe respiratory disease, or who are bedridden with an additional VTE risk factor. The need for thromboprophylaxis is therefore clear in this patient population; however, the optimal duration of prophylaxis in these patients is less clear. In patients undergoing orthopedic or cancer surgery, extended-duration prophylaxis has been shown to be superior to placebo. To date, however, no large-scale clinical trials have assessed the benefits of extended-duration prophylaxis in acutely ill medical patients. This review therefore focuses on the VTE risk profile of acutely ill medical patients, examines the currently available literature for evidence of a potential benefit of extended-duration prophylaxis in these patients, and provides a rationale for the testing of such a hypothesis in a randomized clinical trial.

  1. Severe Acute Respiratory Syndrome and the Delivery of Continuing Medical Education: Case Study from Toronto

    ERIC Educational Resources Information Center

    Davis, Dave; Ryan, David; Sibbald, Gary; Rachlis, Anita; Davies, Sharon; Manchul, Lee; Parikh, Sagar

    2004-01-01

    Introduction: Severe acute respiratory syndrome (SARS) struck Toronto in the spring of 2003, causing many deaths, serious morbidity, forced quarantine of thousands of individuals, and the closure of all provincial hospitals for several weeks. Given the direction by public health authorities to cancel or postpone all continuing medical education…

  2. [Prehospital stage of medical aid to patients with acute coronary syndrome and elevated ST segment].

    PubMed

    Vertkin, A L; Morozov, S N; Fedorov, A I

    2013-01-01

    We studied effect of time on the outcome of acute coronary syndrome and elevated ST segment at the prehospital stage. Logistic regression analysis revealed two time-dependent predictors: "symptom-needle" time and total call service time. In patients undergoing prehospital thrombolysis, these indices (88 and 85 min respectively) reliably predicted the probability of fatal outcome. Their values of 71 and 77 min respectively predicted the risk of unfavourable outcome. The total call service time may serve as an indicator of the quality of work of an ambulance crew at the prehospital stage of management of acute coronary syndrome with elevated ST segment.

  3. 38 CFR 17.241 - Sharing medical information services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ..., research centers, and individual members of the medical profession, under which medical information and... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Sharing medical... AFFAIRS MEDICAL Sharing of Medical Facilities, Equipment, and Information § 17.241 Sharing...

  4. 38 CFR 17.241 - Sharing medical information services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ..., research centers, and individual members of the medical profession, under which medical information and... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Sharing medical... AFFAIRS MEDICAL Sharing of Medical Facilities, Equipment, and Information § 17.241 Sharing...

  5. 38 CFR 17.241 - Sharing medical information services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., research centers, and individual members of the medical profession, under which medical information and... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Sharing medical... AFFAIRS MEDICAL Sharing of Medical Facilities, Equipment, and Information § 17.241 Sharing...

  6. 38 CFR 17.241 - Sharing medical information services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., research centers, and individual members of the medical profession, under which medical information and... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Sharing medical... AFFAIRS MEDICAL Sharing of Medical Facilities, Equipment, and Information § 17.241 Sharing...

  7. Chemotherapy of acute myeloid leukaemia in adults: Medical Research Council.

    PubMed Central

    1979-01-01

    Two hundred and fifty patients with acute myeloid leukaemia (AML) were randomized between 2 regimens of chemotherapy: TRAP and BARTS III. Overall, patients randomized to TRAP, which was the more intensive of the 2 regimens, fared slightly better (P = 0.06) than those on BARTS III. However, the improvement in survival associated with more intensive chemotherapy was substantial only for patients who had favourable prognostic features at presentation, such as a normal total leucocyte count, or absence of palpable liver, or, especially, age under 40. Indeed, for patients under 40, those allocated to the more intensive regimen (TRAP) lived considerably longer than those allocated to BARTS III (P less than 0.002) while for patients over 40 there was no material difference in survival between patients on the 2 protocols. It thus appears that intensive chemotherapy is likely to be more effective when favourable prognostic features are recorded. PMID:365212

  8. 78 FR 28631 - Experian, Experian Healthcare (Medical Present Value (MPV)-Credit Services and Decision Analytics...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-15

    ... Employment and Training Administration Experian, Experian Healthcare (Medical Present Value (MPV)-- Credit... 4, 2013, applicable to workers of Experian, Experian Healthcare, (medical Present Value (MPV... Present Value (MPV)--Credit Services and Decision Analytics), Plymouth, Massachusetts...

  9. Customer satisfaction in medical service encounters -- a comparison between obstetrics and gynecology patients and general medical patients.

    PubMed

    Chang, Ching-Sheng; Weng, Hui-Ching; Chang, Hsin-Hsin; Hsu, Tsuen-Ho

    2006-03-01

    This study is concerned with the "service encounter", and seeks to describe, by use of the Service Encounter Evaluation Model, how the processes involved in the service encounter affect customer satisfaction. Its findings have implications for management practice and research directions, and recommendations are made. With the implementation of a national health insurance scheme, an ever-prospering economy and continually improving educational levels in Taiwan, demand among citizens for good health and medical care is ever increasing. Obstetrics and gynecology patients often differ greatly from general patients, in terms of their moods and emotions. This research involved an empirical study, whose subjects were 590 customers of general clinics and 339 customers of gynecology clinics, in various medical centers in southern Taiwan. By factor analysis, the study established four influencing factors, which were "Medical professionals", "Nursing professionals", "Service personnel" and "Space and facilities". Using the Linear Structural Relation Model (LISREL), it found that medical professionals, nursing professionals, service personnel and space and facilities were effective predictors of medical treatment satisfaction. We also found that the greatest positive impact on overall medical treatment satisfaction resulted from rises in satisfaction with medical professionals, but that the least impact was achieved in relation to service personnel in the general and gynecology clinics.

  10. Preventive Services by Medical and Dental Providers and Treatment Outcomes

    PubMed Central

    Kranz, A.M.; Rozier, R.G.; Preisser, J.S.; Stearns, S.C.; Weinberger, M.; Lee, J.Y.

    2014-01-01

    Objective: Nearly all state Medicaid programs reimburse nondental primary care providers (PCPs) for providing preventive oral health services to young children; yet, little is known about how treatment outcomes compare with children visiting dentists. This study compared the association between the provider of preventive services (PCP, dentist, or both) with Medicaid-enrolled children before their third birthday and subsequent dental caries-related treatment (CRT) and CRT payment. Methods: We conducted a retrospective study of young children enrolled in North Carolina Medicaid during 2000 to 2006. The annual number of CRT and CRT payments per child between the ages of 3 and 5 yr were estimated with a zero-inflated negative binomial regression and a hurdle model, respectively. Models were adjusted for relevant child- and county-level characteristics and used propensity score weighting to address observed confounding. Results: We examined 41,453 children with > 1 preventive oral health visit from a PCP, dentist, or both before their third birthday. Unadjusted annual mean CRT and payments were lowest among children who had only PCP visits (CRT = 0.87, payment = $172) and higher among children with only dentist visits (CRT = 1.48, payment = $234) and both PCP and dentist visits (CRT = 1.52, payment = $273). Adjusted results indicated that children who had dentist visits (with or without PCP visits) had significantly more CRT and higher CRT payments per year during the ages of 3 and 4 yr than children who had only PCP visits. However, these differences attenuated each year after age 3 yr. Conclusions: Because of children’s increased opportunity to receive multiple visits in medical offices during well-child visits, preventive oral health services provided by PCPs may lead to a greater reduction in CRT than dentist visits alone. This study supports guidelines and reimbursement policies that allow preventive dental visits based on individual needs. PMID:24891593

  11. Unit Cost of Medical Services at Different Hospitals in India

    PubMed Central

    Chatterjee, Susmita; Levin, Carol; Laxminarayan, Ramanan

    2013-01-01

    Institutional care is a growing component of health care costs in low- and middle-income countries, but local health planners in these countries have inadequate knowledge of the costs of different medical services. In India, greater utilisation of hospital services is driven both by rising incomes and by government insurance programmes that cover the cost of inpatient services; however, there is still a paucity of unit cost information from Indian hospitals. In this study, we estimated operating costs and cost per outpatient visit, cost per inpatient stay, cost per emergency room visit, and cost per surgery for five hospitals of different types across India: a 57-bed charitable hospital, a 200-bed private hospital, a 400-bed government district hospital, a 655-bed private teaching hospital, and a 778-bed government tertiary care hospital for the financial year 2010–11. The major cost component varied among human resources, capital costs, and material costs, by hospital type. The outpatient visit cost ranged from Rs. 94 (district hospital) to Rs. 2,213 (private hospital) (USD 1 = INR 52). The inpatient stay cost was Rs. 345 in the private teaching hospital, Rs. 394 in the district hospital, Rs. 614 in the tertiary care hospital, Rs. 1,959 in the charitable hospital, and Rs. 6,996 in the private hospital. Our study results can help hospital administrators understand their cost structures and run their facilities more efficiently, and we identify areas where improvements in efficiency might significantly lower unit costs. The study also demonstrates that detailed costing of Indian hospital operations is both feasible and essential, given the significant variation in the country’s hospital types. Because of the size and diversity of the country and variations across hospitals, a large-scale study should be undertaken to refine hospital costing for different types of hospitals so that the results can be used for policy purposes, such as revising payment rates

  12. Improving care planning and coordination for service users with medical co-morbidity transitioning between tertiary medical and primary care services.

    PubMed

    Cranwell, K; Polacsek, M; McCann, T V

    2016-08-08

    WHAT IS KNOWN ON THE SUBJECT?: Mental health service users with medical co-morbidity frequently experience difficulties accessing and receiving appropriate treatment in emergency departments. Service users frequently experience fragmented care planning and coordinating between tertiary medical and primary care services. Little is known about mental health nurses' perspectives about how to address these problems. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Emergency department clinicians' poor communication and negative attitudes have adverse effects on service users and the quality of care they receive. The findings contribute to the international evidence about mental health nurses' perspectives of service users feeling confused and frustrated in this situation, and improving coordination and continuity of care, facilitating transitions and increasing family and caregiver participation. Intervention studies are needed to evaluate if adoption of these measures leads to sustainable improvements in care planning and coordination, and how service users with medical co-morbidity are treated in emergency departments in particular. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Effective planning and coordination of care are essential to enable smooth transitions between tertiary medical (emergency departments in particular) and primary care services for service users with medical co-morbidity. Ongoing professional development education and support is needed for emergency department clinicians. There is also a need to develop an organized and systemic approach to improving service users' experience in emergency departments.

  13. The use of a Swedish telephone medical advice service by the elderly – a population-based study

    PubMed Central

    Dahlgren, K.; Holzmann, M. J.; Carlsson, A. C.; Wändell, P.; Hasselström, J.; Ruge, T.

    2017-01-01

    Objective The present study aimed to describe contact made by the elderly to Sweden’s nationwide medical helpline, Healthcare Guide 1177 by Phone (HGP). Other objectives were to study potential gender differences and the association between different HGP referral levels and acute visits to hospital-based emergency departments and acute visits to primary care centres. Design De-identified data from recorded calls to HGP was extracted for analysis (n = 7477 for the oldest age group). Information about acute visits to emergency departments and to primary care reception was extracted from the patient administration system. Setting Västerbotten County, Sweden. Subjects Patients over 80 years. Main outcome measures Calling and visiting frequencies for different age groups as well as reasons for contact and individual recommendations. Results The utilisation rate of the telephone advice service for the oldest age group was high, with an incidence rate of 533 per 1000 person-years. Women had a 1.17 times higher incidence rate compared with men. The most common reason for contact was drug-related questions (17% of all contacts). Calls that were recommended to care by a medical specialist correlated with total emergency department visits (r = 0.30, p < 0.05) and calls that were given advice correlated with acute primary healthcare visits (r = 0.38, p = 0.005). Conclusion The high utilisation of the telephone advice service by the elderly gives the telephone advice service a unique ability to function as a gatekeeper to further healthcare. Our data suggest that with the telephone advice service’s present guidelines, a significant proportion of all calls are being directed to further medical help. The high frequency of drug-related questions raises concerns about the elderly’s medication regimens. Key points Patients over 80 years of age had a high utilisation of the telephone medical advice service compared with other age groups. Drug

  14. 77 FR 69504 - Calendar Year 2012 Cost of Outpatient Medical and Dental Services Furnished by Department of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-19

    ... the cost of outpatient medical and dental services furnished by military treatment facilities through... BUDGET Calendar Year 2012 Cost of Outpatient Medical and Dental Services Furnished by Department of Defense Medical Treatment Facilities; Certain Rates Regarding Recovery From Tortiously Liable...

  15. Analysis of the Effects Special Pays Have on Retention in the Medical Service Corps

    DTIC Science & Technology

    2011-03-01

    and Medical Service Corps Professions Officers Special Pays. OPNAV Instruction 7220.17 (December 28, 2005). Special Pay for Medical Corps, Dental ...health and industrial hygiene officers. The specialties focused on in this study, the specialties that receive a special pay, are all located in the...level. 2. OPNAV Instruction 7220.17 The overarching instruction that establishes special pays for Medical Corps, Dental Corps, Medical Service Corps

  16. The development of an outcomes management system for acute medical rehabilitation.

    PubMed

    Cohen, B A; Grigonis, A M; Topper, M E; Morrison, M H

    1997-01-01

    In 1993, Continental Medical Systems, Inc. (CMS), a provider of comprehensive medical rehabilitation, developed the Total Outcomes and Prediction Program (TOPP) to measure and evaluate key medical rehabilitation outcomes, quality indicators, and patient satisfaction at its 37 acute rehabilitation hospitals. The broad purposes of TOPP are to manage patient treatment, improve the cost-effectiveness of care, and provide outcomes reporting for managed care and other interested parties. The challenge was to develop a system which could measure, evaluate, and report medical rehabilitation patient outcomes in a way that could be easily understood by multiple audiences, including payers, accrediting organizations, physicians, patients and families, case managers, and CMS clinical staff. Using data from the Uniform Data System for Medical Rehabilitation database, CMS created descriptive outcomes reports for each hospital and for the corporation overall, including performance statistics, outcomes report cards, and quality report cards. These initial reports, as well as updates, quarterly reports, and special ad hoc requests, provide CMS corporate and hospital staff with statistically valid and reliable information to manage the outcomes of medical rehabilitation treatment. TOPP has assisted CMS with meeting accreditation standards for outcomes management and measurement and has been used in managed care contract negotiations. Future TOPP efforts will integrate resource use data, medical acuity and outcomes from acute, subacute, and outpatient rehabilitation levels into CMS' outcomes reporting system.

  17. Nurses' attitudes towards the use of PRN psychotropic medications in acute and forensic mental health settings.

    PubMed

    Barr, Lesley; Wynaden, Dianne; Heslop, Karen

    2017-03-24

    Many countries now have national mental health policies and guidelines to decrease or eliminate the use of seclusion and restraint yet the use of Pro Re Nata (PRN) medications has received less practice evaluation. This research aimed to identify mental health nurses' attitudes towards the use of PRN medications with mental health consumers. Participants were working in forensic mental health and non-forensic acute mental health settings. The "Attitudes towards PRN medication use survey" was used and data were collected online. Data were analysed using the Statistical Package Social Sciences, Version 22.0. Practice differences between forensic and other acute mental health settings were identified related to the use of PRN medications to manage symptoms from nicotine, alcohol and other drug withdrawal. Differences related to the useage of comfort rooms and conducting comprehensive assessments of consumers' psychiatric symptoms were also detected. Qualitative findings highlighted the need for increased accountability for the prescribing and administration of PRN medications along with more nursing education/training to use alternative first line interventions. Nurses administering PRN medications should be vigilant regarding the indications for this practice to ensure they are facilitating the consumer's recovery by reducing the use of all forms of potentially restrictive practices in the hospital setting. The reasons for using PRN medications and PRN administration rates must be continually monitored to avoid practices such as high dose antipsychotics use and antipsychotic polypharmacy to ensure the efficacy of the consumers' management plans on their health care outcomes.

  18. [Market of medical services provided to patients with sexually transmitted diseases].

    PubMed

    Martynenko, A V

    2001-01-01

    Data are presented from an investigation designed to study market of medical services delivered to patients with sexually transmitted diseases (STD). A model of the purchaser's behaviour of consumers of medical services is developed, decisive factors affecting the choice of a medical institution when applying for a profile medical advice are determined. Submitted in the paper is also an algorythm of analysis of expediency of segmentation of market of medical services delivered to STD patients. The most optimal principles of market segmentation include the following--economic (solvency), territorial (place of residence), social (belonging to one or another stratum of society).

  19. Medical treatment of acute poisoning with organophosphorus and carbamate pesticides.

    PubMed

    Jokanović, Milan

    2009-10-28

    Organophosphorus compounds (OPs) are used as pesticides and developed as warfare nerve agents such as tabun, soman, sarin, VX and others. Exposure to even small amounts of an OP can be fatal and death is usually caused by respiratory failure. The mechanism of OP poisoning involves inhibition of acetylcholinesterase (AChE) leading to inactivation of the enzyme which has an important role in neurotransmission. AChE inhibition results in the accumulation of acetylcholine at cholinergic receptor sites, producing continuous stimulation of cholinergic fibers throughout the nervous systems. During more than five decades, pyridinium oximes have been developed as therapeutic agents used in the medical treatment of poisoning with OP. They act by reactivation of AChE inhibited by OP. However, they differ in their activity in poisoning with pesticides and warfare nerve agents and there is still no universal broad-spectrum oxime capable of protecting against all known OP. In spite of enormous efforts devoted to development of new pyridinium oximes as potential antidotes against poisoning with OP only four compounds so far have found its application in human medicine. Presently, a combination of an antimuscarinic agent, e.g. atropine, AChE reactivator such as one of the recommended pyridinium oximes (pralidoxime, trimedoxime, obidoxime and HI-6) and diazepam are used for the treatment of OP poisoning in humans. In this article the available data related to medical treatment of poisoning with OP pesticides are reviewed and the current recommendations are presented.

  20. 38 CFR 21.6242 - Resources for provision of medical treatment, care and services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Temporary... primary resources for the provision of medical treatment, care and services for program participants...

  1. A study of the workload and effectiveness of a comprehensive acute stroke service

    PubMed Central

    Weir, N; Buchan, A

    2005-01-01

    Methods: Prospective record of all acute referrals, diagnoses, and management decisions over a 4 month period. Results: The CSP received 572 referrals (median: 32 per week), 88% of which were made between 7 am and midnight. Of the 427 patients seen in person, 29% had not had an acute stroke or transient ischaemic attack (TIA). Fifty percent of patients with suspected acute stroke were referred within 3 h of symptom onset and 11% with acute ischaemic stroke (equating to 35% of those referred within 3 h of onset and seen in person) were treated with thrombolysis. Conclusion: Centralisation of services facilitates the rapid referral of, and use of acute interventions in, patients with acute stroke and TIA. Centralised services are likely to be busy (although less so at night), to attract large numbers of patients with disorders that mimic stroke and TIA, and yet still likely to treat only the minority of acute strokes using thrombolysis. These observations may help those planning similar services and underline the need to develop more widely applicable treatments for acute stroke. PMID:15897513

  2. The evaluation of the need to share medical data on the community medical ICT network service in Nagasaki, Japan.

    PubMed

    Matsumoto, Takehiro; Honda, Masayuki

    2013-01-01

    The Community Medical ICT Network service at the Nagasaki, Japan was established in 2009. Medical information network for sharing patients data was investigated focused on the access log data from April of 2009 and October of 2010. The total number of the access to the medical information was 30,914 of 2,213 patients. And the total number of access of the image including diagnostic imaging report, medical examination, treatment and medical documents was 10,278(33.2%), 8,949(28.9%), 6,896(22.3%) and 4,791(15.5%) respectively. These results showed that these medical information had enough valued for sharing in the regional medicine. In conclusion, many types of medical information should be required for sharing in the community medical ICT network in Japan.

  3. Mental health consumers' with medical co‐morbidity experience of the transition through tertiary medical services to primary care

    PubMed Central

    Cranwell, Kate; Polacsek, Meg

    2016-01-01

    Abstract Medical comorbidity in people with long‐term mental illness is common and often undetected; however, these consumers frequently experience problems accessing and receiving appropriate treatment in public health‐care services. The aim of the present study was to understand the lived experience of mental health consumers with medical comorbidity and their carers transitioning through tertiary medical to primary care services. An interpretative, phenomenological analysis approach was used, and semistructured, video‐recorded, qualitative interviews were used with 12 consumers and four primary caregivers. Four main themes and related subthemes were abstracted from the data, highlighting consumer's and carers’ experience of transition through tertiary medical to primary care services: (i) accessing tertiary services is difficult and time consuming; (ii) contrasting experiences of clinician engagement and support; (iii) lack of continuity between tertiary medical and primary care services; and (iv) Mental Health Hospital Admission Reduction Programme (MH HARP) clinicians facilitating transition. Our findings have implications for organisational change, expanding the role of MH HARP clinicians (whose primary role is to provide consumers with intensive support and care coordination to prevent avoidable tertiary medical hospital use), and the employment of consumer and carer consultants in tertiary medical settings, especially emergency departments. PMID:26735771

  4. Acute Hyperglycemia Associated with Anti-Cancer Medication

    PubMed Central

    Hwangbo, Yul

    2017-01-01

    Hyperglycemia during chemotherapy occurs in approximately 10% to 30% of patients. Glucocorticoids and L-asparaginase are well known to cause acute hyperglycemia during chemotherapy. Long-term hyperglycemia is also frequently observed, especially in patients with hematologic malignancies treated with L-asparaginase-based regimens and total body irradiation. Glucocorticoid-induced hyperglycemia often develops because of increased insulin resistance, diminished insulin secretion, and exaggerated hepatic glucose output. Screening strategies for this condition include random glucose testing, hemoglobin A1c testing, oral glucose loading, and fasting plasma glucose screens. The management of hyperglycemia starts with insulin or sulfonylurea, depending on the type, dose, and delivery of the glucocorticoid formulation. Mammalian target of rapamycin (mTOR) inhibitors are associated with a high incidence of hyperglycemia, ranging from 13% to 50%. Immunotherapy, such as anti-programmed death 1 (PD-1) antibody treatment, induces hyperglycemia with a prevalence of 0.1%. The proposed mechanism of immunotherapy-induced hyperglycemia is an autoimmune process (insulitis). Withdrawal of the PD-1 inhibitor is the primary treatment for severe hyperglycemia. The efficacy of glucocorticoid therapy is not fully established and the decision to resume PD-1 inhibitor therapy depends on the severity of the hyperglycemia. Diabetic patients should achieve optimized glycemic control before initiating treatment, and glucose levels should be monitored periodically in patients initiating mTOR inhibitor or PD-1 inhibitor therapy. With regard to hyperglycemia caused by anti-cancer therapy, frequent monitoring and proper management are important for promoting the efficacy of anti-cancer therapy and improving patients' quality of life. PMID:28345313

  5. 42 CFR 456.6 - Review by State medical agency of appropriateness and quality of services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... and quality of services. 456.6 Section 456.6 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Provisions § 456.6 Review by State medical agency of appropriateness and quality of services. (a) The... professional health personnel of the appropriateness and quality of Medicaid services. (b) The purpose of...

  6. The implementation of community-based crisis services for people with acute psychiatric illness.

    PubMed

    Finch, S J; Burgess, P M; Herrman, H E

    1991-06-01

    This article describes three recently established community-based crisis services for people with acute psychiatric illness. Data were obtained from local information systems developed in the early phase of service operation. Patterns of service were found to vary among the teams in terms of the frequency of contact with the client, the period of contact with the client and the overall numbers of contacts. Such diversification of services reflects, at least in part, the differences in the service networks within which the new services were Such diversification of services is inevitable and creative, and the evaluation of these services must consider not only the short-term impact of crisis services, but also the impact of the network of care services on longer term outcomes for the client.

  7. Advances in medical revascularisation treatments in acute ischemic stroke.

    PubMed

    Asadi, H; Yan, B; Dowling, R; Wong, S; Mitchell, P

    2014-01-01

    Urgent reperfusion of the ischaemic brain is the aim of stroke treatment and there has been ongoing research to find a drug that can promote vessel recanalisation more completely and with less side effects. In this review article, the major studies which have validated the use and safety of tPA are discussed. The safety and efficacy of other thrombolytic and anticoagulative agents such as tenecteplase, desmoteplase, ancrod, tirofiban, abciximab, eptifibatide, and argatroban are also reviewed. Tenecteplase and desmoteplase are both plasminogen activators with higher fibrin affinity and longer half-life compared to alteplase. They have shown greater reperfusion rates and improved functional outcomes in preliminary studies. Argatroban is a direct thrombin inhibitor used as an adjunct to intravenous tPA and showed higher rates of complete recanalisation in the ARTTS study with further studies which are now ongoing. Adjuvant thrombolysis techniques using transcranial ultrasound are also being investigated and have shown higher rates of complete recanalisation, for example, in the CLOTBUST study. Overall, development in medical therapies for stroke is important due to the ease of administration compared to endovascular treatments, and the new treatments such as tenecteplase, desmoteplase, and adjuvant sonothrombolysis are showing promising results and await further large-scale clinical trials.

  8. 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.

  9. 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

  10. 38 CFR 21.6240 - Medical treatment, care and services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... services (including services related to blindness and deafness) including: (i) Language training, speech... described in paragraph (b) of this section during: (1) Evaluation; (2) Rehabilitation to the...

  11. Experiences of the Implementation of a Learning Disability Nursing Liaison Service within an Acute Hospital Setting: A Service Evaluation

    ERIC Educational Resources Information Center

    Castles, Amy; Bailey, Carol; Gates, Bob; Sooben, Roja

    2014-01-01

    It has been well documented that people with learning disabilities receive poor care in acute settings. Over the last few years, a number of learning disability liaison nurse services have developed in the United Kingdom as a response to this, but there has been a failure to systematically gather evidence as to their effectiveness. This article…

  12. A web service for enabling medical image retrieval integrated into a social medical image sharing platform.

    PubMed

    Niinimäki, Marko; Zhou, Xin; de la Vega, Enrique; Cabrer, Miguel; Müller, Henning

    2010-01-01

    Content-based visual image access is in the process from a research domain towards real applications. So far, most image retrieval applications have been in one specialized domain such as lung CTs as diagnosis aid or for classification of general images based on anatomic region, modality, and view. This article describes the use of a content-based image retrieval system in connection with the medical image sharing platform MEDTING, so a data set with a very large variety. Similarity retrieval is possible for all cases of the social image sharing platform, so cases can be linked by either visual similarity or similarity in keywords. The visual retrieval search is based on the GIFT (GNU Image Finding Tool). The technology for updating the index with new images added by users employs RSS (Really Simple Syndication) feeds. The ARC (Advanced Resource Connector) middleware is used for the implementation of a web service for similarity retrieval, simplifying the integration of this service. Novelty of this article is the application/integration and image updating strategy. Retrieval methods themselves employ existing techniques that are all open source and can easily be reproduced.

  13. Implementation of an Acute Care Surgery Service in a Community Hospital: Impact on Hospital Efficiency and Patient Outcomes.

    PubMed

    Kalina, Michael

    2016-01-01

    A service led by acute care surgeons managing trauma, critically ill surgical, and emergency general surgery patients via an acute care surgery model of patient care improves hospital efficiency and patient outcomes at university-affiliated hospitals and American College of Surgeons-verified trauma centers. Our goal was to determine whether an acute care surgeon led service, entitled the Surgical Trauma and Acute Resuscitative Service (STARS) that implemented an acute care surgery model of patient care, could improve hospital efficiency and patient outcomes at a community hospital. A total of 492 patient charts were reviewed, which included 230 before the implementation of the STARS [pre-STARS (control)] and 262 after the implementation of the STARS [post-STARS (study)]. Demographics included age, gender, Acute Physiology and Chronic Health Evaluation 2 score, and medical comorbidities. Efficiency data included length of stay in emergency department (ED-LOS), length of stay in surgical intensive care unit (SICU-LOS), and length of stay in hospital (H-LOS), and total in hospital charges. Average age was 64.1 + 16.4 years, 255 males (51.83%) and 237 females (48.17%). Average Acute Physiology and Chronic Health Evaluation 2 score was 11.9 + 5.8. No significant differences in demographics were observed. Average decreases in ED-LOS (9.7 + 9.6 hours, pre-STARS versus 6.6 + 4.5 hours, post-STARS), SICU-LOS (5.3 + 9.6 days, pre-STARS versus 3.5 + 4.8 days, post-STARS), H-LOS (12.4 + 12.7 days, pre-STARS versus 11.4 + 11.3 days, post-STARS), and total in hospital charges ($419,602.6 + $519,523.0 pre-STARS to $374,816.7 + $411,935.8 post-STARS) post-STARS. Regression analysis revealed decreased ED-LOS-2.9 hours [P = 0.17; 95% confidence interval (CI): -7.0, 1.2], SICU-LOS-6.3 days (P < 0.001; 95% CI: -9.3, -3.2), H-LOS-7.6 days (P = 0.001; 95% CI: -12.1, -3.1), and 3.4 times greater odds of survival (P = 0.04; 95% CI: 1.1, 10.7) post-STARS. In conclusion, implementation of

  14. Ecological Psychology: Replacing the Medical Model Paradigm for School-Based Psychological and Psychoeducational Services

    ERIC Educational Resources Information Center

    Gutkin, Terry B.

    2012-01-01

    Traditional medical model service delivery systems have facilitated the creation of nationwide mental health and education pandemics for children and youth. The characteristics and shortcomings of medical model approaches leading to these problems are explicated, including the focus of services on individuals rather than populations, relying…

  15. 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...

  16. 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...

  17. 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...

  18. 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...

  19. 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...

  20. 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...

  1. Human Trafficking Identification and Service Provision in the Medical and Social Service Sectors.

    PubMed

    Schwarz, Corinne; Unruh, Erik; Cronin, Katie; Evans-Simpson, Sarah; Britton, Hannah; Ramaswamy, Megha

    2016-06-01

    The medical sector presents a unique opportunity for identification and service to victims of human trafficking. In this article, we describe local and site-specific efforts to develop an intervention tool to be used in an urban hospital's emergency department in the midwestern United States. In the development of our tool, we focused on both identification and intervention to assist trafficked persons, through a largely collaborative process in which we engaged local stakeholders for developing site-specific points of intervention. In the process of developing our intervention, we highlight the importance of using existing resources and services in a specific community to address critical gaps in coverage for trafficked persons. For example, we focus on those who are victims of labor trafficking, in addition to those who are victims of sex trafficking. We offer a framework informed by rights-based approaches to anti-trafficking efforts that addresses the practical challenges of human trafficking victim identification while simultaneously working to provide resources and disseminate services to those victims.

  2. Primary oral health service provision in Aboriginal Medical Services-based dental clinics in Western Australia.

    PubMed

    Kruger, Estie; Perera, Irosha; Tennant, Marc

    2010-01-01

    Australians living in rural and remote areas have poorer access to dental care. This situation is attributed to workforce shortages, limited facilities and large distances to care centres. Against this backdrop, rural and remote Indigenous (Aboriginal) communities in Western Australia seem to be more disadvantaged because evidence suggests they have poorer oral health than non-Indigenous people. Hence, provision of dental care for Aboriginal populations in culturally appropriate settings in rural and remote Western Australia is an important public health issue. The aim of this research was to compare services between the Aboriginal Medical Services (AMS)-based clinics and a typical rural community clinic. A retrospective analysis of patient demographics and clinical treatment data was undertaken among patients who attended the dental clinics over a period of 6 years from 1999 to 2004. The majority of patients who received dental care at AMS dental clinics were Aboriginal (95.3%), compared with 8% at the non-AMS clinic. The rate of emergency at the non-AMS clinic was 33.5%, compared with 79.2% at the AMS clinics. The present study confirmed that more Indigenous patients were treated in AMS dental clinics and the mix of dental care provided was dominated by emergency care and oral surgery. This indicated a higher burden of oral disease and late utilisation of dental care services (more focus on tooth extraction) among rural and remote Indigenous people in Western Australia.

  3. Human Trafficking Identification and Service Provision in the Medical and Social Service Sectors

    PubMed Central

    Unruh, Erik; Cronin, Katie; Evans-Simpson, Sarah; Britton, Hannah; Ramaswamy, Megha

    2016-01-01

    Abstract The medical sector presents a unique opportunity for identification and service to victims of human trafficking. In this article, we describe local and site-specific efforts to develop an intervention tool to be used in an urban hospital’s emergency department in the midwestern United States. In the development of our tool, we focused on both identification and intervention to assist trafficked persons, through a largely collaborative process in which we engaged local stakeholders for developing site-specific points of intervention. In the process of developing our intervention, we highlight the importance of using existing resources and services in a specific community to address critical gaps in coverage for trafficked persons. For example, we focus on those who are victims of labor trafficking, in addition to those who are victims of sex trafficking. We offer a framework informed by rights-based approaches to anti-trafficking efforts that addresses the practical challenges of human trafficking victim identification while simultaneously working to provide resources and disseminate services to those victims. PMID:27781009

  4. Medical neglect death due to acute lymphoblastic leukaemia: an autopsy case report.

    PubMed

    Usumoto, Yosuke; Sameshima, Naomi; Tsuji, Akiko; Kudo, Keiko; Nishida, Naoki; Ikeda, Noriaki

    2014-12-01

    We report the case of 2-year-old girl who died of precursor B-cell acute lymphoblastic leukaemia (ALL), the most common cancer in children. She had no remarkable medical history. She was transferred to a hospital because of respiratory distress and died 4 hours after arrival. Two weeks before death, she had a fever of 39 degrees C, which subsided after the administration of a naturopathic herbal remedy. She developed jaundice 1 week before death, and her condition worsened on the day of death. Laboratory test results on admission showed a markedly elevated white blood cell count. Accordingly, the cause of death was suspected to be acute leukaemia. Forensic autopsy revealed the cause of death to be precursor B-cell ALL. With advancements in medical technology, the 5-year survival rate of children with ALL is nearly 90%. However, in this case, the deceased's parents preferred complementary and alternative medicine (i.e., naturopathy) to evidence-based medicine and had not taken her to a hospital for a medical check-up or immunisation since she was an infant. Thus, if she had received routine medical care, she would have a more than 60% chance of being alive 5 years after diagnosis. Therefore, we conclude that the parents should be accused of medical neglect regardless of their motives.

  5. 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...

  6. 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...

  7. 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...

  8. 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...

  9. 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...

  10. 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...

  11. Dynamic composition of medical support services in the ICU: Platform and algorithm design details.

    PubMed

    Hristoskova, Anna; Moeyersoon, Dieter; Van Hoecke, Sofie; Verstichel, Stijn; Decruyenaere, Johan; De Turck, Filip

    2010-12-01

    The Intensive Care Unit (ICU) is an extremely data-intensive environment where each patient needs to be monitored 24/7. Bedside monitors continuously register vital patient values (such as serum creatinine, systolic blood pressure) which are recorded frequently in the hospital database (e.g. every 2 min in the ICU of the Ghent University Hospital), laboratories generate hundreds of results of blood and urine samples, and nurses measure blood pressure and temperature up to 4 times an hour. The processing of such large amount of data requires an automated system to support the physicians' daily work. The Intensive Care Service Platform (ICSP) offers the needed support through the development of medical support services for processing and monitoring patients' data. With an increased deployment of these medical support services, reusing existing services as building blocks to create new services offers flexibility to the developer and accelerates the design process. This paper presents a new addition to the ICSP, the Dynamic Composer for Web services. Based on a semantic description of the medical support services, this Composer enables a service to be executed by creating a composition of medical services that provide the needed calculations. The composition is achieved using various algorithms satisfying certain quality of service (QoS) constraints and requirements. In addition to the automatic composition the paper also proposes a recovery mechanism in case of unavailable services. When executing the composition of medical services, unavailable services are dynamically replaced by equivalent services or a new composition achieving the same result. The presented platform and QoS algorithms are put through extensive performance and scalability tests for typical ICU scenarios, in which basic medical services are composed to a complex patient monitoring service.

  12. Private land mobile radio services; bio-medical telemetry operations--Federal Communications Commission. Final rule.

    PubMed

    1981-04-20

    This action changes rules in the Special Emergency Radio Service to permit the limited use of bio-medical telemetry systems on certain medical services VHF frequencies. The operation is to be allowed only beyond fifty miles from the center of urbanized areas of 600,000 or more population (U.S. Census of 1970). The bio-medical telemetry system is used to send electrocardiograms from patients to hospitals.

  13. Mesenchymal Stem Cell Therapy for Acute Radiation Syndrome: Innovative Medical Approaches in Military Medicine

    DTIC Science & Technology

    2015-01-30

    lymphoblastic leukemia: a randomized phase III trial. Blood. 1995;86(2):444–50. 36. Hu KX, Sun QY, Guo M, Ai HS. The radiation protection and therapy effects of...Literature 3. DATES COVERED (From - To) 4. TITLE AND SUBTITLE Mesenchymal stem cell therapy for acute radiation syndrome: innovative medical...MONITOR’S REPORT NUMBER(S) 12. DISTRIBUTION / AVAILABILITY STATEMENT Approved for public release; distribution unlimited 13

  14. Strategies to improve medication adherence in patients with schizophrenia: the role of support services

    PubMed Central

    El-Mallakh, Peggy; Findlay, Jan

    2015-01-01

    The purpose of this review is to describe research over the past 10 years on the role of support services in promoting medication adherence in mental health consumers diagnosed with schizophrenia. A literature search was conducted using the terms “medication adherence,” “schizophrenia,” and “support services,” using Medline, PubMed, and CINAHL. Reference lists from published studies were also reviewed to identify additional research studies. Twenty-two articles focused on support-service intervention studies, and these were selected for review. Available support-service interventions include adherence therapy, electronic reminders via text messages and telephones, cognitive–behavioral and motivational strategies, and financial incentives. Support-service intervention strategies need to be tailored to the specific needs of mental health consumers with schizophrenia. More research is needed to investigate effective support services to enhance long-term adherence and adherence to medications for medical illnesses in this population. PMID:25931823

  15. Cost-Effectiveness of a Specialist Geriatric Medical Intervention for Frail Older People Discharged from Acute Medical Units: Economic Evaluation in a Two-Centre Randomised Controlled Trial (AMIGOS)

    PubMed Central

    Tanajewski, Lukasz; Franklin, Matthew; Gkountouras, Georgios; Berdunov, Vladislav; Edmans, Judi; Conroy, Simon; Bradshaw, Lucy E.; Gladman, John R. F.; Elliott, Rachel A.

    2015-01-01

    designing effective and cost-effective specialist service for frail older people discharged from acute medical units is needed. Trial Registration ISRCTN registry ISRCTN21800480 http://www.isrctn.com/ISRCTN21800480 PMID:25942421

  16. The role of medical management for acute intravascular hemolysis in patients supported on axial flow LVAD.

    PubMed

    Hasin, Tal; Deo, Salil; Maleszewski, Joseph J; Topilsky, Yan; Edwards, Brooks S; Pereira, Naveen L; Stulak, John M; Joyce, Lyle; Daly, Richard; Kushwaha, Sudhir S; Park, Soon J

    2014-01-01

    Continuous flow left ventricular assist devices (LVADs) are used with good outcome. However, acute intravascular hemolysis due to thrombus in the pump remains a clinical challenge. We screened for LVAD-related intravascular hemolysis among 115 consecutive patients surviving HeartMateII implantation and investigated the role of medical therapy in resolving the hemolysis. Hemolytic events were identified in 7% of patients, 2-26 months after implant, manifested by peak lactate dehydrogenase (LDH) levels >6 times normal. With the institution of heparin and enhanced antiplatelet therapy, LDH levels receded rapidly reaching a stable trough level near baseline within 2 weeks with the resolution of clinical symptoms except in one patient who required additional therapy with tissue plasminogen activator (tPA). Complications included transient renal failure, one splenic infarct, and a cerebrovascular attack after tPA. The acute event of hemolysis resolved with medical therapy, and all were successfully discharged. However, recurrent hemolysis was common (6/8 patients over the next 1-7 months). At the end of follow-up, three patients were transplanted, one patient died refusing LVAD exchange for recurrent hemolysis, and 4 remained alive on LVAD support. Medical treatment with intensification of anticoagulation can be effective in resolving the acute hemolytic event. However, a definitive long-term strategy should be planned because the recurrence rate is high.

  17. A network system of medical and welfare information service for the patients, their families, hospitals, local governments, and commercial companies in a medical service area.

    PubMed

    Matsumura, Kouji; Antoku, Yasuaki; Inoue, Reika; Kobayashi, Mariko; Hanada, Eisuke; Iwasaki, Yasutaka; Kumagai, Yasushi; Iwamoto, Haruya; Tsuchihashi, Saburo; Iwaki, Miho; Kira, Jun-ichi; Nose, Yoshiaki

    2002-06-01

    A service information system using the Internet, which connected the various people who are related to medical treatment and nursing welfare, was constructed. An intractable neurological disease patient who lives in the Onga district, Fukuoka, Japan, and the people who are related to the service were chosen as test users in an experimental model. The communicated service information was divided into open-use data (electronic bulletin board, welfare service, medical care service, and link to private company service home page) and closed-use data (the individual patient's hysterics). The open data server was installed in an Internet service provider The open data could be accessed not only by the patient, but also by the family, information center, companies, hospitals, and nursing commodity store related to patient's nursing and medical treatment. Closed data server was installed in an information center (public health center). Only patient and information center staff can access the closed data. Patients should search and collect the service information of various medical and welfare services by themselves. Therefore, services prepared for the patient are difficult to know, and they cannot be sufficiently utilized. With the use of this information system, all usable service information became accessible, and patients could easily use it. The electronic bulletin board system (BBS) was used by patients for knowing each other or each others' family, and was used as a device for exchange of wisdom. Also, the questions for the specialist, such as doctor, dentist, teacher, physical therapist, care manager, welfare office staff member, and public health nurse, and the answers were shown on the BBS. By arranging data file, a reference of various patients in question and answer, which appeared in this BBS, was made as "advisory hints" and was added to the open data. The advisory hints became the new service information for the patients and their family. This BBS discovered

  18. Acute Pain Management Services: What Does the Air Force Have to Offer?

    DTIC Science & Technology

    2013-01-29

    Unrelieved pain due to this nociception , after surgery or trauma is often unhealthy, but it is preventable or controllable in a majority of cases...DC 20503. 1. AGENCY USE ONLY (Leaveblank) 2. REPORT DATE 26-Sep-97 3. REPORT TYPE AND DATES COVERED 4. TITLE AND SUBTITLE ACUTE PAIN MANAGEMENT...Prescribed by ANSI Std. 239.18 Designed using Perform Pro, WHS/DIOR. Oct 94 ACUTE PAIN MANAGEMENT SERVICES: WHAT DOES THE AIR FORCE HAVE TO OFFER

  19. Comparison of medication policies to guide nursing practice across seven Victorian health services.

    PubMed

    Fossum, Mariann; Hughes, Lee; Manias, Elizabeth; Bennett, Paul; Dunning, Trisha; Hutchinson, Alison; Considine, Julie; Botti, Mari; Duke, Maxine M; Bucknall, Tracey

    2016-01-25

    Objectives The objective of this paper is to review and compare the content of medication management policies across seven Australian health services located in the state of Victoria.Methods The medication management policies for health professionals involved in administering medications were obtained from seven health services under one jurisdiction. Analysis focused on policy content, including the health service requirements and regulations governing practice.Results and Conclusions The policies of the seven health services contained standard information about staff authorisation, controlled medications and poisons, labelling injections and infusions, patient self-administration, documentation and managing medication errors. However, policy related to individual health professional responsibilities, single- and double-checking medications, telephone orders and expected staff competencies varied across the seven health services. Some inconsistencies in health professionals' responsibilities among medication management policies were identified.What is known about the topic? Medication errors are recognised as the single most preventable cause of patient harm in hospitals and occur most frequently during administration. Medication management is a complex process involving several management and treatment decisions. Policies are developed to assist health professionals to safely manage medications and standardise practice; however, co-occurring activities and interruptions increase the risk of medication errors.What does this paper add? In the present policy analysis, we identified some variation in the content of medication management policies across seven Victorian health services. Policies varied in relation to medications that require single- and double-checking, as well as by whom, nurse-initiated medications, administration rights, telephone orders and competencies required to check medications.What are the implications for practitioners? Variation in

  20. 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

  1. [Service Middleware of Medical Information Integration and Exchange Based on HL7 and DICOM].

    PubMed

    Huang, Mian; Liu, Lijun; Xiong, Xin; Fan, Hongbo; Jia, Lianyin; Tang, Shouguo

    2015-08-01

    Medical information exchange and integration is the effective method to solve the interoperability and medical information island, and is the basis of medical information sharing. In this paper, we take medical texts and medical images as the basic integrated objects, DICOM, HL7 messages and datasets as the integrated units, efficient DI-COM, HL7 message construction and parsing methods as basis, design and realize a universal medical information integration and exchange service middleware. Experimental results show that the prototype system could perform medical information integration and exchange among relational database, HL7 and DICOM message, provide a feasible scheme to solve the medical information island and lay a good foundation for establishing the unified medical information integration and sharing platform. The middleware has been applied in the project named "development and demonstration of opened medical information integration system".

  2. A conceptual model of public medical service system based-on cell phone mobile platform

    NASA Astrophysics Data System (ADS)

    Fu, Hongjiao; Zhao, Yue

    In recent years, cell phones have played an increasingly important role in rapidly-developing global telecommunication services. At present, mobile business develops very fast. However, the development in other mobile service fields, such as public service, mobile medical service, etc, is still in its infant stage. Drawing on the experience of the 'doctor workstation project' which is cooperated by Renmin University of China and Norway Fredskorps Corporation, this paper discusses the research and implementation of the Doctor Workstation System based on cell phone mobile platform. From the practice of the Doctor Workstation System, the paper advances a conceptual model of public medical service system based-on cell phone mobile platform.

  3. 42 CFR 405.511 - Reasonable charges for medical services, supplies, and equipment.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., and equipment. 405.511 Section 405.511 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES..., and equipment. (a) General rule. (1) A charge for any medical service, supply, or equipment (including equipment servicing) that in the judgment of CMS generally does not vary significantly in quality from...

  4. 42 CFR 482.24 - Condition of participation: Medical record services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... to surgery or a procedure requiring anesthesia services. The medical history and physical examination... prior to surgery or a procedure requiring anesthesia services. (B) An updated examination of the patient... surgery or a procedure requiring anesthesia services. (ii) Admitting diagnosis. (iii) Results of...

  5. Is the acute care of frail elderly patients in a comprehensive geriatric assessment unit superior to conventional acute medical care?

    PubMed Central

    Ekerstad, Niklas; Karlson, Björn W; Dahlin Ivanoff, Synneve; Landahl, Sten; Andersson, David; Heintz, Emelie; Husberg, Magnus; Alwin, Jenny

    2017-01-01

    Objective The aim of this study was to investigate whether the acute care of frail elderly patients in a comprehensive geriatric assessment (CGA) unit is superior to the care in a conventional acute medical care unit. Design This is a clinical, prospective, randomized, controlled, one-center intervention study. Setting This study was conducted in a large county hospital in western Sweden. Participants The study included 408 frail elderly patients, aged ≥75 years, in need of acute in-hospital treatment. The patients were allocated to the intervention group (n=206) or control group (n=202). Mean age of the patients was 85.7 years, and 56% were female. Intervention This organizational form of care is characterized by a structured, systematic interdisciplinary CGA-based care at an acute elderly care unit. Measurements The primary outcome was the change in health-related quality of life (HRQoL) 3 months after discharge from hospital, measured by the Health Utilities Index-3 (HUI-3). Secondary outcomes were all-cause mortality, rehospitalizations, and hospital care costs. Results After adjustment by regression analysis, patients in the intervention group were less likely to present with decline in HRQoL after 3 months for the following dimensions: vision (odds ratio [OR] =0.33, 95% confidence interval [CI] =0.14–0.79), ambulation (OR =0.19, 95% CI =0.1–0.37), dexterity (OR =0.38, 95% CI =0.19–0.75), emotion (OR =0.43, 95% CI =0.22–0.84), cognition (OR = 0.076, 95% CI =0.033–0.18) and pain (OR =0.28, 95% CI =0.15–0.50). Treatment in a CGA unit was independently associated with lower 3-month mortality adjusted by Cox regression analysis (hazard ratio [HR] =0.55, 95% CI =0.32–0.96), and the two groups did not differ significantly in terms of hospital care costs (P>0.05). Conclusion Patients in an acute CGA unit were less likely to present with decline in HRQoL after 3 months, and the care in a CGA unit was also independently associated with lower mortality

  6. Optimizing medication use with a pharmacist-provided comprehensive medication management service for patients with psychiatric disorders.

    PubMed

    Cobb, Carla D

    2014-12-01

    Our objective was to evaluate a pharmacist-delivered comprehensive medication management (CMM) service provided to patients with psychiatric disorders. We conducted a retrospective review and analysis of medication-related data, and a return on investment cost analysis. The project consisted of 154 patients with psychiatric disorders who were referred to the CMM service by physicians, therapists, case managers, friends, or family, and were seen by the service between April 2011 and July 2013. CMM evaluates a patient's medications to ensure that they are appropriate, effective, safe, and convenient. Patients were seen by pharmacists trained in CMM and the treatment of mental illnesses, including one board-certified psychiatric pharmacist. All medications were reviewed including prescriptions, over-the-counter medications, and nutritional supplements. The patients' medication-related concerns, goals of treatment, vital signs, and laboratory studies were reviewed. Drug therapy problems such as adverse reactions, unnecessary medications, excessive doses, and poor medication adherence were identified, and written recommendations were mailed to patients and physicians within 1 week. Patients were offered follow-up in 4-6 weeks and were seen as many times as needed to resolve drug therapy problems. The 154 patients completed 256 CMM visits. A mean of 10.1 medical and psychiatric conditions and 13.7 medications/person were assessed. A mean of 5.6 drug therapy problems/patient were identified. A total net cost savings was estimated to be $90,484.00, with a mean savings of $586.55/patient. The cost of providing the service was estimated at $32,185.93. The return on investment was estimated to be 2.8; thus for every dollar spent on providing the service, $2.80 was estimated to be saved. Patients with mental illnesses may benefit from pharmacist-delivered CMM to help resolve drug therapy problems. Medication management may improve clinical outcomes and reduce costs. In

  7. Pediatric Medical Care System in China Has Significantly Reduced Abandonment of Acute Lymphoblastic Leukemia Treatment

    PubMed Central

    Zhou, Qi; Hong, Dan; Lu, Jun; Zheng, Defei; Ashwani, Neetica

    2015-01-01

    In this study, we have analyzed both administrative and clinical data from our hospital during 2002 to 2012 to evaluate the influence of government medical policies on reducing abandonment treatment in pediatric patients with acute lymphoblastic leukemia. Two policies funding for the catastrophic diseases and the new rural cooperative medical care system (NRCMS) were initiated in 2005 and 2011, respectively. About 1151 children diagnosed with acute lymphoblastic leukemia were enrolled in our study during this period and 316 cases abandoned treatment. Statistical differences in sex, age, number of children in the family, and family financial status were observed. Of most importance, the medical insurance coverage was critical for reducing abandonment treatment. However, 92 cases abandoning treatment after relapse did not show significant difference either in medical insurance coverage or in duration from first complete remission. In conclusion, financial crisis was the main reason for abandoning treatment. Government-funded health care expenditure programs reduced families’ economic burden and thereby reduced the abandonment rate with resultant increased overall survival. PMID:25393454

  8. A Business Case Analysis: Establishment of a Sub-Acute Ward for Tripler Army Medical Center

    DTIC Science & Technology

    2007-03-31

    comprises palliative care , rehabilitation medicine, psychogeriatrics, and geriatric evaluation and management. Non-acute care includes nursing home... Care Division for their assistance in gathering data. I would also like to thank Ms. Tessa Travers, and Mr. Donald McGue from the Resource Management...Services for her support in gathering data. Finally, I would like to express thanks to Mr. Richard Meiers, President of the Health Care Association of

  9. 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

  10. Medication Adherence Following Acute Coronary Syndrome: Does One Size Fit All?

    PubMed

    Bernal, Daniel D L; Bereznicki, Luke R E; Chalmers, Leanne; Castelino, Ronald L; Thompson, Angus; Davidson, Patricia M; Peterson, Gregory M

    2016-02-01

    Guideline-based management of acute coronary syndrome (ACS) is well established, yet some may challenge that strict implementation of guideline recommendations can limit the individualization of therapy. The use of all recommended medications following ACS places a high burden of responsibility and cost on patients, particularly when these medications have not been previously prescribed. Without close attention to avoiding non-adherence to these medications, the full benefits of the guideline recommendations will not be realized in many patients. Using a case example, we discuss how the recognition of adherence barriers can be an effective and efficient process for identifying patients at risk of non-adherence following ACS. For those identified as at risk, the World Health Organization's model of adherence barriers is explored as a potentially useful tool to assist with individualization of therapy and promotion of adherence.

  11. The Medical Home: Every Child Deserves One! Program Services Paper.

    ERIC Educational Resources Information Center

    Vitaglione, Tom

    Noting that health benefits for children should be one of the principal goals of comprehensive early childhood initiatives, this Smart Start brochure provides information on "medical homes" and their importance to the overall health of children; the brochure also describes community strategies to help promote a medical home for all…

  12. 78 FR 76061 - Authorization for Non-VA Medical Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-16

    ... Administrative practice and procedure, Alcohol abuse, Alcoholism, Claims, Day care, Dental health, Drug abuse...-VA medical care. In the Federal Register on November 28, 2012, VA proposed to remove an outdated regulatory limitation on veterans' eligibility to be referred for non- VA medical care. On the same date,...

  13. Cases from the Osler Medical Service at Johns Hopkins University.

    PubMed

    Habas, Allison B; Kim, Yuli; Jefferson, Brian K

    2003-12-01

    A 50-year-old African American woman presented with bilateral lower extremity pain, a history of falls during the past several months, and personality and behavior changes. She had been in good health until approximately 5 months before admission, when she began to fall with increasing frequency, often while going down a flight of stairs. She described these falls as her "legs giving out" and feeling very heavy and unsteady. There was no head trauma or loss of consciousness. Her daughter noticed that her gait had become somewhat unsteady during the last several months. Her family also noted a change in her personality at this time. Previously, she had been a very tidy person who took great care with her appearance, who was working as a customer service representative. However, she had become less social and very withdrawn. She had been observed putting on dirty clothes after showering, as well as eating constantly. The patient denied any fevers, chills, night sweats, headaches, vision changes, or tinnitus. She also denied any rashes, muscle pain, or intolerance to heat or cold. There was no history of seizure disorder or depression. Her past medical history was notable only for hypertension and being a passenger in a motor vehicle crash 1 year before admission. She denied any alcohol, tobacco, or illicit drug use, and had no travel history other than coming to the United States, as she was originally from Trinidad. On physical examination, she was a moderately obese African American woman with a flat affect, psychomotor slowing, and alopecia of the scalp. She was alert and oriented to person, place, and time, but had a score of 26 out of 30 on the Mini-Mental State Examination. She lost points only for recall; she had no difficulty with serial 7s. Her cranial nerves were intact and her speech was fluent, although sparse, and she did not make any paraphasic errors. Her muscle strength was 5/5 in both the upper and lower extremities. Reflexes were 2+ in the upper

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

    PubMed

    Dick, W

    1994-01-01

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

  15. A Proposal for the Consolidation of Dermatology Services of Walter Reed Army Medical Center and the National Naval Medical Center

    DTIC Science & Technology

    1999-08-01

    Prescribed by ANSI Std Z39-18 Dermatology Consolidation 2 ACKNOWLEDGEMENTS This project could not have been possible without the support of my family ...California and Hawaii (Assistant Secretary for Defense, Health Affairs (ASD (HA)), 1998). Beginning in 1988, CRI offered service families a choice of ways...TRICARE program. TRICARE is DoD’s regional managed health care program for service families . It is designed to meet the department’s medical mission

  16. Use and Safety of Anthroposophic Medications for Acute Respiratory and Ear Infections: A Prospective Cohort Study

    PubMed Central

    Hamre, Harald J.; Glockmann, Anja; Fischer, Michael; Riley, David S.; Baars, Erik; Kiene, Helmut

    2007-01-01

    Objective Anthroposophic medications (AMED) are widely used, but safety data on AMED from large prospective studies are sparse. The objective of this analysis was to determine the frequency of adverse drug reactions (ADR) to AMED in outpatients using AMED for acute respiratory and ear infections. Methods A prospective four-week observational cohort study was conducted in 21 primary care practices in Europe and the U.S.A. The cohort comprised 715 consecutive outpatients aged ≥1 month, treated by anthroposophic physicians for acute otitis and respiratory infections. Physicians’ prescription data and patient reports of adverse events were analyzed. Main outcome measures were use of AMED and ADR to AMED. Results Two patients had confirmed ADR to AMED: 1) swelling and redness at the injection site after subcutaneous injections of Prunus spinosa 5%, 2) sleeplessness after intake of Pneumodoron® 2 liquid. These ADR lasted one and two days respectively; both subsided after dose reduction; none were unexpected; none were serious. The frequency of confirmed ADR to AMED was 0.61% (2/327) of all different AMED used, 0.28% (2/715) of patients, and 0.004% (3/73,443) of applications. Conclusion In this prospective study, anthroposophic medications used by primary care patients with acute respiratory or ear infections were well tolerated. PMID:21901075

  17. Houston's medical disaster response to Hurricane Katrina: part 1: the initial medical response from Trauma Service Area Q.

    PubMed

    Hamilton, Douglas R; Gavagan, Thomas F; Smart, Kieran T; Upton, Lori A; Havron, Douglas A; Weller, Nancy F; Shah, Umair A; Fishkind, Avrim; Persse, David; Shank, Paul; Mattox, Kenneth

    2009-04-01

    After Hurricane Katrina hit the Gulf Coast on August 29, 2005, thousands of ill and injured evacuees were transported to Houston, TX. Houston's regional disaster plan was quickly implemented, leading to the activation of the Regional Hospital Preparedness Council's Catastrophic Medical Operations Center and the rapid construction of a 65-examination-room medical facility within the Reliant Center. A plan for triage of arriving evacuees was quickly developed and the Astrodome/Reliant Center Complex mega-shelter was created. Herein, we discuss major elements of the regional disaster response, including regional coordination, triage and emergency medical service transfers into the region's medical centers, medical care in population shelters, and community health challenges.

  18. 48 CFR 1842.7003 - Emergency medical services and evacuation.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... AERONAUTICS AND SPACE ADMINISTRATION CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Additional... contracts when employees of the contractor are required to travel outside the United States or to...

  19. 48 CFR 1842.7003 - Emergency medical services and evacuation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... AERONAUTICS AND SPACE ADMINISTRATION CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Additional... contracts when employees of the contractor are required to travel outside the United States or to...

  20. The medical laboratory scientist in the clinical chemistry service laboratory.

    PubMed

    Georges, R J

    1983-02-26

    The recent opening of an official register for medical laboratory scientists in South Africa has prompted an examination of the professional role, training and qualification of one particular group of scientists, namely clinical chemists working in hospital pathology departments. Lack of recognition of the potential contribution of these non-medical graduates towards improved health care, together with the lack of facilities for their professional advancement, has hitherto inhibited the growth and development of clinical chemistry in this country. An urgent need is the local establishment of a specialist postgraduate qualification open to the non-medical clinical chemist.

  1. Medical Student Service Learning Program Teaches Secondary Students about Career Opportunities in Health and Medical Fields

    ERIC Educational Resources Information Center

    Karpa, Kelly; Vakharia, Kavita; Caruso, Catherine A.; Vechery, Colin; Sipple, Lanette; Wang, Adrian

    2015-01-01

    Engagement of academic medical centers in community outreach provides the public with a better understanding of basic terms and concepts used in biomedical sciences and increases awareness of important health information. Medical students at one academic medical center initiated an educational outreach program, called PULSE, that targets secondary…

  2. Perspectives of patients on factors relating to adherence to post-acute coronary syndrome medical regimens

    PubMed Central

    Lambert-Kerzner, Anne; Havranek, Edward P; Plomondon, Mary E; Fagan, Katherine M; McCreight, Marina S; Fehling, Kelty B; Williams, David J; Hamilton, Alison B; Albright, Karen; Blatchford, Patrick J; Mihalko-Corbitt, Renee; Bryson, Chris L; Bosworth, Hayden B; Kirshner, Miriam A; Giacco, Eric J Del; Ho, P Michael

    2015-01-01

    Purpose Poor adherence to cardioprotective medications after acute coronary syndrome (ACS) hospitalization is associated with increased risk of rehospitalization and mortality. Clinical trials of multifaceted interventions have improved medication adherence with varying results. Patients’ perspectives on interventions could help researchers interpret inconsistent outcomes. Identifying factors that patients believe would improve adherence might inform the design of future interventions and make them more parsimonious and sustainable. The objective of this study was to obtain patients’ perspectives on adherence to medical regimens after experiencing an ACS event and their participation in a medication adherence randomized control trial following their hospitalization. Patients and methods Sixty-four in-depth interviews were conducted with ACS patients who participated in an efficacious, multifaceted, medication adherence randomized control trial. Interview transcripts were analyzed using the constant comparative approach. Results Participants described their post-ACS event experiences and how they affected their adherence behaviors. Patients reported that adherence decisions were facilitated by mutually respectful and collaborative provider–patient treatment planning. Frequent interactions with providers and medication refill reminder calls supported improved adherence. Additional facilitators included having social support, adherence routines, and positive attitudes toward an ACS event. The majority of patients expressed that being active participants in health care decision-making contributed to their health. Conclusion Our findings demonstrate that respectful collaborative communication can contribute to medication adherence after ACS hospitalization. These results suggest a potential role for training health-care providers, including pharmacists, social workers, registered nurses, etc, to elicit and acknowledge the patients’ views regarding medication

  3. Reimbursement for Medical Genetics Services: A Selected Bibliography.

    ERIC Educational Resources Information Center

    Connecticut Univ., Farmington. Div. of Human Genetics.

    This bibliography cites genetics literature identified during a project to investigate the issue of accessibility to genetics services through the reimbursement process. Citations represent both traditional published literature and such "fugitive literature" as unpublished manuscripts, government documents, service provider protocols, and health…

  4. 76 FR 72003 - Calendar Year 2011 Cost of Outpatient Medical, Dental, and Cosmetic Surgery Services Furnished by...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ... the cost of outpatient medical, dental, and cosmetic surgery services furnished by military treatment... BUDGET Calendar Year 2011 Cost of Outpatient Medical, Dental, and Cosmetic Surgery Services Furnished by... outpatient medical, dental, and cosmetic surgery services rates referenced are effective upon publication...

  5. 38 CFR 1.513 - Disclosure of information contained in Armed Forces service and related medical records in...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... contained in Armed Forces service and related medical records in Department of Veterans Affairs custody. 1... information contained in Armed Forces service and related medical records in Department of Veterans Affairs.... (b) Medical records. Information contained in the medical records (including clinical records...

  6. 38 CFR 1.513 - Disclosure of information contained in Armed Forces service and related medical records in...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... contained in Armed Forces service and related medical records in Department of Veterans Affairs custody. 1... information contained in Armed Forces service and related medical records in Department of Veterans Affairs.... (b) Medical records. Information contained in the medical records (including clinical records...

  7. 38 CFR 1.513 - Disclosure of information contained in Armed Forces service and related medical records in...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... contained in Armed Forces service and related medical records in Department of Veterans Affairs custody. 1... information contained in Armed Forces service and related medical records in Department of Veterans Affairs.... (b) Medical records. Information contained in the medical records (including clinical records...

  8. A nonhuman primate model of the hematopoietic acute radiation syndrome plus medical management.

    PubMed

    Farese, Ann M; Cohen, Melanie V; Katz, Barry P; Smith, Cassandra P; Jackson, William; Cohen, Daniel M; MacVittie, Thomas J

    2012-10-01

    The development of medical countermeasures against the hematopoietic subsyndrome of the acute radiation syndrome requires well characterized and validated animal models. The model must define the radiation dose- and time-dependent relationships for mortality and major signs of morbidity to include other organ damage that may contribute to morbidity and mortality. Herein, the authors define these parameters for a nonhuman primate exposed to total body radiation and administered medical management. A blinded, randomized study (n = 48 rhesus macaques) determined the lethal dose-response relationship using bilateral 6 MV linear accelerator photon radiation to doses in the range of 7.20 to 8.90 Gy at 0.80 Gy min(-1). Following irradiation, animals were monitored for complete bloodcounts, body weight, temperature, diarrhea, and hydration status for 60 d. Animals were administered medical management consisting of intravenous fluids, prophylactic antibiotics, blood transfusions, anti-diarrheals, analgesics, and nutrition. The primary endpoint was survival at 60 d post-irradiation; secondary endpoints included hematopoietic-related parameters, number of transfusions, incidence of documented infection, febrile neutropenia, severity of diarrhea, mean survival time of decedents, and tissue histology. The study defined an LD30/60 of 7.06 Gy, LD50/60 of 7.52 Gy, and an LD70/60 of 7.99 Gy with a relatively steep slope of 1.13 probits per linear dose. This study establishes a rhesus macaque model of the hematopoietic acute radiation syndrome and shows the marked effect of medical management on increased survival and overall mean survival time for decedents. Furthermore, following a nuclear terrorist event, medical management may be the only treatment administered at its optimal schedule.

  9. A Nonhuman Primate Model of the Hematopoietic Acute Radiation Syndrome Plus Medical Management

    PubMed Central

    Farese, A.M.; Cohen, M.V.; Katz, B. P.; Smith, C. P.; Jackson, W.; Cohen, D. M.; MacVittie, T.J.

    2012-01-01

    The development of medical countermeasures against the hematopoietic sub-syndrome of the acute radiation syndrome requires well characterized and validated animal models. The model must define the radiation dose- and time-dependent relationships for mortality and major signs of morbidity to include other organ damage that may contribute to the morbidity and mortality. Herein, we define these parameters for the nonhuman primate exposed to total-body radiation and administered medical management. A blinded, randomized study (n=48 rhesus macaques) determined the lethal dose response relationship using bilateral, 6 MV linear accelerator photon radiation to doses in the range of 7.20 to 8.90Gy at 0.80Gy minute−1. Following irradiation animals were monitored for complete blood counts, body weight, temperature, diarrhea, and hydration status for 60 days. Animals were administered medical management consisting of intravenous fluids, prophylactic antibiotics, blood transfusions, anti-diarrheals, analgesics and nutrition. The primary endpoint was survival at 60 days post irradiation; secondary endpoints included hematopoietic-related parameters, number of transfusions, incidence of documented infection, febrile neutropenia, severity of diarrhea, mean survival time of decedents and tissue histology. The study defined an LD30/60 of 7.06Gy, LD50/60 of 7.52Gy, and an LD70/60 of 7.99Gy with a relatively steep slope of 1.13 probits per linear dose. This study establishes a rhesus macaque model of the hematopoietic acute radiation syndrome and shows the marked effect of medical management on increased survival and overall mean survival time for decedents. Furthermore, following a nuclear terrorist event, medical management may be the only treatment administered at its optimal schedule. PMID:22929469

  10. [The head of battlefronts medical service during the Great Patriotic War].

    PubMed

    Gribovskaia, G A

    2014-05-01

    The article is dedicated to unrenowned moments of life of the outstanding organizer of the system of military healthcare general-lieutenant of medical service Arsenii Yakovlevich Barabanov (1901-1952). His outstanding organizing skills and deep knowledge in the field of military medicine revealed during the Second World War, when he was the head of medical service of 31st Army of the Western Front and 34th Army of North-Western Front and since 1942 he has helmed medical service of Donskoy, Central, 1st Belorussian Fronts. His experience in organization of collecting of PW, system medical treatment for PW acquired during the battle of Stalingrad and afterwards was used and improved during further offensive operations, especially during the final stage of the Second World War and also in organization of medical aid for prisoners of war from the Soviet Union and allied states freed from Nazi extermination camps.

  11. Mesenchymal stem cell therapy for acute radiation syndrome: innovative medical approaches in military medicine.

    PubMed

    Eaton, Erik B; Varney, Timothy R

    2015-01-01

    After a radiological or nuclear event, acute radiation syndrome (ARS) will present complex medical challenges that could involve the treatment of hundreds to thousands of patients. Current medical doctrine is based on limited clinical data and remains inadequate. Efforts to develop medical innovations that address ARS complications are unlikely to be generated by industry because of market uncertainties specific to this type of injury. A prospective strategy could be the integration of cellular therapy to meet the medical demands of ARS. The most clinically advanced cellular therapy to date is the administration of mesenchymal stem cells (MSCs). Results of currently published investigations describing MSC safety and efficacy in a variety of injury and disease models demonstrate the unique qualities of this reparative cell population in adapting to the specific requirements of the damaged tissue in which the cells integrate. This report puts forward a rationale for the further evaluation of MSC therapy to address the current unmet medical needs of ARS. We propose that the exploration of this novel therapy for the treatment of the multivariate complications of ARS could be of invaluable benefit to military medicine.

  12. Smart environment as a service: three factor cloud based user authentication for telecare medical information system.

    PubMed

    Siddiqui, Zeeshan; Abdullah, Abdul Hanan; Khan, Muhammad Khurram; Alghamdi, Abdullah S

    2014-01-01

    The Telecare Medical Information System (TMIS) provides a set of different medical services to the patient and medical practitioner. The patients and medical practitioners can easily connect to the services remotely from their own premises. There are several studies carried out to enhance and authenticate smartcard-based remote user authentication protocols for TMIS system. In this article, we propose a set of enhanced and authentic Three Factor (3FA) remote user authentication protocols utilizing a smartphone capability over a dynamic Cloud Computing (CC) environment. A user can access the TMIS services presented in the form of CC services using his smart device e.g. smartphone. Our framework transforms a smartphone to act as a unique and only identity required to access the TMIS system remotely. Methods, Protocols and Authentication techniques are proposed followed by security analysis and a performance analysis with the two recent authentication protocols proposed for the healthcare TMIS system.

  13. 78 FR 67463 - National Emergency Medical Services Advisory Council (NEMSAC) and Federal Interagency Committee...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-12

    ... emergency medical services representatives and consumers, is to advise and consult with DOT and the FICEMS... coordination among Federal agencies supporting EMS and 9-1-1 systems. DATES: The NEMSAC meeting will be held...

  14. The delivery of medical abortion services: the views of experienced providers.

    PubMed

    Beckman, Linda J; Harvey, S Marie; Satre, Sarah J

    2002-01-01

    This study examined beliefs about the delivery of medical abortion services and current roles of 76 providers of methotrexate-induced abortion. The sample included physicians, midlevel professionals, administrators, and counselors/other medical staff. Over 75% of participants believed that, given proper training and emergency backup, physicians and midlevel clinicians alike could provide medical abortions. Over 85% agreed that methotrexate-induced abortions could be provided in any physician's office or medical facility. There were no differences in perceptions by participant group. Involvement of midlevel providers in provision of medical abortion could potentially increase access and options for women seeking to terminate an early pregnancy.

  15. Swept Away: Use of General Medical and Mental Health Services Among Veterans Displaced By Hurricane Katrina

    PubMed Central

    Druss, Benjamin G.; Henderson, Kathy L.; Rosenheck, Robert A.

    2007-01-01

    Objective This study examined national patterns of outpatient service use by veterans from regions affected by Hurricane Katrina. Methods Analyses tracked use of general medical and mental/substance use services in September and October through December 2005 in New Orleans and Biloxi-Gulfport compared to a cohort receiving care during the same months in the previous 2 years. Results In adjusted models, veterans from New Orleans and Biloxi-Gulfport were, respectively, 73% and 41% less likely in September 2005 to use any outpatient services as were cohorts from 2003–2004. Particularly in New Orleans, the relative decline in service use was substantially greater for specialty mental health and substance use services than for general medical services. Conclusions Although many veterans were able to obtain care after Hurricane Katrina, there was a substantial disruption in delivery of Veterans Administration services, with disproportionate declines in mental health and substance use care. PMID:17202558

  16. Impact of the Pacific Southwest Regional Medical Library Service on hospital library development.

    PubMed Central

    Graham, E; Van Vuren, D D; Flack, V

    1987-01-01

    A study was designed to evaluate the progress of hospital libraries within Region 7 since the Pacific Southwest Regional Medical Library Services (PSRMLS) began in 1969. Library progress was defined as an increase in extent and types of services and resources offered. The study assessed the impact of Regional Medical Library programs on hospital libraries and compared resources and services reported in 1969, 1971, and 1984. The 1984 data were also measured against a set of core library services and resources that should be provided by a full-service hospital library. In addition to assessing the quality of PSRMLS programs and their effect on Region 7 hospital libraries, the study documented extensive growth in staffing, collection size, and services. PSRMLS programs were highly rated by the respondents, who also indicated that participation in PSRMLS programs improved specific library resources and services. PMID:3676532

  17. Risk assessment models for venous thromboembolism in acutely ill medical patients. A systematic review.

    PubMed

    Stuck, Anna K; Spirk, David; Schaudt, Jil; Kucher, Nils

    2017-04-03

    Although the use of thromboprophylaxis is recommended for acutely ill medical patients at increased risk of venous thromboembolism (VTE), it remains unclear which risk assessment model (RAM) should be routinely used to identify at-risk patients requiring thromboprophylaxis. We therefore aimed to describe existing RAMs, and to compare these tools in terms of validity and applicability for clinical decision-making. We performed a comprehensive systematic search in MEDLINE from the date of initiation until May 2016 for studies in acutely ill medical patients investigating validity of RAMs for VTE. Two reviewers independently screened the title, abstract, and full text, and evaluated the characteristics of studies, and the composition, evidence of validation, and results on validity of the RAMs. We included 11 studies assessing eight RAMs: 4-Element RAM, Caprini RAM, a full logistic model, Geneva risk score, IMPROVE-RAM, Kucher Model, a "Multivariable Model", and Padua Prediction Score. The 4-Element RAM, IMPROVE-RAM, Multivariable Model, and full logistic model had derivation by identifying factors with predictive power. The other four RAMs were empirically generated based on consensus guidelines, published data, and clinical expertise. The Kucher Model, the Padua Prediction Score, the Geneva Risk Score and the IMPROVE-RAM underwent multicenter external validation. The Kucher Model, the Padua Prediction Score, and the Geneva Risk Score improved rates of thromboprophylaxis or clinical outcomes. In conclusion, existing RAMs to evaluate the need of thromboprophylaxis in acutely ill medical patients are difficult to compare and none fulfills the criteria of an ideal RAM. Nevertheless, the adequacy of thromboprophylaxis may be improved by implementing one of the validated RAMs.

  18. Leveraging Air Force Medical Service (AFMS) Senior Leadership Corps Diversity to Improve Efficiency

    DTIC Science & Technology

    2013-04-01

    commanders and AFMS senior leadership; • Set a single PME standard for AFMS officers; • Shift provider billets to patient care roles and establish...single PME standard, and by realigning human resources to increase clinical currency, medical readiness and resource efficiency. Some structural...organizational entity. Like running a surgical service or a medical service. . . . It’s much bigger than that, because you’re dealing with finance and

  19. [Automation of medical literature--and information services].

    PubMed

    Bakker, S

    1997-01-04

    It is important for clinical practice to be able to find (or retrieve) relevant literature and to keep informed of the state of medical science. The fact that the contents of articles in journals are now accessible via computers is the result of integration of bibliographic techniques, medical knowledge and computer technology. Articles published in some 5000 medical journals can nowadays be retrieved electronically via Medline and Embase together (but medical literature in Dutch is underrepresented). Computerised insertion of publications into Internet dose not make information traceable or accessible, let alone reliable and readable. It cannot be predicted if electronic versions of scientific periodicals will replace the printed editions completely. However, valuable, reliable information will always have its price, even on Internet. It is unlikely that electronic information published privately (internet) will replace scientific publishers soon, for readers will still want selection and monitoring of contents and language. Good layout, professional typography and suitable illustrations to enhance reading comfort and cognitive processes, will even become more important. The problems arising from the immensity of scientific knowledge are not (any longer) of a technological nature-what is needed is a cultural about-turn of the information infrastructure in medical-scientific associations, organizations and institutions.

  20. Research in medical education: balancing service and science.

    PubMed

    Albert, Mathieu; Hodges, Brian; Regehr, Glenn

    2007-02-01

    Since the latter part of the 1990's, the English-speaking medical education community has been engaged in a debate concerning the types of research that should have priority. To shed light on this debate and to better understand its implications for the practice of research, 23 semi-structured interviews were conducted with "influential figures" from the community. The results were analyzed using the concept of "field" developed by the sociologist Pierre Bourdieu. The results reveal that a large majority of these influential figures believe that research in medical education continues to be of insufficient quality despite the progress that has taken place over the past 2 decades. According to this group, studies tend to be both redundant and opportunistic, and researchers tend to have limited understanding of both theory and methodological practice from the social sciences. Three factors were identified by the participants to explain the current problems in research: the working conditions of researchers, budgetary restraints in financing research in medical education, and the conception of research in the medical environment. Two principal means for improving research are presented: intensifying collaboration between PhD's and clinicians, and encouraging the diversification of perspectives brought to bear on research in medical education.