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Sample records for emergency medical system

  1. 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.

  2. Queensland emergency medical system: a structural and organizational model for the emergency medical system in Australia.

    PubMed

    FitzGerald, Gerry; Tippett, Vivienne; Schuetz, Michael; Clark, Michele; Tighe, Trevor; Gillard, Noel; Higgins, Jim; Elcock, Mark

    2009-12-01

    The emergency medical system (EMS) can be defined as a comprehensive, coordinated and integrated system of care for patients suffering acute illness and injury. The aim of the present paper is to describe the evolution of the Queensland Emergency Medical System (QEMS) and to recommend a strategic national approach to EMS development. Following the formation of the Queensland Ambulance Service in 1991, a state EMS committee was formed. This committee led the development and approval of the cross portfolio QEMS policy framework that has resulted in dynamic policy development, system monitoring and evaluation. This framework is led by the Queensland Emergency Medical Services Advisory Committee. There has been considerable progress in the development of all aspects of the EMS in Queensland. These developments have derived from the improved coordination and leadership that QEMS provides and has resulted in widespread satisfaction by both patients and stakeholders. The strategic approach outlined in the present paper offers a model for EMS arrangements throughout Australia. We propose that the Council of Australian Governments should require each state and Territory to maintain an EMS committee. These state EMS committees should have a broad portfolio of responsibilities. They should provide leadership and direction to the development of the EMS and ensure coordination and quality of outcomes. A national EMS committee with broad representation and broad scope should be established to coordinate the national development of Australia's EMS.

  3. 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.

  4. National Emergency Medical Services Information System (NEMSIS).

    PubMed

    Dawson, Drew E

    2006-01-01

    The absence of emergency medical services (EMS) patient care data has hindered development and evaluation of EMS systems. The National Highway Traffic Safety Administration (NHTSA), in cooperation with the Health Resources and Services Administration (HRSA), has provided funding to the National Association of State EMS Directors to develop a National EMS Information System (NEMSIS). NEMSIS is being designed to provide a uniform national EMS dataset, with standard terms, definitions, and values, as well as a national EMS database, with aggregated data from all states on a limited number of data elements. Forty-eight of the states, the District of Columbia, and three territories signed a memorandum of agreement documenting support for the NEMSIS project and expressing a desire for full implementation of the NEMSIS dataset. NHTSA has agreed to house the National EMS Database at its National Center for Statistics and Analysis. NHTSA, in cooperation with HRSA and the Centers for Disease Control and Prevention, recently entered into a cooperative agreement with the University of Utah School of Medicine to operate a NEMSIS Technical Assistance Center that will provide related assistance to official EMS agencies and to commercial software vendors. The Technical Assistance Center will also biannually assess state and territorial capabilities to provide data to the national EMS database. NEMSIS will provide a uniform national EMS dataset, with standard terms, definitions, and values, as well as a national EMS database, with aggregated data from all states on a limited number of data elements. Many of the potential benefits of implementation of NEMSIS are enumerated in this report.

  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. 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.

  7. 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.

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

    PubMed

    Stewart, R D

    1990-02-01

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

  9. Emerging Security Mechanisms for Medical Cyber Physical Systems.

    PubMed

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

    2016-01-01

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

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

    PubMed

    Dolan, Margaret A; Mace, Sharon E

    2006-10-01

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

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

    PubMed

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

    2002-05-01

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

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

    PubMed

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

    2014-01-01

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

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

    PubMed

    Wilde, Elizabeth Ty

    2013-07-01

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

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

    PubMed

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

    2007-07-01

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

  15. Inflight medical emergencies.

    PubMed

    Lyznicki, J M; Williams, M A; Deitchman, S D; Howe, J P

    2000-08-01

    This report responds to resolutions asking the American Medical Association (AMA) to develop recommendations for the use of medical equipment and technology onboard commercial airlines. Information for the report was derived from a search of the MEDLINE database and references listed in pertinent articles, as well as through communications with experts in aerospace and emergency medicine. Based on this information, the AMA Council on Scientific Affairs determined that, while inflight morbidity and mortality are uncommon, serious events do occur, which require immediate emergency care. Management of serious problems requires an integrated emergency response system that ensures rapid notification of medical personnel on the ground, assistance from appropriately trained flight crews and passenger volunteers (if available), and adequate medical supplies and equipment to stabilize the victim. Physicians have an important role in the preflight evaluation and counseling of potential passengers who are at risk of inflight medical complications, and in providing inflight medical assistance. Some U.S. and foreign air carriers are upgrading inflight emergency medical kits and placing automated external defibrillators aboard aircraft. Few data are available regarding the effectiveness of such improvements in improving health or survival outcomes. Recent federal legislation requires assessment of the extent of inflight medical emergencies, including the adequacy of emergency medical supplies and equipment carried onboard commercial airliners. This legislation also should alleviate liability concerns by providing immunity for physicians and others who render inflight medical assistance.

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

    PubMed

    Banner, Greg

    2004-01-01

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

  17. 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.

  18. 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 ...

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

    PubMed

    Nikić-Sovilj, Ljiljana

    2009-01-01

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

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

    PubMed

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

    2012-10-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2014-02-01

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

  2. Emergency medical service systems in Sri Lanka: problems of the past, challenges of the future.

    PubMed

    Wimalaratne, Kelum; Lee, Jeong Il; Lee, Kang Hyun; Lee, Hee Young; Lee, Jung Hun; Kang, In Hye

    2017-12-01

    The concept of emergency medical services (EMS) is new to Sri Lanka. This article describes the development, delivery, and future ideas for EMS in Sri Lanka. Sri Lanka also faces frequent natural hazards that justify the establishment of an EMS service. Data and information regarding emergency medical care in Sri Lanka were collected and reviewed from resources including websites and research papers. Currently, there are no qualified emergency medical physicians in Sri Lanka. However, a specialist training program for emergency physicians was initiated in 2012. There is no formal system to train emergency medical technicians (EMTs). Sri Lankans usually use taxies or their private vehicles to get to the hospital in the case of an emergency. All of the hospitals have ambulances that they can use to transport patients between hospitals. Most hospitals have emergency treatment units. Those at larger hospitals tend to be better than those at smaller hospitals. Although there is a disaster management system, it is not focused on emergency medical needs. Many aspects of the EMS system in Sri Lanka need improvement. To start, the emergency telephone number should cover the entire country. Training programs for EMTs should be conducted regularly. In addition, ambulances should be allocated for prehospital care. In the process of these developmental changes, public awareness programs are essential to improve the function of the EMS system. Despite many current shortcomings, Sri Lanka is capable of developing a successful EMS system.

  3. Clinical outcomes on real-time telemetry system in developing emergency medical service system.

    PubMed

    Kim, Yun Kwon; Kim, Ki Young; Lee, Kang Hyun; Kim, Sang Chul; Kim, Hyun; Hwang, Sung Oh; Cha, Kyoung Chul

    2011-05-01

    With the development of information technology, real-time telemetry has been invented for checking patients' physiologic parameters during their transport, via an Emergency Medical Service (EMS) system. We developed a Real-Time Telemetry System (RTS), which sends physiologic parameters including electrocardiogram (ECG), vital signs, and pulse asymmetry in real-time from the ambulance to a hospital through the Emergency Medical Information Center, a kind of central control unit. Therefore, we asked whether the RTS monitoring affects the use of medical direction in EMS system. Of six ambulance stations covering EMS transport with RTS monitor, 941 patients who were classified as emergency patients by an Emergency Medical Technician were retrospectively enrolled in this study. We divided them into two groups: group 1 (the patients using RTS monitoring) and group 2 (control group). The mean age was 53.5 ± 22.8 years, and 494 patients were men. RTS monitoring was used in 118 (20%) patients. Medical direction for treatments in group 1 was much more than that of group 2 (8.0% vs. 0.3%; p  <0.001). Ambulance diversion to proper hospitals in group 1 was much more than that of group 2 (14.4% vs. 0.1%; p  <0.001). The mean treatment time at the scene in group 1 also decreased more significantly than that of group 2 (4.4 ± 3.5  min vs. 6.3 ± 5.9 min; p  <0.001). The results showed that intermediate medical direction in the cases using the RTS was conducted more than in the conventional method-ambulance to the hospital. These results suggest that the RTS monitoring enhances the quality in developing EMS system.

  4. [To further strengthen the construction of emergency medical treatment system of massive burn].

    PubMed

    Jia, C Y

    2017-03-20

    Although clinical medicine of our country has made great progress in recent years, the rescue of massive burn casualties is still facing enormous challenges. No matter it is the top level design, system configuration, plan preparation, training, education, or the operation process, the medical resource allocation, and the treatment efficiency, are far behind the demand of social development. Therefore, further strengthen the construction of emergency medical treatment system of massive burn is the unshirkable responsibility of burn medical workers in our country.

  5. A secure 2G-RFID-Sys mechanism for applying to the medical emergency system.

    PubMed

    Chen, Yu-Yi; Wang, Yao-Jen; Jan, Jinn-Ke

    2013-06-01

    In the Medical Emergency System, any moment of delay in an emergency such as ambulance dispatch, ambulance diversion and clinical handover communication can significantly reduce a patient's chance of survival. Without the disadvantage of centralized management, a new type of RFID application named 2G-RFID-Sys will be more efficient. It is suitable for the tagged ambulance dispatch management in a huge range. In this article, the prototype of 2G-RFID-Sys and the responsibility of each participant are refined. We take an example of applying the 2G-RFID-Sys to the Medical Emergency System, the traffic condition of the ambulance will be able to ensure.

  6. Medical Emergencies in Goa

    PubMed Central

    Saddichha, Sahoo; Saxena, Mukul Kumar

    2010-01-01

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

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

    PubMed

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

    2016-05-01

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

  8. Emergency Medical Technician.

    ERIC Educational Resources Information Center

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

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

  9. Emergency Medical Technician.

    ERIC Educational Resources Information Center

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

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

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

    PubMed Central

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

    2005-01-01

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

  11. Development of a Texas Statewide Information System for Emergency Medical Services

    PubMed Central

    Renaud, Yves; Roule, Pascale; Eaton, David

    1989-01-01

    This paper describes the development of TEXEMS, a statewide information system for two state agencies and over a thousand emergency medical service providers in Texas. The system automates collection, transfer, and analysis of hundreds of variables of information concerning calls for emergency medical care and responses of pre-hospital medical providers. The software incorporates subroutines that provide internal quality control for data entry, automated information transfer via modem and telephone lines, and user-friendly reporting for system management at local, regional, or state levels. Four unusual elements of the TEXEMS system include: (a) a minimum data set to provide a basis for standardized local record keeping and data collection; (b) software to allow local customized databases with subsequent output of standardized files to be included in the state system; (c) automated data transfer into a statewide database; and (d) portability of software within diverse MS-DOS, Macintosh, and Unix micro- and mini-computer operating systems.

  12. Emergency Medical Services Systems Research Projects, 1977. NCHSR Research Management Series.

    ERIC Educational Resources Information Center

    National Center for Health Services Research (DHEW/PHS), Hyattsville, MD.

    This document contains summaries of thirty-two research projects supported by the National Center for Health Services Research (NCHSR) under authority of the Emergency Medical Services (EMS) Systems Act. (Focus of these research projects is to describe, explain, and predict the performance of more than 200 EMS systems being established under Title…

  13. National Training Course. Emergency Medical Technician. Paramedic. Instructor's Lesson Plans. Module V. Respiratory System.

    ERIC Educational Resources Information Center

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

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

  14. National Training Course. Emergency Medical Technician. Paramedic. Instructor's Lesson Plans. Module VI. Cardiovascular System.

    ERIC Educational Resources Information Center

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

    This instructor's lesson plan guide on the cardiovascular system is one of fifteen modules designed for use in the training of emergency medical technicians (paramedics). Seven units of study are presented: (1) the anatomy and physiology of the cardiovascular system; (2) patient assessment for the cardiac patient; (3) pathophysiology; (4) reading…

  15. Design Constraints Regarding The Use Of Fluids In Emergency Medical Systems For Space Flight

    NASA Technical Reports Server (NTRS)

    McQuillen, John

    2013-01-01

    The Exploration Medical Capability Project of the Human Research Program is tasked with identifying, investigating and addressing gaps existing gaps in either knowledge or technology that need to be addressed in order to enable safer exploration missions. There are several gaps that involve treatment for emergency medical situations. Some of these treatments involve the handling of liquids in the spacecraft environment which involve gas-liquid mixtures handling, dissolution chemistry and thermal issues. Some of the recent technology efforts include the Intravenous fluid generation (IVGEN) experiment, the In-Suit Injection System (ISIS) experiment, and medical suction. Constraints include limited volume, shelf life, handling biohazards, availability of power, crew time and medical training.

  16. 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." Copyright © 2014 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

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

    PubMed

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

    2012-01-01

    A usable medical information system should allow for reliable and accurate interaction between users and the system in emergencies. A participatory design approach was used to develop a medical information system in two Turkish hospitals. The process consisted of task and user analysis, an icon design survey, initial icon design, final icon design and evaluation, and installation of the iconic medical information system with the icons. We observed work sites to note working processes and tasks related to the information system and interviewed medical personnel. Emergency personnel then participated in the design process to develop a usable graphical user interface, by drawing icon sketches for 23 selected tasks. Similar sketches were requested for specific tasks such as family medical history, contact information, translation, addiction, required inspections, requests and applications, and nurse observations. The sketches were analyzed and redesigned into computer icons by professional designers and the research team. A second group of physicians and nurses then tested the understandability of the icons. The user interface layout was examined and evaluated by system users, followed by the system's installation. Medical personnel reported the participatory design process was interesting and believed the resulting designs would be more familiar and friendlier. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  18. The development of intelligent, triage-based, mass-gathering emergency medical service PDA support systems.

    PubMed

    Chang, Polun; Hsu, Yueh-Shuang; Tzeng, Yuann-Meei; Sang, Yiing-Yiing; Hou, I-Ching; Kao, Wei-Fong

    2004-09-01

    The support systems for the Emergency Medical Services (EMS) at mass gatherings, such as the local marathon or large international baseball games, are underdeveloped. The purposes of this study were to extend well-developed, triage-based, EMS Personal Digital Assistant (PDA) support systems to cover pre-hospital emergency medical services and onsite evaluation forms for the mass gatherings, and to evaluate users ' perceived ease of use and usefulness of the systems in terms of Davis ' Technology Acceptance Model (TAM). The systems were developed based on an established intelligent triage PDA support system and two other forms the general EMS form from the Taipei EMT and the customer-made Mass Gathering Medical form used by a medical center. Twenty-three nurses and six physicians in the medical center, who had served at mass gatherings, were invited to examine the new systems and answer the TAM questionnaire. The PDA systems were composed of 450 information items within 42 screens in 6 categories. The results supported the potential for using triage-based PDA systems at mass gatherings. Overall, most of the subjects agreed that the systems were easy to use and useful for mass gatherings, and they were willing to accept the systems.

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

    PubMed

    Chalwin, R P; Flabouris, A

    2013-09-01

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

  20. Perceptions of emergency care in Kenyan communities lacking access to formalised emergency medical systems: a qualitative study

    PubMed Central

    Broccoli, Morgan C; Calvello, Emilie J B; Skog, Alexander P; Wachira, Benjamin; Wallis, Lee A

    2015-01-01

    Objectives We undertook this study in Kenya to understand the community's emergency care needs and barriers they face when trying to access care, and to seek community members’ thoughts regarding high impact solutions to expand access to essential emergency services. Design We used a qualitative research methodology to conduct 59 focus groups with 528 total Kenyan community member participants. Data were coded, aggregated and analysed using the content analysis approach. Setting Participants were uniformly selected from all eight of the historical Kenyan provinces (Central, Coast, Eastern, Nairobi, North Eastern, Nyanza, Rift Valley and Western), with equal rural and urban community representation. Results Socioeconomic and cultural factors play a major role both in seeking and reaching emergency care. Community members in Kenya experience a wide range of medical emergencies, and seem to understand their time-critical nature. They rely on one another for assistance in the face of substantial barriers to care—a lack of: system structure, resources, transportation, trained healthcare providers and initial care at the scene. Conclusions Access to emergency care in Kenya can be improved by encouraging recognition and initial treatment of emergent illness in the community, strengthening the pre-hospital care system, improving emergency care delivery at health facilities and creating new policies at a national level. These community-generated solutions likely have a wider applicability in the region. PMID:26586324

  1. National Training Course. Emergency Medical Technician. Paramedic. Instructor's Lesson Plans. Module VII. Central Nervous System.

    ERIC Educational Resources Information Center

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

    This instructor's lesson plan guide on the central nervous system is one of fifteen modules designed for use in the training of emergency medical technicians. Four units of study are presented: (1) anatomy and physiology; (2) assessment of patients with neurological problems; (3) pathophysiology and management of neurological problems; (4)…

  2. Emergency Medical Services System Research Project Abstracts, 1979. NCHSR Research Management Series.

    ERIC Educational Resources Information Center

    National Center for Health Services Research (DHEW/PHS), Hyattsville, MD.

    Abstracts are presented that describe research grants related to Emergency Medical Services (EMS) System's techniques, methods, devices, and delivery; the research effort was supported by the National Center for Health Services Research during fiscal year 1979. Two sections included in the document describe projects funded under section 1205 of…

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

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2015-02-27

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

  5. Emergency medical dispatch.

    PubMed

    Dunford, James V

    2002-11-01

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

  6. Promoting emergency medical care systems in the developing world: weighing the costs.

    PubMed

    Anthony, David R

    2011-01-01

    Despite the global health community's historical focus on providing basic, cost-effective primary health care delivered at the community level, recent trends in the developing world show increasing demand for the implementation of emergency care infrastructures, such as prehospital care systems and emergency departments, as well as specialised training programmes. However, the question remains whether, in a setting of limited global health care resources, it is logical to divert these already-sparse resources into the development of emergency care frameworks. The existing literature overwhelmingly supports the idea that emergency care systems, both community-based and within medical institutions, improve important outcomes, including significant morbidity and mortality. Crucial to the success of any public health or policy intervention, emergency care systems also seem to be strongly desired at the community and governmental levels. Integrating emergency care into existing health care systems will ideally rely on modest, low-cost steps to augment current models of primary health care delivery, focusing on adapting the lessons learned in the developed world to the unique needs and local variability of the rest of the globe.

  7. Effect of military conflicts on the formation of emergency medical services systems worldwide.

    PubMed

    Goniewicz, Mariusz

    2013-05-01

    This article briefly reviews the evolution of medical support during wars and conflicts from ancient to modern times and discusses the effect warfare has had on the development of civilian health care and emergency medical services (EMS). Medical breakthroughs and discoveries made of necessity during military conflicts have developed into new paradigms of medical care, including novel programs of triage and health assessment, emergency battlefield treatment and stabilization, anesthesia, and other surgical and emergency procedures. The critical role of organizations that provide proper emergency care to help the sick and injured both on the battlefield and in the civilian world is also highlighted. © 2013 by the Society for Academic Emergency Medicine.

  8. Pediatric and adolescent mental health emergencies in the emergency medical services system.

    PubMed

    Dolan, Margaret A; Fein, Joel A

    2011-05-01

    Emergency department (ED) health care professionals often care for patients with previously diagnosed psychiatric illnesses who are ill, injured, or having a behavioral crisis. In addition, ED personnel encounter children with psychiatric illnesses who may not present to the ED with overt mental health symptoms. Staff education and training regarding identification and management of pediatric mental health illness can help EDs overcome the perceived limitations of the setting that influence timely and comprehensive evaluation. In addition, ED physicians can inform and advocate for policy changes at local, state, and national levels that are needed to ensure comprehensive care of children with mental health illnesses. This report addresses the roles that the ED and ED health care professionals play in emergency mental health care of children and adolescents in the United States, which includes the stabilization and management of patients in mental health crisis, the discovery of mental illnesses and suicidal ideation in ED patients, and approaches to advocating for improved recognition and treatment of mental illnesses in children. The report also addresses special issues related to mental illness in the ED, such as minority populations, children with special health care needs, and children's mental health during and after disasters and trauma.

  9. Recognizing medical emergencies

    MedlinePlus

    ... home phone. Also enter the numbers into your cell phone. Everyone in your household, including children, should know ... the symptoms mentioned. Get a personal emergency response system if you're an older adult, especially if ...

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

    ERIC Educational Resources Information Center

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

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

  11. 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

  12. Emerging Standards for Medical Logic

    PubMed Central

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

    1990-01-01

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

  13. A Study of the Emergency Medical Service System at Womack Army Hospital, Fort Bragg, North Carolina.

    DTIC Science & Technology

    1978-04-01

    UNAIF!ED A" i mlii~ - 5l,, S2 2 ŕ,3 25 ~If.II4 16 A STUDY OF THE EMERGENCY MEDICAL SERVICE SYSTEM AT WOMACK ARMY HOSPITAL FORT BRAGG , NORTH CAROLINA...Administration By Major Michael Averbuch, MSC Fort Bragg , North Carolina April, 1978 7- • A H 2& IUOWY-vCLASSlPCATON AUT4WpT1 3. O6?UION I AVALAITY 00 now...and ZIP Cock) FT Sam Houston, TX 78234-6100 Ga. NAME OF FUNDING/ SPONSORING Sb OFFICE SYMBOL 9 PROCUREMENT INSTRUMENT IDENTIFICATION NUMBER

  14. A feasibility study for an emergency medical services system to serve the Permian basin in the state of Texas

    NASA Technical Reports Server (NTRS)

    1975-01-01

    The development of an Emergency Medical Services System grant application for the Permian Basin Region of West Texas is described along with the application of NASA-developed technology. Conclusions and recommendations are included.

  15. 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:…

  16. 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.

  17. Old age and chronic disease: is the emergency medical system the appropriate provider for the elderly?

    PubMed

    Mochmann, Hans-Christian; Arntz, Hans-Richard; Dincklage, Falk V; Rauch, Ursula; Schultheiss, Heinz P; Bobbert, Peter

    2014-04-01

    The use of emergency medical services increases with the age of patients. Some care providers hold on to the prejudice that these alarms are unnecessary or of a lower importance. We assessed the relation of age and age-dependent emergency characteristics, taking into consideration the ratings of emergency physicians on whether or not emergency cases were considered truly in need of emergency physician attendance. Emergency physicians dispatched by the Berlin Fire Department evaluated for each case the necessity of emergency physician attendance. Case characteristics such as the day of the week and location of the emergency as well as patient characteristics such as age, sex, prior status, and care dependency were recorded. In addition, whether or not the physician accompanied the patient to the hospital was recorded as a parameter for emergency severity. Analysis was performed using multiple logistic regression modeling. During the 6-month prospective study period, 2702 cases were evaluated. Emergency medical services are used more frequently by older individuals, especially octogenarians. Emergency cases in older individuals were significantly more often rated as in need of emergency physician attendance; however, the rate of patients accompanied by the emergency physician to the hospital did not differ between the age groups. The age of patients, the primary diagnosis, the day and location of the emergency, and the presence of pre-existing dementia showed a significant impact on the necessity of physician-attended emergency missions. Despite common prejudices, emergency cases in elder patients are rated more often as in need of emergency physician attendance compared with those involving younger patients.

  18. A comprehensive framework for determining the cost of an emergency medical services system.

    PubMed

    Lerner, E Brooke; Nichol, Graham; Spaite, Daniel W; Garrison, Herbert G; Maio, Ronald F

    2007-03-01

    To determine the cost of an emergency medical services (EMS) system, researchers, policymakers, and EMS providers need a framework with which to identify the components of the system that must be included in any cost calculations. Such a framework will allow for cost comparisons across studies, communities, and interventions. The objective of this article is to present an EMS cost framework. This framework was developed by a consensus panel after analysis of existing peer-reviewed and non-peer-reviewed resources, as well as independent expert input. The components of the framework include administrative overhead, bystander response, communications, equipment, human resources, information systems, medical oversight, physical plant, training, and vehicles. There is no hierarchical rank to these components; they are all necessary. Within each component, there are subcomponents that must be considered. This framework can be used to standardize the calculation of EMS system costs to a community. Standardizing the calculation of EMS cost will allow for comparisons of costs between studies, communities, and interventions.

  19. Liability immunity as a legal defense for recent emergency medical services system litigation.

    PubMed

    Morgan, D L; Trail, W R; Trompler, V A

    1995-01-01

    Although many emergency medical services (EMS) providers are concerned about liability litigation, no comprehensive, national studies of EMS appelate cases have been published. Information about these cases and the use of liability immunity (sovereign immunity, emergency medical care immunity, or Good Samaritan immunity) as a defense could be used for EMS risk management and better patient care. To review recent EMS system civil litigation cases to determine their common characteristics and the number that used liability immunity as a legal defense. An observational study of the WESTLAW computerized database of legal cases from all state and federal appellate courts. All legal cases that named a member of the EMS system as a defendant, involved either a patient-care incident or ambulance collision, and received an appellate court opinion from 1987 through 1992, were studied. Eighty-six cases were identified and analyzed. Most cases (85%) were related to a patient-care incident, and 71% of the cases involved a death or significant physical injury. More than 49% of the patient cases alleged inadequate assessment or treatment, and 27% alleged delay in ambulance arrival or no ambulance arrival. There were 11 cases (15%) that alleged no transport of the patient to the hospital. Liability immunity was used as a defense in 53% of the cases. The appellate courts ruled in favor of 68% of the defendants that did not use an immunity defense and in favor of 72% of those that did use liability immunity. There have been a large number of recent appellate cases involving EMS systems. The common characteristics of many of these cases demonstrate the need for providing rapid ambulance arrival, proper assessment and treatment, and rapid patient transportation to a hospital. Although liability immunity was used as a legal defense by most EMS system defendants, the appellate court outcome was similar regardless of its use.

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

    PubMed

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

    2006-12-01

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

  1. Sustainable emergency medical service systems: how much energy do we need?

    PubMed

    Brown, Lawrence H; Blanchard, Ian E

    2015-02-01

    Modern emergency medical service (EMS) systems are vulnerable to both rising energy prices and potential energy shortages. Ensuring the sustainability of EMS systems requires an empirical understanding of the total energy requirements of EMS operations. This study was undertaken to determine the life cycle energy requirements of US EMS systems. Input-output-based energy requirement multipliers for the US economy were applied to the annual budgets for a random sample of 19 metropolitan or county-wide EMS systems. Calculated per capita energy requirements of the EMS systems were used to estimate nationwide EMS energy requirements, and the leading energy sinks of the EMS supply chain were determined. Total US EMS-related energy requirements are estimated at 30 to 60 petajoules (10(15) J) annually. Direct ("scope 1") energy consumption, primarily in the form of vehicle fuels but also in the form of natural gas and heating oil, accounts for 49% of all EMS-related energy requirements. The energy supply chain-including system electricity consumption ("scope 2") as well as the upstream ("scope 3") energy required to generate and distribute liquid fuels and natural gas-accounts for 18% of EMS energy requirements. Scope 3 energy consumption in the materials supply chain accounts for 33% of EMS energy requirements. Vehicle purchases, leases, maintenance, and repair are the most energy-intense components of the non-energy EMS supply chain (23%), followed by medical supplies and equipment (21%). Although less energy intense than other aspects of the US healthcare system, ground EMS systems require substantial amounts of energy each year. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Role of the emergency medical services system in regionwide health monitoring and referral.

    PubMed

    Hsiao, A K; Hedges, J R

    1993-11-01

    The emergency medical services (EMS) system of the future has the opportunity to serve as a regional community health monitoring and referral system. Such a system would shift attention from care of the individual to cost-effective community health efforts using community resource integration, while emphasizing individual responsibility for health. This health care system model requires the establishment of a centralized monitoring agency, the "regional center." The regional center would coordinate the monitoring of regional EMS use and linkage of patients with essential health promotion and behavior change organizations. Many of these supporting organizations are in place but are functioning without the benefit of communitywide health monitoring or effective referral and follow-up links with other resources. Coordination through the EMS system and a regional center would permit these resources to be used in an efficient and accountable fashion. We propose a model in which the EMS system could contribute to coordinated regional health monitoring and maintenance, timely and appropriate health care legislation and regulation, and high-impact health care education and intervention in the setting of self-destructive individual behavior.

  3. [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.

  4. Job Involvement and Organizational Commitment of Employees of Prehospital Emergency Medical System

    PubMed Central

    Rahati, Alireza; Sotudeh-Arani, Hossein; Adib-Hajbaghery, Mohsen; Rostami, Majid

    2015-01-01

    Background: Several studies are available on organizational commitment of employees in different organizations. However, the organizational commitment and job involvement of the employees in the prehospital emergency medical system (PEMS) of Iran have largely been ignored. Objectives: This study aimed to investigate the organizational commitment and job involvement of the employees of PEMS and the relationship between these two issues. Materials and Methods: This cross-sectional study was conducted on 160 employees of Kashan PEMS who were selected through a census method in 2014. A 3-part instrument was used in this study, including a demographic questionnaire, the Allen and Miller’s organizational commitment inventory, and the Lodahl and Kejner’s job involvement inventory. We used descriptive statistics, Spearman correlation coefficient, Kruskal-Wallis, Friedman, analysis of variance, and Tukey post hoc tests to analyze the data. Results: The mean job involvement and organizational commitment scores were 61.78 ± 10.69 and 73.89 ± 13.58, respectively. The mean scores of job involvement and organizational commitment were significantly different in subjects with different work experiences (P = 0.043 and P = 0.012, respectively). However, no significant differences were observed between the mean scores of organizational commitment and job involvement in subjects with different fields of study, different levels of interest in the profession, and various educational levels. A direct significant correlation was found between the total scores of organizational commitment and job involvement of workers in Kashan PEMS (r = 0.910, P < 0.001). Conclusions: This study showed that the employees in the Kashan PEMS obtained half of the score of organizational commitment and about two-thirds of the job involvement score. Therefore, the higher level managers of the emergency medical system are advised to implement some strategies to increase the employees’ job involvement

  5. Job Involvement and Organizational Commitment of Employees of Prehospital Emergency Medical System.

    PubMed

    Rahati, Alireza; Sotudeh-Arani, Hossein; Adib-Hajbaghery, Mohsen; Rostami, Majid

    2015-12-01

    Several studies are available on organizational commitment of employees in different organizations. However, the organizational commitment and job involvement of the employees in the prehospital emergency medical system (PEMS) of Iran have largely been ignored. This study aimed to investigate the organizational commitment and job involvement of the employees of PEMS and the relationship between these two issues. This cross-sectional study was conducted on 160 employees of Kashan PEMS who were selected through a census method in 2014. A 3-part instrument was used in this study, including a demographic questionnaire, the Allen and Miller's organizational commitment inventory, and the Lodahl and Kejner's job involvement inventory. We used descriptive statistics, Spearman correlation coefficient, Kruskal-Wallis, Friedman, analysis of variance, and Tukey post hoc tests to analyze the data. The mean job involvement and organizational commitment scores were 61.78 ± 10.69 and 73.89 ± 13.58, respectively. The mean scores of job involvement and organizational commitment were significantly different in subjects with different work experiences (P = 0.043 and P = 0.012, respectively). However, no significant differences were observed between the mean scores of organizational commitment and job involvement in subjects with different fields of study, different levels of interest in the profession, and various educational levels. A direct significant correlation was found between the total scores of organizational commitment and job involvement of workers in Kashan PEMS (r = 0.910, P < 0.001). This study showed that the employees in the Kashan PEMS obtained half of the score of organizational commitment and about two-thirds of the job involvement score. Therefore, the higher level managers of the emergency medical system are advised to implement some strategies to increase the employees' job involvement and organizational commitment.

  6. An automated dispensing system for improving medication timing in the emergency department.

    PubMed

    Ward, Michael J; Boyd, Jeremy S; Harger, Nicole J; Deledda, John M; Smith, Carol L; Walker, Susan M; Hice, Jeffrey D; Hart, Kimberly W; Lindsell, Christopher J; Wright, Stewart W

    2012-06-12

    Numerous medical conditions require timely medication administration in the emergency department (ED). Automated dispensing systems (ADSs) store premixed common doses at the point-of-care to minimize time to administration, but the use of such automation to improved time to medication administration has not been studied. Since vancomycin is a commonly used empiric antimicrobial, we sought to quantify the effect of using an ADS on time to drug delivery in patients presenting to the ED. The study aimed to determine the efficacy of utilizing an ADS to improve time to administration of vancomycin and determine any negative effects on dosing appropriateness. The institional review board approved the retrospective quality improvement study took place in a single, urban academic tertiary care ED with an annual census of 80 000. Study subjects were all patients receiving vancomycin for the management of sepsis between March 1 to September 30, 2008 and the same time period in 2009. The primary outcome was the proportion of patients who received vancomycin within one hour of bed placement and the secondary outcome was dosing appropriateness. Sixty-three patients had weight and dosing information available (29 before and 34 after intervention) and were included in the study. Before intervention, no patient received vancomycin in less than 60 minutes, while after intervention 14.7% of the patients received it in less than 60 minutes (difference in proportions 14.7%, 95% CI 0.39%-30.0%, P=0.04). A similar proportion of the patients received correct dosing before and after intervention (44.8% vs. 41.2%, difference in proportions 3.7%, 95% CI -20.0%-26.7%, P=0.770). The use of an ADS may improve the timing of medication administration in patients presenting to the ED without affecting dosing appropriateness.

  7. Medical emergencies in dental practice.

    PubMed

    Wilson, M H; McArdle, N S; Fitzpatrick, J J; Stassen, L F A

    2009-01-01

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

  8. The influence of the workplace-related biological agents on the immune systems of emergency medical personnel.

    PubMed

    Brewczyńska, Aleksandra; Depczyńska, Daria; Borecka, Anna; Winnicka, Izabela; Kubiak, Leszek; Skopińska-Różewska, Ewa; Niemcewicz, Marcin; Kocik, Janusz

    2015-01-01

    Emergency medical services workers' (EMSWs) acute exposures to many biological agents are frequent and well recognised in their workplaces, as well as occupational diseases resulting from some of these exposures. At the same time, there is only scant information on the adverse effects of chronic exposure to biological hazard factors on the immune systems of EMSWs. In the Polish legislation system, the Ordinance of the Minister of Health about harmful biological agents in the workplace and ways of protecting workers from exposure to those agents is an implement of Directive 2000/54/EC, which deals thoroughly with those issues in European Union Countries. Emergency medical services workers play an essential role as primary providers of pre-hospital emergency medical care, and they are part of the integral components of disaster response. Traumatic experiences can affect emergency medical staff immune systems negatively, by functioning as a chronic stressor. Conscious use of biological agents in workplaces such as microbial laboratories can be easily controlled and monitored. However, risk assessment is more difficult for workers when they are exposed unintentionally to biological agents. Exposure to bio-aerosols is considered especially harmful. This review summarises available information about biological risk factors for emergency medical services workers, and some information about the influence of these factors on their immune systems.

  9. New Intervention Model of Regional Transfer Network System to Alleviate Crowding of Regional Emergency Medical Center

    PubMed Central

    2016-01-01

    Emergency department (ED) crowding is a serious problem in most tertiary hospitals in Korea. Although several intervention models have been established to alleviate ED crowding, they are limited to a single hospital-based approach. This study was conducted to determine whether the new regional intervention model could alleviate ED crowding in a regional emergency medical center. This study was designed as a “before and after study” and included patients who visited the tertiary hospital ED from November 2011 to October 2013. One tertiary hospital and 32 secondary hospitals were included in the study. A transfer coordinator conducted inter-hospital transfers from a tertiary hospital to a secondary hospital for suitable patients. A total of 1,607 and 2,591 patients transferred from a tertiary hospital before and after the study, respectively (P < 0.001). We found that the median ED length of stay (LOS) decreased significantly from 3.68 hours (interquartile range [IQR], 1.85 to 9.73) to 3.20 hours (IQR, 1.62 to 8.33) in the patient group after implementation of the Regional Transfer Network System (RTNS) (P < 0.001). The results of multivariate analysis showed a negative association between implementation of the RTNS and ED LOS (beta coefficient -0.743; 95% confidence interval -0.914 to -0.572; P < 0.001). In conclusion, the ED LOS in the tertiary hospital decreased after implementation of the RTNS. PMID:27134506

  10. Medical Emergencies in Pediatric Dentistry

    PubMed Central

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

    2016-01-01

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

  11. Maryland's Helicopter Emergency Medical Services Experience From 2001 to 2011: System Improvements and Patients' Outcomes.

    PubMed

    Hirshon, Jon Mark; Galvagno, Samuel M; Comer, Angela; Millin, Michael G; Floccare, Douglas J; Alcorta, Richard L; Lawner, Benjamin J; Margolis, Asa M; Nable, Jose V; Bass, Robert R

    2016-03-01

    Helicopter emergency medical services (EMS) has become a well-established component of modern trauma systems. It is an expensive, limited resource with potential safety concerns. Helicopter EMS activation criteria intended to increase efficiency and reduce inappropriate use remain elusive and difficult to measure. This study evaluates the effect of statewide field trauma triage changes on helicopter EMS use and patient outcomes. Data were extracted from the helicopter EMS computer-aided dispatch database for in-state scene flights and from the state Trauma Registry for all trauma patients directly admitted from the scene or transferred to trauma centers from July 1, 2000, to June 30, 2011. Computer-aided dispatch flights were analyzed for periods corresponding to field triage protocol modifications intended to improve system efficiency. Outcomes were separately analyzed for trauma registry patients by mode of transport. The helicopter EMS computer-aided dispatch data set included 44,073 transports. There was a statewide decrease in helicopter EMS usage for trauma patients of 55.9%, differentially affecting counties closer to trauma centers. The Trauma Registry data set included 182,809 patients (37,407 helicopter transports, 128,129 ambulance transports, and 17,273 transfers). There was an increase of 21% in overall annual EMS scene trauma patients transported; ground transports increased by 33%, whereas helicopter EMS transports decreased by 49%. Helicopter EMS patient acuity increased, with an attendant increase in patient mortality. However, when standardized with W statistics, both helicopter EMS- and ground-transported trauma patients showed sustained improvement in mortality. Modifications to state protocols were associated with decreased helicopter EMS use and overall improved trauma patient outcomes. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  12. Equipment for pre-hospital airway management on Helicopter Emergency Medical System helicopters in central Europe.

    PubMed

    Schmid, M; Schüttler, J; Ey, K; Reichenbach, M; Trimmel, H; Mang, H

    2011-05-01

    For advanced out-of-hospital airway management, skilled personnel and adequate equipment are key prerequisites. There are little data on the current availability of airway management equipment and standards of medical staff on Helicopter Emergency Medical System (HEMS) helicopters in central Europe. An internet search identified all HEMS helicopters in Austria, Switzerland and Luxembourg. We identified 15 HEMS helicopter bases in Switzerland, 28 in Austria and three in Luxembourg. A questionnaire was sent to all bases, asking both for the details of the clinical background and experience of participating staff, and details of airway management equipment carried routinely on board. Replies were received from 14 helicopter bases in Switzerland (93%), 25 bases in Austria (89%) and all three bases in Luxembourg. Anaesthesiologists were by far the most frequent attending physicians (68-85%). All except one bases reported to have at least one alternative supraglottic airway device. All bases had capnometry and succinylcholine. All bases in the study except two in Austria had commercial pre-packed sets for a surgical airway. All helicopters were equipped with automatic ventilators, although not all were suitable for non-invasive ventilation (NIV; Switzerland: 43%, Austria: 12%, Luxembourg: 100%). Masks for NIV were rarely available in Switzerland (two bases; 14%) and in Austria (three bases; 12%), whereas all three bases in Luxembourg carried those masks. Most HEMS helicopters carry appropriate equipment to meet the demands of modern advanced airway management in the pre-hospital setting. Further work is needed to ensure that appropriate airway equipment is carried on all HEMS helicopters.

  13. Emergency Victim Care. A Training Manual for Emergency Medical Technicians. Module 7--Medical Emergencies. Revised.

    ERIC Educational Resources Information Center

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

    This training manual for emergency medical technicians, one of 14 modules that comprise the Emergency Victim Care textbook, covers medical emergencies. The objectives for the chapter are for students to be able to describe the causes, signs, and symptoms for specified medical emergencies and to describe emergency care for them. Informative…

  14. Emergency Victim Care. A Training Manual for Emergency Medical Technicians. Module 7--Medical Emergencies. Revised.

    ERIC Educational Resources Information Center

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

    This training manual for emergency medical technicians, one of 14 modules that comprise the Emergency Victim Care textbook, covers medical emergencies. The objectives for the chapter are for students to be able to describe the causes, signs, and symptoms for specified medical emergencies and to describe emergency care for them. Informative…

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

    PubMed Central

    Hinkelbein, J; Schwalbe, M; Genzwuerker, HV

    2010-01-01

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

  16. Evaluation of an emergency medical system. The prognosis in patients with an out-of-hospital cardiac arrest.

    PubMed

    van der Hoeven, J G; Waanders, H; Compier, E A; van der Weyden, P K; Meinders, A E

    1994-01-01

    In a retrospective chart review, we evaluated the efficiency of the emergency medical system of the Leiden area in patients with an out-of-hospital cardiac arrest. A total of 309 adult patients were included. Two hundred patients (64.7%) died in the emergency department and 67 (21.7%) died during subsequent hospital stay. Finally, 42 patients (13.6%) survived after hospital discharge. Favourable prognostic factors were the presence of witnesses at the time of arrest, a short call-response interval, an initial cardiac rhythm of ventricular fibrillation or tachycardia, and adequate advanced cardiac life support provided by the emergency medical system. We detected several shortcomings in the system such as an unacceptably prolonged call-response interval for some patients at the periphery of the Leiden area and a delay in the first defibrillation attempt. Improvement of this "pre-hospital chain of survival" is likely to result in a better outcome for these patients.

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

    PubMed

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

    2015-03-01

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

  18. Impact of a computerized provider radiography order entry system without clinical decision support on emergency department medical imaging requests.

    PubMed

    Claret, Pierre-Géraud; Bobbia, Xavier; Macri, Francesco; Stowell, Andrew; Motté, Antony; Landais, Paul; Beregi, Jean-Paul; de La Coussaye, Jean-Emmanuel

    2016-06-01

    The adoption of computerized physician order entry is an important cornerstone of using health information technology (HIT) in health care. The transition from paper to computer forms presents a change in physicians' practices. The main objective of this study was to investigate the impact of implementing a computer-based order entry (CPOE) system without clinical decision support on the number of radiographs ordered for patients admitted in the emergency department. This single-center pre-/post-intervention study was conducted in January, 2013 (before CPOE period) and January, 2014 (after CPOE period) at the emergency department at Nîmes University Hospital. All patients admitted in the emergency department who had undergone medical imaging were included in the study. Emergency department admissions have increased since the implementation of CPOE (5388 in the period before CPOE implementation vs. 5808 patients after CPOE implementation, p=.008). In the period before CPOE implementation, 2345 patients (44%) had undergone medical imaging; in the period after CPOE implementation, 2306 patients (40%) had undergone medical imaging (p=.008). In the period before CPOE, 2916 medical imaging procedures were ordered; in the period after CPOE, 2876 medical imaging procedures were ordered (p=.006). In the period before CPOE, 1885 radiographs were ordered; in the period after CPOE, 1776 radiographs were ordered (p<.001). The time between emergency department admission and medical imaging did not vary between the two periods. Our results show a decrease in the number of radiograph requests after a CPOE system without clinical decision support was implemented in our emergency department. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. Saving President Reagan's life. The need for an organized emergency medical system in the United States to save lives of all casualties.

    PubMed

    Edlich, Richard F; Winters, Kathryne L; Gebhart, Jocelynn H

    2004-01-01

    We are describing a heretofore untold narrative description of the emergency medical plan that saved the life of President Reagan on March 30th 1981. In 1976, Dr. Richard Edlich, director of the Emergency Medical Services at the University of Virginia Medical Center, wrote an editorial on the need for an emergency medical plan for the President of the United States. One year later Dr. Edlich enlisted the help of five distinguished experts in emergency medical systems in our nation to develop an emergency medical plan for the President of the United States. This published emergency medical plan was coauthored by Dr. David Boyd, the Director of Emergency Medical Services of the Department of Public Health and Welfare. Dr. Boyd wisely alerted both the Department of Health and Welfare as well as the White House staff, including Secret Service, of this plan. Realizing the importance of immediate emergency care, the Secret Service agent wisely recommended that the wounded President Reagan be immediately transported to the George Washington University Health Center, which has skilled emergency physicians as well as trauma surgeons, who saved the President's life. Realizing the benefits of this emergency medical plan that saved the life of the President of the United States, Drs. Edlich, Britt, and Wish will now be coordinating a medical narrative report that describes the development of emergency medical systems in the United States as well as modern trauma care in our nation.

  20. Using ArcGIS software in the pre-hospital emergency medical system.

    PubMed

    Manole, M; Duma, Odetta; Custură, Maria Alexandra; Petrariu, F D; Manole, Alina

    2014-01-01

    To measure the accessibility to healtcare services in order to reveal their quality and to improve the overall coverage, continuity and other features. We used the software ESRI Arc GIS 9.3, the Network Analyst function and data provided by Ambulance Service of Iasi (A.S.I.) with emergencies statistics for the first four months of 2012, processed by Microsoft Office Excel 2010. As examples, we chose "St. Maria" Children's Emergency Hospital and "St. Spiridon" Emergency Hospital. ArcGIS Network Analyst finds the best route to get from one location to another or a route that includes multiple locations. Each route is characterized by three stops. The starting point is always the office of Ambulance Service of Iasi (A.S.I.), a second stop at the case address and the third to the hospital unit chosen according to the patient's diagnosis and age. Spatial distribution of emergency cases for the first four months of 2012 in these two examples is one unequable, with higher concentrations in districts located in two areas of the city. The presented examples highlight the poor coverage of healthcare services for the population of Iasi, Romania, especially the South-West area and its vulnerability in situations of emergency. Implementing such a broad project would lead to more complex analyses that would improve the situation of pre-hospital emergency medical services, with final goal to deserve the population, improve the quality of healthcare and develop the interdisciplinary relationships.

  1. Customer satisfaction in a large urban fire department emergency medical services system.

    PubMed

    Persse, David E; Jarvis, Jeffrey L; Corpening, Jerry; Harris, Bobbie

    2004-01-01

    The purpose of this study was to determine if emergency medical services (EMS) customer satisfaction could be assessed using telephone-survey methods. The process by which customer satisfaction with the EMS service in a large, fire department-based EMS system is reported, and five month results are presented. Ten percent of all patients transported during the period of October 15, 2001, through March 15, 2002, were selected for study. In addition, during the same period, all EMS incidents in which a patient was not transported were identified for contact. Customer-service representatives contacted patients via telephone and surveyed them from prepared scripts. A total of 88,528 EMS incidents occurred during the study period. Of these, 53,649 resulted in patient transports and 34,879 did not. Ten percent of patients transported (5,098) were selected for study participation, of which 2,498 were successfully contacted; of these, 2,368 (94.8%) reported overall satisfaction with the service provided. Of the 34,879 incidents without transport, only 5,859 involved patients who were seen but not transported. All of these patients were selected for study. Of these, 2,975 were successfully contacted, with 2,865 (96.3%) reporting overall satisfaction. The most common reason given for nonsatisfaction in both groups was the perception of a long response time. It is possible to conduct a survey of EMS customer satisfaction using telephone-survey methods. Although difficulties exist in contacting patients, useful information is made available with this method. Such surveys should be an integral part of any EMS system's quality-improvement efforts. In this survey, the overwhelming majority of patients, both transported and not transported, were satisfied with their encounter with EMS.

  2. [Introduction of a bar coding pharmacy stock replenishment system in a prehospital emergency medical unit: economical impact].

    PubMed

    Dupuis, S; Fecci, J-L; Noyer, P; Lecarpentier, E; Chollet-Xémard, C; Margenet, A; Marty, J; Combes, X

    2009-01-01

    To assess economical impact after introduction of a bar coding pharmacy stock replenishment system in a prehospital emergency medical unit. Observational before and after study. A computer system using specific software and bare-code technology was introduced in the pre hospital emergency medical unit (Smur). Overall activity and costs related to pharmacy were recorded annually during two periods: the first 2 years period before computer system introduction and the second one during the 4 years following this system installation. The overall clinical activity increased by 10% between the two periods whereas pharmacy related costs continuously decreased after the start of pharmacy management computer system use. Pharmacy stock management was easier after introduction of the new stock replenishment system. The mean pharmacy related cost of one patient management was 13 Euros before and 9 Euros after the introduction of the system. The overall cost savings during the studied period was calculated to reach 134,000 Euros. The introduction of a specific pharmacy management computer system allowed to do important costs savings in a prehospital emergency medical unit.

  3. Current, emerging, and newly available insomnia medications.

    PubMed

    Krystal, Andrew D

    2015-08-01

    Research into the sleep-wake cycle has provided new treatment targets for patients with insomnia as well as a better understanding of how medications affect sleep processes. Current insomnia medications, including benzodiazepines and nonbenzodiazepines, focus on enhancing sleep-promoting systems through broad antagonism of GABA. Other medications that promote sleep by blocking wake-promoting systems include antidepressants, antipsychotics, and antihistamines, but adverse effects and nonspecific therapeutic effects limit their use. New and emerging insomnia medications are focusing on blocking wake-promoting systems via more selective antagonism of orexin, serotonin, and norepinephrine. These medications may offer improved efficacy with fewer adverse effects. © Copyright 2015 Physicians Postgraduate Press, Inc.

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

    NASA Astrophysics Data System (ADS)

    Buckner, Steven A.

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

  5. Systemic Arterial Hypertension in the Emergency Service: medication adherence and understanding of this disease

    PubMed Central

    Vancini-Campanharo, Cássia Regina; Oliveira, Gabriella Novelli; Andrade, Thaisa Fernanda Landim; Okuno, Meiry Fernanda Pinto; Lopes, Maria Carolina Barbosa Teixeira; Batista, Ruth Ester Assayag

    2015-01-01

    Objective: to identify the epidemiological profile of hypertension patients, how much they understand about the disease and the rate of adherence to treatment by these patients who had been hospitalized in the Brazilian emergency service. Methods: this cross-sectional study was performed with 116 patients, both male and female and aged over 18 years, who had been hospitalized in the Emergency Service of a University Hospital between March and June, 2013. The studied variables were data referring to socio-demographics, comorbidities, physical activity and knowledge regarding the disease. Patient adherence to treatment and the identification of the barriers were respectively evaluated using the Morisky test and the Brief Medication Questionnaire. Results: most of the patients involved in this study were women (55%), with white skin color (55%), married (51%), retirees or pensioners (64%) and with a low educational level (58%). Adherence to treatment, in most cases (55%), was moderate and the most prevalent adherence barrier was recall (67%). When medication was acquired at no cost to the patient, there was greater adherence to treatment. Conclusion: this study's patients had a moderate understanding about the disease. The high correlation between the number of drugs used and the recall barrier suggests that monotherapy is an option that can facilitate treatment adherence and reduce how often the patients forget to take their medication. PMID:26626007

  6. In-flight Medical Emergencies

    PubMed Central

    Chandra, Amit; Conry, Shauna

    2013-01-01

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

  7. [Investigation of patients suspected of drinking, who visited emergency department, and their negative influence on emergency medical system].

    PubMed

    Shibayama, Mikine; Cho, Tetsuji; Ino, Aro

    2012-12-01

    We investigated the nature of patients who have a pathological drinking problem visiting the emergency department (ED). During the investigation period, 107 (1.2%) of 8,812 referred patients, including children, were suspected of having consumed alcohol by the medical staff in the ED on the basis of the interview, the smell of alcohol on the patient's breath, pre-hospital information, etc. One hundred and seven patients were divided into either of the two groups, "problem drinkers" or "others". When the patient fulfilled at least one of the following conditions, he/she was categorized as a "problem drinker". The conditions were either drunken patients who did not cooperate with the staff in the ED, who came to the ED after drinking more than two times during the investigation period, who usually consumed over 60 g of ethanol in a day, or who injured themselves intentionally after having consumed alcohol. Statistical significance was revealed with regard to "arrival time" and "diagnosis" between both groups. In the "problem drinkers" group, a larger number of patients visited the ED during the day (08:00-18:00 hrs.) and almost half the illness were diagnosed as trauma-related. The tendency of statistical significance was noted with regard to "sex" and "transportation". There was no statistical significance with regard to "age", "health insurance", "severity of illness", "opportunity to drink", or "CAGE questionnaire.

  8. 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.

  9. Implementing a nationwide criteria-based emergency medical dispatch system: A register-based follow-up study

    PubMed Central

    2013-01-01

    Background A criteria-based nationwide Emergency Medical Dispatch (EMD) system was recently implemented in Denmark. We described the system and studied its ability to triage patients according to the severity of their condition by analysing hospital admission and case-fatality risks. Methods This was a register-based follow-up study of all 1-1-2 calls in a 6-month period that were triaged according to the Danish Index – the new criteria-based dispatch protocol. Danish Index data were linked with hospital and vital status data from national registries. Confidence intervals (95%) for proportions with binomial data were computed using exact methods. To test for trend the Wald test was used. Results Information on level of emergency according to the Danish Index rating was available for 67,135 patients who received ambulance service. Emergency level A (urgent cases) accounted for 51.4% (n = 34,489) of patients, emergency level B for 46.3% (n = 31,116), emergency level C for 2.1% (n = 1,391) and emergency level D for 0.2% (n = 139). For emergency level A, the median time from call receipt to ambulance dispatch was 2 min 1 s, and the median time to arrival was 6 min 11 s. Data concerning admission and case fatality was available for 55,270 patients. The hospital admission risk for emergency level A patients was 64.4% (95% CI = 63.8-64.9). There was a significant trend (p < 0.001) towards lower admission risks for patients with lower levels of emergency. The case fatality risk for emergency level A patients on the same day as the 1-1-2 call was 4.4% (95% CI = 4.1-4.6). The relative case-fatality risk among emergency level A patients compared to emergency level B–D patients was 14.3 (95% CI: 11.5-18.0). Conclusion The majority of patients were assessed as Danish Index emergency level A or B. Case fatality and hospital admission risks were substantially higher for emergency level A patients than for emergency level B–D patients. Thus

  10. Implementing a nationwide criteria-based emergency medical dispatch system: a register-based follow-up study.

    PubMed

    Andersen, Mikkel S; Johnsen, Søren Paaske; Sørensen, Jan Nørtved; Jepsen, Søren Bruun; Hansen, Jesper Bjerring; Christensen, Erika Frischknecht

    2013-07-09

    A criteria-based nationwide Emergency Medical Dispatch (EMD) system was recently implemented in Denmark. We described the system and studied its ability to triage patients according to the severity of their condition by analysing hospital admission and case-fatality risks. This was a register-based follow-up study of all 1-1-2 calls in a 6-month period that were triaged according to the Danish Index - the new criteria-based dispatch protocol. Danish Index data were linked with hospital and vital status data from national registries. Confidence intervals (95%) for proportions with binomial data were computed using exact methods. To test for trend the Wald test was used. Information on level of emergency according to the Danish Index rating was available for 67,135 patients who received ambulance service. Emergency level A (urgent cases) accounted for 51.4% (n = 34,489) of patients, emergency level B for 46.3% (n = 31,116), emergency level C for 2.1% (n = 1,391) and emergency level D for 0.2% (n = 139). For emergency level A, the median time from call receipt to ambulance dispatch was 2 min 1 s, and the median time to arrival was 6 min 11 s. Data concerning admission and case fatality was available for 55,270 patients. The hospital admission risk for emergency level A patients was 64.4% (95% CI = 63.8-64.9). There was a significant trend (p < 0.001) towards lower admission risks for patients with lower levels of emergency. The case fatality risk for emergency level A patients on the same day as the 1-1-2 call was 4.4% (95% CI = 4.1-4.6). The relative case-fatality risk among emergency level A patients compared to emergency level B-D patients was 14.3 (95% CI: 11.5-18.0). The majority of patients were assessed as Danish Index emergency level A or B. Case fatality and hospital admission risks were substantially higher for emergency level A patients than for emergency level B-D patients. Thus, the newly implemented Danish criteria

  11. 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…

  12. The role of the emergency medical dispatch centre (EMDC) and prehospital emergency care safety: results from an incident report (IR) system.

    PubMed

    Mortaro, Alberto; Pascu, Diana; Zerman, Tamara; Vallaperta, Enrico; Schönsberg, Alberto; Tardivo, Stefano; Pancheri, Serena; Romano, Gabriele; Moretti, Francesca

    2015-07-01

    The role of the emergency medical dispatch centre (EMDC) is essential to ensure coordinated and safe prehospital care. The aim of this study was to implement an incident report (IR) system in prehospital emergency care management with a view to detecting errors occurring in this setting and guiding the implementation of safety improvement initiatives. An ad hoc IR form for the prehospital setting was developed and implemented within the EMDC of Verona. The form included six phases (from the emergency call to hospital admission) with the relevant list of potential error modes (30 items). This descriptive observational study considered the results from 268 consecutive days between February and November 2010. During the study period, 161 error modes were detected. The majority of these errors occurred in the resource allocation and timing phase (34.2%) and in the dispatch phase (31.0%). Most of the errors were due to human factors (77.6%), and almost half of them were classified as either moderate (27.9%) or severe (19.9%). These results guided the implementation of specific corrective actions, such as the adoption of a more efficient Medical Priority Dispatch System and the development of educational initiatives targeted at both EMDC staff and the population. Despite the intrinsic limits of IR methodology, results suggest how the implementation of an IR system dedicated to the emergency prehospital setting can act as a major driver for the development of a "learning organization" and improve both efficacy and safety of first aid care.

  13. Survival After Application of Automatic External Defibrillators Before Arrival of the Emergency Medical System

    PubMed Central

    Weisfeldt, Myron L.; Sitlani, Colleen M.; Ornato, Joseph P.; Rea, Thomas; Aufderheide, Tom P.; Davis, Daniel; Dreyer, Jonathan; Hess, Erik P.; Jui, Jonathan; Maloney, Justin; Sopko, George; Powell, Judy; Nichol, Graham; Morrison, Laurie J.

    2010-01-01

    Objectives The purpose of this study was to assess the effectiveness of contemporary automatic external defibrillator (AED) use. Background In the PAD (Public Access Defibrillation) trial, survival was doubled by focused training of lay volunteers to use an AED in high-risk public settings. Methods We performed a population-based cohort study of persons with nontraumatic out-of-hospital cardiac arrest before emergency medical system (EMS) arrival at Resuscitation Outcomes Consortium (ROC) sites between December 2005 and May 2007. Multiple logistic regression was used to assess the independent association between AED application and survival to hospital discharge. Results Of 13,769 out-of-hospital cardiac arrests, 4,403 (32.0%) received bystander cardiopulmonary resuscitation but had no AED applied before EMS arrival, and 289 (2.1%) had an AED applied before EMS arrival. The AED was applied by health care workers (32%), lay volunteers (35%), police (26%), or unknown (7%). Overall survival to hospital discharge was 7%. Survival was 9% (382 of 4,403) with bystander cardiopulmonary resuscitation but no AED, 24% (69 of 289) with AED application, and 38% (64 of 170) with AED shock delivered. In multivariable analyses adjusting for: 1) age and sex; 2) bystander cardiopulmonary resuscitation performed; 3) location of arrest (public or private); 4) EMS response interval; 5) arrest witnessed; 6) initial shockable or not shockable rhythm; and 7) study site, AED application was associated with greater likelihood of survival (odds ratio: 1.75; 95% confidence interval: 1.23 to 2.50; p < 0.002). Extrapolating this greater survival from the ROC EMS population base (21 million) to the population of the U.S. and Canada (330 million), AED application by bystanders seems to save 474 lives/year. Conclusions Application of an AED in communities is associated with nearly a doubling of survival after out-of-hospital cardiac arrest. These results reinforce the importance of strategically

  14. A Statistical Evaluation of the Diagnostic Performance of MEDAS-The Medical Emergency Decision Assistance System

    PubMed Central

    Georgakis, D. Christine; Trace, David A.; Naeymi-Rad, Frank; Evens, Martha

    1990-01-01

    Medical expert systems require comprehensive evaluation of their diagnostic accuracy. The usefulness of these systems is limited without established evaluation methods. We propose a new methodology for evaluating the diagnostic accuracy and the predictive capacity of a medical expert system. We have adapted to the medical domain measures that have been used in the social sciences to examine the performance of human experts in the decision making process. Thus, in addition to the standard summary measures, we use measures of agreement and disagreement, and Goodman and Kruskal's λ and τ measures of predictive association. This methodology is illustrated by a detailed retrospective evaluation of the diagnostic accuracy of the MEDAS system. In a study using 270 patients admitted to the North Chicago Veterans Administration Hospital, diagnoses produced by MEDAS are compared with the discharge diagnoses of the attending physicians. The results of the analysis confirm the high diagnostic accuracy and predictive capacity of the MEDAS system. Overall, the agreement of the MEDAS system with the “gold standard” diagnosis of the attending physician has reached a 90% level.

  15. NASA Worldwide Emergency Medical Assistance

    NASA Technical Reports Server (NTRS)

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

    1997-01-01

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

  16. NASA Worldwide Emergency Medical Assistance

    NASA Technical Reports Server (NTRS)

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

    1997-01-01

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

  17. Endotracheal administration of emergency medications.

    PubMed

    Powers, R D; Donowitz, L G

    1984-03-01

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

  18. Real-time Medical Emergency Response System: Exploiting IoT and Big Data for Public Health.

    PubMed

    Rathore, M Mazhar; Ahmad, Awais; Paul, Anand; Wan, Jiafu; Zhang, Daqiang

    2016-12-01

    Healthy people are important for any nation's development. Use of the Internet of Things (IoT)-based body area networks (BANs) is increasing for continuous monitoring and medical healthcare in order to perform real-time actions in case of emergencies. However, in the case of monitoring the health of all citizens or people in a country, the millions of sensors attached to human bodies generate massive volume of heterogeneous data, called "Big Data." Processing Big Data and performing real-time actions in critical situations is a challenging task. Therefore, in order to address such issues, we propose a Real-time Medical Emergency Response System that involves IoT-based medical sensors deployed on the human body. Moreover, the proposed system consists of the data analysis building, called "Intelligent Building," depicted by the proposed layered architecture and implementation model, and it is responsible for analysis and decision-making. The data collected from millions of body-attached sensors is forwarded to Intelligent Building for processing and for performing necessary actions using various units such as collection, Hadoop Processing (HPU), and analysis and decision. The feasibility and efficiency of the proposed system are evaluated by implementing the system on Hadoop using an UBUNTU 14.04 LTS coreTMi5 machine. Various medical sensory datasets and real-time network traffic are considered for evaluating the efficiency of the system. The results show that the proposed system has the capability of efficiently processing WBAN sensory data from millions of users in order to perform real-time responses in case of emergencies.

  19. Medical Emergency Triage and Treatment System (METTS): a new protocol in primary triage and secondary priority decision in emergency medicine.

    PubMed

    Widgren, Bengt R; Jourak, Majid

    2011-06-01

    In many Emergency Department (ED) triage scoring systems, vital signs are not included as an assessment parameter. To evaluate the validity of a new protocol for Emergency Medicine in a large cohort of patients referred to in-hospital care. From January 1 to June 30, 2006, 22,934 patients were admitted to the ED at Sahlgrenska University Hospital. Of those, 8695 were referred to in-hospital care and included in the study. A new five-level triage tool, combining vital signs, symptoms, and signs in the triage decision, was used. A small control of the inter-rater disagreement was also performed in 132 parallel, single-blinded observations. Fifty percent of the patients were admitted by ambulance and the other 50% by walk-in. Hospital stay was significantly (p < 0.001) longer in those admitted by ambulance (9.3 ± 14 days) as compared with walk-in patients (6.2 ± 10 days). In-hospital mortality incidence was higher (8.1%) in patients admitted by ambulance, as compared with walk-in patients (2.4%). Hospital stay and in-hospital mortality increased with higher level of priority. In the highest priority groups, 32-53% of the patients were downgraded to a lower priority level after primary treatment. In the present study, the METTS protocol was shown to be a reliable triage method and a sensitive tool for secondary re-evaluation of the patient in the ED. Copyright © 2011 Elsevier Inc. All rights reserved.

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

    PubMed

    Ojino, Mayo; Ishii, Masami

    2014-02-01

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

  1. [Medical emergencies and sea rescue].

    PubMed

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

    2013-01-01

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

  2. 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,…

  3. [The status quo and future prospects of emergency medical service systems in Japan in view of the tight supply-demand situation for medical resources].

    PubMed

    Aruga, Tohru

    2016-02-01

    Considering the tight supply-demand situation for medical resources contributing to emergency medical service(EMS) systems at present and in the future in Japan, the author has explained the present states and future prospects of EMS systems in our country. EMS in remote places in this country is now consisting of the concentration of limited human resources, and is therefore suggestive of the EMS systems in the future, because we will have to deal with the possible exhaustion of EMS in our superannuated society progressing now and in the future. And also EMS systems will have to be maintained in the future with concerted efforts of all the medical staffs. The transferring the medical doctors' tasks to those of nurses and other staffs, that is to say the task shifting has just authorized by recent laws, and so the task shifting will be useful in the future EMS systems performed by all kinds of medical workers, in whom general physicians will be included as they are to be distributed throughout this country in the future.

  4. Shuttle abort landing site emergency medical services

    NASA Technical Reports Server (NTRS)

    Mckenas, David K.; Jennings, Richard T.

    1991-01-01

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

  5. Ubiquitous Emergency Medical Service System Based on Wireless Biosensors, Traffic Information, and Wireless Communication Technologies: Development and Evaluation

    PubMed Central

    Tan, Tan-Hsu; Gochoo, Munkhjargal; Chen, Yung-Fu; Hu, Jin-Jia; Chiang, John Y.; Chang, Ching-Su; Lee, Ming-Huei; Hsu, Yung-Nian; Hsu, Jiin-Chyr

    2017-01-01

    This study presents a new ubiquitous emergency medical service system (UEMS) that consists of a ubiquitous tele-diagnosis interface and a traffic guiding subsystem. The UEMS addresses unresolved issues of emergency medical services by managing the sensor wires for eliminating inconvenience for both patients and paramedics in an ambulance, providing ubiquitous accessibility of patients’ biosignals in remote areas where the ambulance cannot arrive directly, and offering availability of real-time traffic information which can make the ambulance reach the destination within the shortest time. In the proposed system, patient’s biosignals and real-time video, acquired by wireless biosensors and a webcam, can be simultaneously transmitted to an emergency room for pre-hospital treatment via WiMax/3.5 G networks. Performances of WiMax and 3.5 G, in terms of initialization time, data rate, and average end-to-end delay are evaluated and compared. A driver can choose the route of the shortest time among the suggested routes by Google Maps after inspecting the current traffic conditions based on real-time CCTV camera streams and traffic information. The destination address can be inputted vocally for easiness and safety in driving. A series of field test results validates the feasibility of the proposed system for application in real-life scenarios. PMID:28117724

  6. Ubiquitous Emergency Medical Service System Based on Wireless Biosensors, Traffic Information, and Wireless Communication Technologies: Development and Evaluation.

    PubMed

    Tan, Tan-Hsu; Gochoo, Munkhjargal; Chen, Yung-Fu; Hu, Jin-Jia; Chiang, John Y; Chang, Ching-Su; Lee, Ming-Huei; Hsu, Yung-Nian; Hsu, Jiin-Chyr

    2017-01-21

    This study presents a new ubiquitous emergency medical service system (UEMS) that consists of a ubiquitous tele-diagnosis interface and a traffic guiding subsystem. The UEMS addresses unresolved issues of emergency medical services by managing the sensor wires for eliminating inconvenience for both patients and paramedics in an ambulance, providing ubiquitous accessibility of patients' biosignals in remote areas where the ambulance cannot arrive directly, and offering availability of real-time traffic information which can make the ambulance reach the destination within the shortest time. In the proposed system, patient's biosignals and real-time video, acquired by wireless biosensors and a webcam, can be simultaneously transmitted to an emergency room for pre-hospital treatment via WiMax/3.5 G networks. Performances of WiMax and 3.5 G, in terms of initialization time, data rate, and average end-to-end delay are evaluated and compared. A driver can choose the route of the shortest time among the suggested routes by Google Maps after inspecting the current traffic conditions based on real-time CCTV camera streams and traffic information. The destination address can be inputted vocally for easiness and safety in driving. A series of field test results validates the feasibility of the proposed system for application in real-life scenarios.

  7. Development of prehospital emergency medical services: strategies for system assessment and planning.

    PubMed

    VanRooyen, Michael J

    2002-03-01

    Increasing economic capacity in the Pacific Rim has led to a greater demand for integrated pre-hospital care systems. The economic and technological growth of Taiwan, South Korea, Japan, Singapore and Hong Kong has lead to health system developments and growth of advanced healthcare and prehospital medical services. Changing economies and population distribution of many of the Southwestern countries and island regions in the South Pacific, as well as the geographical constraints necessitate a systematic and individually tailored planning process, while standardizing communication and quality of service with more will developed neighbors. While EMS systems in such a broad geographical region may take a variety of forms, each system contains some system components similar to those found in the United States and Southwest Pacific regions such as Australia and New Zealand. In evaluating EMS abroad, it is useful to compare the developing system type to one of five models: hospital based, municipal, private, volunteer, and complex. In so doing, the appropriate model system may be constructed to accommodate the demands of an evolving system.

  8. 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…

  9. [Emergency medical care in small urban regions] .

    PubMed

    Hasanicević, E

    2000-01-01

    Emergency medical care is a health care segment which is essential one both in large and in small urban places. To be effective it is necessary to be well organised, and also technically equipped and properly staffed. Concerning the situation in this field, conclusions are very often made on the basis of large and very well organised units. Current legislation gave it a pretty significant place. In practice it was proven as an indispensable part of system that provides medical care for suddenly ill or injured patients, both in war and peacetime. During the war, out of total number of admissions, 5231 injured patients were treated (including cases of death), out of which 36% had just that treatment as a definite one while the rest had to be treated in hospital. In the post-war period (1996, 1997, 1998, and 1999), out of total number of 95.000 treated patients, 848 was injured in car accidents and 52% of them got a final treatment on the level of emergency medical service. However, medical amateurs but medical professionals as well put emergency medical care on a margin of evaluation. Certain number of patients is coming to emergency medical service to get prescription, be directed to specialist or simply they don't want to waist their time while waiting in the crowded surgery of general practitioner. The management does not give enough attention to staff, facilities or technical equipment of emergency medical service. Only by properly established emergency medical service we would have better and more effective subsequent stages in the treatment of suddenly ill and injured persons in large but even more in small urban places.

  10. 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...

  11. 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...

  12. 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...

  13. Development of an Emergency Medical Video Multiplexing Transport System (EMTS): aiming at the nation-wide prehospital care in ambulance.

    PubMed

    Nagatuma, Hideaki

    2003-06-01

    The Emergency Medical Video Multiplexing Transport System (EMTS) is designed to support prehospital care by delivering high quality patient's live video streams in an ambulance to emergency doctors in a remote hospital on the basis of satellite communications. The feature is that EMTS divides a patient's live video scene into four pieces and transports the four video streams on four separate network channels. By multiplexing the four video streams, EMTS is able to transport high quality videos through low data transmission rate networks such as satellite communications and cellular phone networks. In order to transport live video streams constantly, EMTS adopts Real-Time Transport Protocol/Real-Time Control Protocol as a network protocol, and video stream data are compressed by Moving Picture Experts Group 4 format. As EMTS combines four video streams with checking video frame numbers, it uses a refresh packet that initializes server's frame numbers to synchronize the four video streams.

  14. Development of an emergency medical video multiplexing transport system. Aiming at the nation wide prehospital care on ambulance.

    PubMed

    Nagatuma, Hideaki

    2003-04-01

    The Emergency Medical Video Multiplexing Transport System (EMTS) is designed to support prehospital cares by delivering high quality live video streams of patients in an ambulance to emergency doctors in a remote hospital via satellite communications. The important feature is that EMTS divides a patient's live video scene into four pieces and transports the four video streams on four separate network channels. By multiplexing four video streams, EMTS is able to transport high quality videos through low data transmission rate networks such as satellite communications and cellular phone networks. In order to transport live video streams constantly, EMTS adopts Real-time Transport Protocol/Real-time Control Protocol as a network protocol and video stream data are compressed by Moving Picture Experts Group 4 format. As EMTS combines four video streams with checking video frame numbers, it uses a refresh packet that initializes server's frame numbers to synchronize the four video streams.

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  16. 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…

  17. 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.

  18. The Potential Linkage between Emergency Medical Services Systems and Health Systems Agencies to Civil Defense Related Health and Medical Care Plans and Operations.

    DTIC Science & Technology

    1980-07-01

    other crisis situations which involve a FEMA damage assessnent capability are: * Terrorist associated nuclear disaster * Major nuclear power reactor...appointment of a qualified surgeon to act as EMS director with all the necessary emergency powers to enforce decisions on all the medical care...says on paper--I want the job done and somebody get the details taken care of and run it properly." FEA has no power to compel another agency to

  19. Patient-centered medical home: an emerging primary care model and the military health system.

    PubMed

    Marshall, Robert C; Doperak, Martin; Milner, Michelle; Motsinger, Charles; Newton, Terry; Padden, Maureen; Pastoor, Sara; Hughes, Cortney L; LeFurgy, Jennifer; Mun, Seong K

    2011-11-01

    The patient-centered medical home (PCMH) is a primary care model that aims to provide quality care that is coordinated, comprehensive, and cost-effective. PCMH is hinged upon building a strong patient-provider relationship and using a team-based approach to care to increase continuity and access. It is anticipated that PCMH can curb the growth of health care costs through better preventative medicine and lower utilization of services. The Navy, Air Force, and Army are implementing versions of PCMH, which includes the use of technologies for improved documentation, better disease management, improved communication between the care teams and patients, and increased access to care. This article examines PCMH in the Military Health System by providing examples of the transition from each of the branches. The authors argue that the military must overcome unique challenges to implement and sustain PCMH that civilian providers may not face because of the deployment of patients and staff, the military's mission of readiness, and the use of both on-base and off-base care by beneficiaries. Our objective is to lay out these considerations and to provide ways that they have been or can be addressed within the transition from traditional primary care to PCMH.

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

    ERIC Educational Resources Information Center

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

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

  1. [Emergency calls in the Samu system].

    PubMed

    Barrier, G

    2001-07-01

    The French emergency medical system is public and medical. Named Samu, it is almost entirely managed by anesthesiologists specially trained for emergency medical assistance and advanced medical support. The system comprises a reception and dispatching center for emergency calls, directly connected to police and firemen, but assuring patient confidentiality. This fixed center is managing mobile units which are Medical Intensive Care Ambulances (MICA named Smur in France). The Samu's mission consists in performing urgent individual medical assistance and also medical services for treatment of mass casualties. It is also to find adequate hospital units for the patients, to perform medical transport and to be a consultant for general practitioners in emergency.

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

    PubMed Central

    OJINO, Mayo; ISHII, Masami

    2014-01-01

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

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

    PubMed

    Jama, Timo J; Kuisma, Markku J

    2016-08-01

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

  4. Medication errors recovered by emergency department pharmacists.

    PubMed

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

    2010-06-01

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

  5. [Prehospital cardiac resuscitation in Queretaro, Mexico. Report of 3 cases. Importance of an integral emergency medical care system].

    PubMed

    Fraga-Sastrías, Juan Manuel; Aguilera-Campos, Andrea; Barinagarrementería-Aldatz, Fernando; Ortíz-Mondragón, Claudio; Asensio-Lafuente, Enrique

    2014-01-01

    In Mexico, out-of-hospital cardiac arrest is a health problem that represents 33,000 to 150,000 or more deaths per year. The few existent reports show mortality as high as 100% in contrast to some international reports that show higher survival rates. In Queretaro, during the last 5 years there were no successful resuscitation cases. However, in 2012 some patients were reported to have return of spontaneous circulation. We report in this article 3 cases with return of spontaneous circulation and pulse at arrival to the hospital. Two of the patients were discharged alive, one of them with poor cerebral performance category. Community cardiopulmonary resuscitation, early defibrillation and better emergency medical system response times, are related with survival. This poorly explored health problem in Queretaro could be increased with quality and good public education, bystander assisted cardiopulmonary resuscitation, police involvement in cardiopulmonary resuscitation and defibrillation, public access defibrillation programs and measurement of indicators and feedback for better results.

  6. Emergency Victim Care. A Training Manual for Emergency Medical Technicians. Module 10. Injuries of the Eye, Ear, Nose, Abdomen, Central Nervous System and Genitalia. Burns and Environmental Injuries. Revised.

    ERIC Educational Resources Information Center

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

    This training manual for emergency medical technicians, one of 14 modules that comprise the Emergency Victim Care textbook, covers injuries of the eyes, ears, nose, abdomen, central nervous system (CNS), and genitalia; burns; and environmental injuries. Objectives stated for the two chapters are for the student to be able to describe procedures…

  7. Emergency Victim Care. A Training Manual for Emergency Medical Technicians. Module 10. Injuries of the Eye, Ear, Nose, Abdomen, Central Nervous System and Genitalia. Burns and Environmental Injuries. Revised.

    ERIC Educational Resources Information Center

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

    This training manual for emergency medical technicians, one of 14 modules that comprise the Emergency Victim Care textbook, covers injuries of the eyes, ears, nose, abdomen, central nervous system (CNS), and genitalia; burns; and environmental injuries. Objectives stated for the two chapters are for the student to be able to describe procedures…

  8. Standardization and Implementation of a Standard Emergency Code Call System within Estern Region Medical Command

    DTIC Science & Technology

    2009-03-01

    of Texas-Austin in 1966, the Columbine High School shooting in Colorado which left 15 dead and the Beslan School Massacre in Russia in 2004. Most...ARMY MEDICAL DEPARTMENT CENTER AND SCHOOL MCCS-HGE-HA (RENE PRYOR) 3151 SCOTT RD, SUITE 1411 FORT SAM HOUSTON, TX 78234 10. SPONSOR/MONITOR’S...the Our Lady of Angels School fire in Chicago in 1958 when a staff member hesitated in alerting the fire department. This led, in part, to the

  9. An emergency medical communications system by low altitude platform at the early stages of a natural disaster in Indonesia.

    PubMed

    Qiantori, Andri; Sutiono, Agung Budi; Hariyanto, Hadi; Suwa, Hirohiko; Ohta, Toshizumi

    2012-02-01

    A natural disaster is a consequence of a natural hazard, such as a tsunami, earthquake or volcanic eruption, affecting humans. In order to support emergency medical communication services in natural disaster areas where the telecommunications facility has been seriously damaged, an ad hoc communication network backbone should be build to support emergency medical services. Combinations of requirements need to be considered before deciding on the best option. In the present study we have proposed a Low Altitude Platform consisting of tethered balloons combined with Wireless Fidelity (WiFi) 802.11 technology. To confirm that the suggested network would satisfy the emergency medical service requirements, a communications experiment, including performance service measurement, was carried out.

  10. 38 CFR 1.485 - Medical emergencies.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  11. 38 CFR 1.485 - Medical emergencies.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

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

  12. Iterative user-centered design of a next generation patient monitoring system for emergency medical response.

    PubMed

    Gao, Tia; Kim, Matthew I; White, David; Alm, Alexander M

    2006-01-01

    We have developed a system for real-time patient monitoring during large-scale disasters. Our system is designed with scalable algorithms to monitor large numbers of patients, an intuitive interface to support the overwhelmed responders, and ad-hoc mesh networking capabilities to maintain connectivity to patients in the chaotic settings. This paper describes an iterative approach to user-centered design adopted to guide development of our system. This system is a part of the Advanced Health and Disaster Aid Network (AID-N) architecture.

  13. Technical and organisational feasibility of a multifunctional telemedicine system in an emergency medical service - an observational study.

    PubMed

    Bergrath, Sebastian; Rörtgen, Daniel; Rossaint, Rolf; Beckers, Stefan K; Fischermann, Harold; Brokmann, Jörg Ch; Czaplik, Michael; Felzen, Marc; Schneiders, Marie-Thérèse; Skorning, Max

    2011-01-01

    We evaluated the technical and organisational feasibility of a multifunctional telemedicine system in an emergency medical service (EMS) from the user's perspective. The telemedicine system was designed to transmit vital signs data and 12-lead-ECG data, send still pictures and allow voice communication and video transmission from an ambulance. The data were sent to a teleconsultation centre staffed with EMS physicians (tele-EMS physician). The system was used in 157 EMS missions. The applications were used successfully on 80% of missions for real-time vital signs transmission and on 97% for video transmission. The quality of the transmitted still images (n = 64) was: 23% excellent, 50% good, 17% moderate, 9% rather poor and 0% unusable. The quality of the video streaming (n = 36) was: 33% excellent, 56% good, 6% moderate, 6% rather poor and 0% unusable. The tele-EMS physician was able to assist the EMS team in several cases and provided the preliminary information for the hospital in nearly all missions. Use of the telemedical system in EMS is feasible and the quality of the transmitted images and video was satisfactory. However, technical reliability and availability need to be improved prior to routine use.

  14. Distributed virtual environment for emergency medical training

    NASA Astrophysics Data System (ADS)

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

    1997-07-01

    paper we report on our prototype VER system and its distributed system architecture for an emergency department distributed virtual environment for emergency medical staff training. The virtual environment enables emergency department physicians and staff to develop their diagnostic and treatment skills using the virtual tools they need to perform diagnostic and treatment tasks. Virtual human imagery, and real-time virtual human response are used to create the virtual patient and present a scenario. Patient vital signs are available to the emergency department team as they manage the virtual case. The work reported here consists of the system architectures we developed for the distributed components of the virtual emergency room. The architectures we describe consist of the network level architecture as well as the software architecture for each actor within the virtual emergency room. We describe the role of distributed interactive simulation and other enabling technologies within the virtual emergency room project.

  15. Alcohol as a trigger for medical emergencies.

    PubMed

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

    2013-05-01

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

  16. Alcohol as a trigger for medical emergencies

    PubMed Central

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

    2013-01-01

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

  17. 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

  18. Flying Squad response to medical emergencies.

    PubMed Central

    Barton, D; Pritty, P

    1990-01-01

    The Flying Squad of the Accident and Emergency Department, of the Derbyshire Royal Infirmary, was established in 1955 by Collins. The initial function was to provide emergency care to victims of industrial accidents. However, the spectrum of emergencies they now respond to has expanded and includes predominantly road traffic accidents and medical emergencies. Despite the proliferation of Flying Squads their benefit has been difficult to quantify even in a trauma setting (Robertson & Steedman, 1985; Gorman & Coals, 1983). The outcome in medical emergencies is reported as dismal (Robertson & Steedman, 1985; Rowley & Collins, 1979) yet the number of calls for the flying squad to attend medical emergencies are many. Previous reports have recorded 20-30% of Squad calls responding to medical emergencies (Gorman & Coals, 1983; Rowley & Collins, 1979; Steedman & Robertson, 1986; Harrop & Bodiwala, 1983). PMID:2135174

  19. Importance of awareness in improving performance of emergency medical services (EMS) systems in enhancing traffic safety: A lesson from India.

    PubMed

    Vasudevan, Vinod; Singh, Preeti; Basu, Samyajit

    2016-10-02

    India has been slow in implementing a central emergency medical services (EMS) system across the country. "108 services" is one of the most popular services that is functional under the public-private partnership model. Limited available literature shows that despite access to services, many traffic crash victims are transported using private vehicles. The objective of this study is to understand the effectiveness of 108 services from a traffic safety perspective. A questionnaire survey is conducted to understand the awareness of EMS and their function. Using traffic-related fatalities as the dependent variable, a fixed effect panel data model is developed to analyze the effectiveness of the 108 services in improving the traffic safety. The results from the survey show that, in general, people are not aware of the 108 services. A majority of the population prefers taking victims to the hospital using their personal vehicles or any other vehicles available compared to calling an ambulance. Results from panel data analysis show that despite having an efficient system, these services failed to make significant improvement in the safety of road users in the states in which their services were subscribed. The lack of awareness of an important safety service is alarming. This could be a major reason for lower utilization of 108 services for transporting victims of traffic crashes. This article shows the importance of having efficient awareness campaigns to improve the efficiency of any similar programs that are aimed to enhance the safety of a region.

  20. Computer order entry systems in the emergency department significantly reduce the time to medication delivery for high acuity patients

    PubMed Central

    2013-01-01

    Background Computerized physician order entry (CPOE) systems are designed to increase safety and improve quality of care; however, their impact on efficiency in the ED has not yet been validated. This study examined the impact of CPOE on process times for medication delivery, laboratory utilization and diagnostic imaging in the early, late and control phases of a regional ED-CPOE implementation. Methods Setting: Three tertiary care hospitals serving a population in excess of 1 million inhabitants that initiated the same CPOE system during the same 3-week time window. Patients were stratified into three groupings: Control, Early CPOE and Late CPOE (n = 200 patients per group/hospital site). Eligible patients consisted of a stratified (40% CTAS 2 and 60% CTAS 3) random sample of all patients seen 30 days preceding CPOE implementation (Control), 30 days immediately after CPOE implementation (Early CPOE) and 5–6 months after CPOE implementation (Late CPOE). Primary outcomes were time to (TT) from physician assignment (MD-sign) up to MD-order completion. An ANOVA and t-test were employed for statistical analysis. Results In comparison with control, TT 1st MD-Ordered Medication decreased in both the Early and Late CPOE groups (102.6 min control, 62.8 Early and 65.7 late, p < 0.001). TT 1st MD-ordered laboratory results increased in both the Early and Late CPOE groups compared to Control (76.4, 85.3 and 73.8 min, respectively, p < 0.001). TT 1st X-Ray also significantly increased in both the Early and Late CPOE groups (80.4, 84.8 min, respectively, compared to 68.1, p < 0.001). Given that CT and ultrasound imaging inherently takes increased time, these imaging studies were not included, and only X-ray was examined. There was no statistical difference found between TT discharge and consult request. Conclusions Regional implementation of CPOE afforded important efficiencies in time to medication delivery for high acuity ED patients. Increased times observed for laboratory

  1. 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.

  2. Military Emergency Medical Service System Assessment: Application of the National Park Service Needs Assessment and Program Audit to Objectively Evaluate the Military EMS System of Okinawa, Japan.

    PubMed

    Ross, Elliot M; Harper, Stephen A; Cunningham, Cord; Walrath, Benjamin D; DeMers, Gerard; Kharod, Chetan U

    2017-03-01

    As part of a Military Emergency Medical Services (EMS) system process improvement initiative, the authors sought to objectively evaluate the U.S. military EMS system for the island of Okinawa. They applied a program evaluation tool currently utilized by the U.S. National Park Service (NPS). A comprehensive needs assessment was conducted to evaluate the current Military EMS system in Okinawa, Japan. The NPS EMS Program Audit Worksheet was used to get an overall "score" of our assessment. After all the data had been collected, a joint committee of Military EMS physicians reviewed the findings and made formal recommendations. From 2011 to 2014, U.S. military EMS on Okinawa averaged 1,345 ± 137 patient transports annually. An advanced life support (ALS) provider would have been dispatched on 558 EMS runs (38%) based on chief complaint in 2014 had they been available. Over 36,000 man-hours were expended during this period to provide National Registry Emergency Medical Technician (EMT)-accredited instruction to certify 141 Navy Corpsman as EMT Basics. The NPS EMS Program Audit Worksheet was used and the program scored a total of 31, suggesting the program is well planned and operating within standards. This evaluation of the Military EMS system on Okinawa using the NPS program assessment and audit worksheet demonstrates the NPS evaluation instruments may offer a useful assessment tool for the evaluation of Military EMS systems. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

  3. EMS incident management: emergency medical logistics.

    PubMed

    Maniscalco, P M; Christen, H T

    1999-01-01

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

  4. Emergency Medical Rescue in a Radiation Environment

    SciTech Connect

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

    1999-09-14

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

  5. 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.

  6. 10 CFR 4.14 - Medical emergencies.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 1 2013-01-01 2013-01-01 false Medical emergencies. 4.14 Section 4.14 Energy NUCLEAR... and Title IV of the Energy Reorganization Act of 1974 Discrimination Prohibited § 4.14 Medical... health, and such service or other benefit cannot be provided except by or through a medical institution...

  7. 10 CFR 4.14 - Medical emergencies.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 1 2012-01-01 2012-01-01 false Medical emergencies. 4.14 Section 4.14 Energy NUCLEAR... and Title IV of the Energy Reorganization Act of 1974 Discrimination Prohibited § 4.14 Medical... health, and such service or other benefit cannot be provided except by or through a medical institution...

  8. 10 CFR 4.14 - Medical emergencies.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 1 2014-01-01 2014-01-01 false Medical emergencies. 4.14 Section 4.14 Energy NUCLEAR... and Title IV of the Energy Reorganization Act of 1974 Discrimination Prohibited § 4.14 Medical... health, and such service or other benefit cannot be provided except by or through a medical institution...

  9. 42 CFR 2.51 - Medical emergencies.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Medical emergencies. 2.51 Section 2.51 Public... OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Disclosures Without Patient Consent § 2.51 Medical... identifying information may be disclosed to medical personnel who have a need for information about a patient...

  10. 10 CFR 4.14 - Medical emergencies.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

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

  11. 42 CFR 2.51 - Medical emergencies.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  12. 10 CFR 4.14 - Medical emergencies.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

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

    PubMed

    Cook, R T

    1995-07-01

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

  14. An evaluation of pre-hospital emergency medical systems for suspected ST-elevation myocardial infarction in Colorado.

    PubMed

    Engelman, Glenn H; Carry, Patrick M; Kubes, Kyle M; Gleason, Michael J

    2016-11-01

    Patients presenting with ST-elevation myocardial infarction (STEMI) benefit from rapid cardiac reperfusion therapy. Emergency medical service (EMS) agencies can improve patient outcomes by calling STEMI alerts to the receiving facility. The aim of this study was to evaluate the use of pre-hospital activation systems for suspected ST-elevation myocardial infarctions (STEMI) throughout Colorado. A cross sectional, survey design was utilized to collect all data from EMS agencies in Colorado. A univariable logistic regression model was used to identify factors predictive of an agency reporting that they utilize a STEMI activation protocol. 84.5% [95% CI: 78.3 to 90.7%] of agencies included indicate that they utilize a STEMI activation protocol. Based on the logistic regression analysis, the number of EMT employees was significantly associated with whether or not an agency indicates that they utilize a STEMI activation protocol. For every 10% increase in the number of EMTs employed by an EMS agency, there was a 3.0 [95% CI: 1.5 to 6.0, p = 0.0012] fold increase in the odds of the agency indicating they utilize a STEMI activation protocol. Our study provides evidence that larger agencies are more likely to utilize a STEMI activation protocol. In areas without a STEMI system of care, improvements in smaller agencies that cover more ground (with longer transport times) should be the focus for protocol implementation. Based on the current prevalence of such training, competency based training in reading ST-elevations on ECG should be considered by EMS agencies.

  15. Emergency Victim Care. A Training Manual for Emergency Medical Technicians. Module 11--Childbirth, Pediatric Emergencies. Revised.

    ERIC Educational Resources Information Center

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

    This training manual for emergency medical technicians, one of 14 modules that comprise the Emergency Victim Care textbook, covers childbirth and pediatric emergencies. Objectives stated for the two chapters are for the students to be able to describe: emergency procedures for normal childbirth, unusual childbirth emergencies, emergency care for…

  16. Emergency Victim Care. A Training Manual for Emergency Medical Technicians. Module 11--Childbirth, Pediatric Emergencies. Revised.

    ERIC Educational Resources Information Center

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

    This training manual for emergency medical technicians, one of 14 modules that comprise the Emergency Victim Care textbook, covers childbirth and pediatric emergencies. Objectives stated for the two chapters are for the students to be able to describe: emergency procedures for normal childbirth, unusual childbirth emergencies, emergency care for…

  17. The National Disaster Medical System

    NASA Technical Reports Server (NTRS)

    Reutershan, Thomas P.

    1991-01-01

    The Emergency Mobilization Preparedness Board developed plans for improved national preparedness in case of major catastrophic domestic disaster or the possibility of an overseas conventional conflict. Within the health and medical arena, the working group on health developed the concept and system design for the National Disaster Medical System (NDMS). A description of NDMS is presented including the purpose, key components, medical response, patient evacuation, definitive medical care, NDMS activation and operations, and summary and benefits.

  18. Thirsk during CHeCS medical emergency training

    NASA Image and Video Library

    2009-07-02

    ISS020-E-016866 (2 July 2009) --- Canadian Space Agency astronaut Robert Thirsk, Expedition 20 flight engineer, participates in Crew Health Care Systems (CHeCS) medical emergency training in the Destiny laboratory of the International Space Station.

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

    ERIC Educational Resources Information Center

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

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

  20. Autonomic dysreflexia: a medical emergency

    PubMed Central

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

    2005-01-01

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

  1. Exploration Medical System Demonstration

    NASA Technical Reports Server (NTRS)

    Rubin, D. A.; Watkins, S. D.

    2014-01-01

    BACKGROUND: Exploration class missions will present significant new challenges and hazards to the health of the astronauts. Regardless of the intended destination, beyond low Earth orbit a greater degree of crew autonomy will be required to diagnose medical conditions, develop treatment plans, and implement procedures due to limited communications with ground-based personnel. SCOPE: The Exploration Medical System Demonstration (EMSD) project will act as a test bed on the International Space Station (ISS) to demonstrate to crew and ground personnel that an end-to-end medical system can assist clinician and non-clinician crew members in optimizing medical care delivery and data management during an exploration mission. Challenges facing exploration mission medical care include limited resources, inability to evacuate to Earth during many mission phases, and potential rendering of medical care by non-clinicians. This system demonstrates the integration of medical devices and informatics tools for managing evidence and decision making and can be designed to assist crewmembers in nominal, non-emergent situations and in emergent situations when they may be suffering from performance decrements due to environmental, physiological or other factors. PROJECT OBJECTIVES: The objectives of the EMSD project are to: a. Reduce or eliminate the time required of an on-orbit crew and ground personnel to access, transfer, and manipulate medical data. b. Demonstrate that the on-orbit crew has the ability to access medical data/information via an intuitive and crew-friendly solution to aid in the treatment of a medical condition. c. Develop a common data management framework that can be ubiquitously used to automate repetitive data collection, management, and communications tasks for all activities pertaining to crew health and life sciences. d. Ensure crew access to medical data during periods of restricted ground communication. e. Develop a common data management framework that

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

    PubMed

    Johnson, D R; Maggiore, W A

    1993-03-01

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

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

    ERIC Educational Resources Information Center

    National Association for Search and Rescue, Fairfax, VA.

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

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

    ERIC Educational Resources Information Center

    National Association for Search and Rescue, Fairfax, VA.

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

  5. 42 CFR 2.51 - Medical emergencies.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  6. 42 CFR 2.51 - Medical emergencies.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

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

  7. 42 CFR 2.51 - Medical emergencies.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

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

  8. German critical incident reporting system database of prehospital emergency medicine: Analysis of reported communication and medication errors between 2005–2015

    PubMed Central

    Hohenstein, Christian; Fleischmann, Thomas; Rupp, Peter; Hempel, Dorothea; Wilk, Sophia; Winning, Johannes

    2016-01-01

    BACKGROUND: Communication failure in prehospital emergency medicine can affect patient safety as it does in other areas of medicine as well. We analyzed the database of the critical incident reporting system for prehospital emergency medicine in Germany retrospectively regarding communication errors. METHODS: Experts of prehospital emergency medicine and risk management screened the database for verbal communication failure, non-verbal communication failure and missing communication at all. RESULTS: Between 2005 and 2015, 845 reports were analyzed, of which 247 reports were considered to be related to communication failure. An arbitrary classification resulted in six different kinds: 1) no acknowledgement of a suggestion; 2) medication error; 3) miscommunication with dispatcher; 4) utterance heard/understood improperly; 5) missing information transfer between two persons; and 6) other communication failure. CONCLUSION: Communication deficits can lead to critical incidents in prehospital emergency medicine and are a very important aspect in patient safety. PMID:27313802

  9. 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.

  10. Characteristics of Emergency Pages Using a Computer-Based Anesthesiology Paging System in Children and Adults Undergoing Procedures at a Tertiary Care Medical Center

    PubMed Central

    Weingarten, Toby N.; Abenstein, John P.; Dutton, Claire H.; Kohn, Melinda A.; Lee, Elizabeth A.; Mullenbach, Tami E.; Narr, Bradly J.; Schroeder, Darrell R.; Sprung, Juraj

    2012-01-01

    Background In our large academic supervisory practice attending anesthesiologists concomitantly care for multiple patients. To manage communications within the procedural environment, we use a proprietary electronic computer-based anesthesiology visual paging system. This system can send an emergency page which instantly alerts the attending anesthesiologist and other available personnel that immediate help is needed. We analyzed the characteristics of intraoperative emergency pages in children and adults. Methods We identified all emergency page activations between January 1, 2005 and July 31, 2010 in our main operating rooms. Electronic medical records were reviewed for rates and characteristics of pages such as primary etiology, performed interventions, and outcomes. Results During the study period, 258,135 anesthetics were performed (n= 32,103 children, <18 years) and 370 emergency pages (n=309 adults, n=61 children) were recorded (1.4 per 1,000 cases; 95% CI, 1.3–1.6). Infants had the highest rates (9.4 per 1,000; 95% CI, 5.7–14.4) of emergency page activations (P<0.001 compared to each other age group). In adults, the most frequent causes were hemodynamic (55%), and in children respiratory and airway (60.7%). Conclusion Emergency pages were rare in patients older than 2 years. Infants were more likely than children 1–2 yr to have emergency page activation, despite both groups being cared for by pediatric fellowship trained anesthesiologists. PMID:23354339

  11. Portable Medical System

    NASA Technical Reports Server (NTRS)

    1982-01-01

    Portable Medical Status and Treatment System (PMSTS) is designed for use in remote areas where considerable time may elapse before a patient can be transported to a hospital. First units were delivered to the Department of Transportation last year and tested in two types of medical emergency environments: one in a rural Pennsylvania community and another aboard a U.S. Coast Guard rescue helicopter operating along Florida's Gulf Coast. The system has the capability to transmit vital signs to a distantly located physician, who can perform diagnosis and relay treatment instructions to the attendant at the scene. The battery powered PMSTS includes a vital signs monitor and a defibrillator. Narco has also developed a companion system, called Porta-Fib III designed for use in a hospital environment with modifications accordingly. Both systems are offshoots of an earlier NASA project known as the Physician's Black Bag developed by Telecare, Inc., a company now acquired by NARCO.

  12. Postal survey methodology to assess patient satisfaction in a suburban emergency medical services system: an observational study

    PubMed Central

    Bernard, Aaron W; Lindsell, Christopher J; Handel, Daniel A; Collett, Lindsey; Gallo, Paul; Kaiser, Kevin D; Locasto, Donald

    2007-01-01

    Background Patient satisfaction is of growing importance to providers of emergency medical services (EMS). Prior reports of patient satisfaction have frequently used resource-intensive telephone follow-up to assess satisfaction. We determine the feasibility of using a single mailing, anonymous postal survey methodology for collecting patient satisfaction data from a suburban EMS system. Methods Patients transported between January 2001 and December 2004 were mailed a brief satisfaction questionnaire. The questionnaire was printed on a pre-addressed, postage paid postcard and consisted of five questions that used a five-point Likert scale to assess satisfaction with EMS personnel and services provided. Three open-ended questions assessed concerns, the most important service provided, and methods for improving service. Survey response rate was the primary outcome of interest. The Chi-square test was used to compare rates between years. Results The survey required about 6 man hours and cost about $70 per month. Overall response rate was 32.0% (857/2764; 95CI 30.3% – 33.9%). During the first year, response rate was 42.6% (95CI 38.5% – 46.8%), but was significantly lower in subsequent years (29.0% in year 2, 30.8% in year 3, and 27.6% in year 4, p < 0.05). There were 847/851 respondents (99.5%) who were satisfied or very satisfied with their EMS experience. Three patients felt the service was adequate and one was very unsatisfied. Open-ended questions suggested that interpersonal communications were the single most important contributor to patient satisfaction. Patients also reported that response times and technical aspects of care were important to them. Conclusion Postal surveys for assessing patient satisfaction following EMS transport can achieve comparable response rates to similar surveys in other health care settings. Response rates did not decline after the second year of patient surveys, suggesting some stability after the initial year. Interpersonal

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

    PubMed

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

    2004-01-01

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

  14. Emergency medical equipment on board German airliners.

    PubMed

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

    2014-01-01

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

  15. Development of the Inventory Management and Tracking System (IMATS) to Track the Availability of Public Health Department Medical Countermeasures During Public Health Emergencies.

    PubMed

    Sahar, Liora; Faler, Guy; Hristov, Emil; Hughes, Susan; Lee, Leslie; Westnedge, Caroline; Erickson, Benjamin; Nichols, Barbara

    2015-01-01

    To bridge gaps identified during the 2009 H1N1 influenza pandemic by developing a system that provides public health departments improved capability to manage and track medical countermeasures at the state and local levels and to report their inventory levels to the Centers for Disease Control and Prevention (CDC). The CDC Countermeasure Tracking Systems (CTS) program designed and implemented the Inventory Management and Tracking System (IMATS) to manage, track, and report medical countermeasure inventories at the state and local levels. IMATS was designed by CDC in collaboration with state and local public health departments to ensure a "user-centered design approach." A survey was completed to assess functionality and user satisfaction. IMATS was deployed in September 2011 and is provided at no cost to public health departments. Many state and local public health departments nationwide have adopted IMATS and use it to track countermeasure inventories during public health emergencies and daily operations. A successful response to public health emergencies requires efficient, accurate reporting of countermeasure inventory levels. IMATS is designed to support both emergency operations and everyday activities. Future improvements to the system include integrating barcoding technology and streamlining user access. To maintain system readiness, we continue to collect user feedback, improve technology, and enhance its functionality. IMATS satisfies the need for a system for monitoring and reporting health departments' countermeasure quantities so that decision makers are better informed. The "user-centered design approach" was successful, as evident by the many public health departments that adopted IMATS.

  16. Medical emergency management among Iranian dentists.

    PubMed

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

    2014-11-01

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

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

    PubMed

    Razzak, Junaid A; Kellermann, Arthur L

    2002-01-01

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

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

    PubMed Central

    Razzak, Junaid A.; Kellermann, Arthur L.

    2002-01-01

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

  19. Emergency medical services in crisis: an Italian case study.

    PubMed

    Koff, S Z

    1975-01-01

    This paper deals with the system of emergency medical services in Italy. More specifically, it is a case study of the organization and operation of this system in the region of Tuscany. Recent decentralization decrees have established regional governments with major responsibilities for health care, including emergency medical services. The effects of a long history of social and political cleavages on provision of these services at the regional level are presented and discussed. The paper concludes that prospects for rational reform of emergency care service are dim.

  20. Factors influencing readiness to deploy in disaster response: findings from a cross-sectional survey of the Department of Veterans Affairs Disaster Emergency Medical Personnel System

    PubMed Central

    2014-01-01

    Background The Disaster Emergency Medical Personnel System (DEMPS) program provides a system of volunteers whereby active or retired Department of Veterans Affairs (VA) personnel can register to be deployed to support other VA facilities or the nation during national emergencies or disasters. Both early and ongoing volunteer training is required to participate. Methods This study aims to identify factors that impact willingness to deploy in the event of an emergency. This analysis was based on responses from 2,385 survey respondents (response rate, 29%). Latent variable path models were developed and tested using the EQS structural equations modeling program. Background demographic variables of education, age, minority ethnicity, and female gender were used as predictors of intervening latent variables of DEMPS Volunteer Experience, Positive Attitude about Training, and Stress. The model had acceptable fit statistics, and all three intermediate latent variables significantly predicted the outcome latent variable Readiness to Deploy. Results DEMPS Volunteer Experience and a Positive Attitude about Training were associated with Readiness to Deploy. Stress was associated with decreased Readiness to Deploy. Female gender was negatively correlated with Readiness to Deploy; however, there was an indirect relationship between female gender and Readiness to Deploy through Positive Attitude about Training. Conclusions These findings suggest that volunteer emergency management response programs such as DEMPS should consider how best to address the factors that may make women less ready to deploy than men in order to ensure adequate gender representation among emergency responders. The findings underscore the importance of training opportunities to ensure that gender-sensitive support is a strong component of emergency response, and may apply to other emergency response programs such as the Medical Reserve Corps and the American Red Cross. PMID:25038628

  1. 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

  2. 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.

  3. Chemical warfare agents: emergency medical and emergency public health issues.

    PubMed

    Brennan, R J; Waeckerle, J F; Sharp, T W; Lillibridge, S R

    1999-08-01

    The threat of exposure to chemical warfare agents has traditionally been considered a military issue. Several recent events have demonstrated that civilians may also be exposed to these agents. The intentional or unintentional release of a chemical warfare agent in a civilian community has the potential to create thousands of casualties, thereby overwhelming local health and medical resources. The resources of US communities to respond to chemical incidents have been designed primarily for industrial agents, but must be expanded and developed regarding incident management, agent detection, protection of emergency personnel, and clinical care. We present an overview of the risk that chemical warfare agents presently pose to civilian populations and a discussion of the emergency medical and emergency public health issues related to preparedness and response.

  4. [Intraosseous infusion in the pediatric emergency medical service. Analysis of emergency medical missions 1990-2009].

    PubMed

    Sommer, A; Weiss, M; Deanovic, D; Dave, M; Neuhaus, D

    2011-02-01

    a peripheral intravenous access, 3 (0.7%) a central venous line access, 77 (19%) an intraosseous needle and in 22 (5.4%) no vascular or intraosseous access was used during the course of prehospital treatment (NACA VII - 13 patients, NACA VI - 2 patients, NACA V - 7 patients). Of the NACA VII patients 3 were transported under continuous cardiopulmonary resuscitation without vascular access. After 2002 all patients with NACA index VII were treated with vascular or intraosseous access. In 48 patients (12%) at least initial medication was given by the endobronchial or alternative route but within the last 3 years endobronchial drug administration was no longer reported. Thus, in 124 critically ill patients (31%) routine peripheral venous access could not be established initially or until the end of treatment (77 times IOI, 22 times no access over the course of treatment, 3 times CVC and 22 times initial endobronchial followed by peripheral venous access). Over the reviewed period the use of IOI increased significantly (p<0.001), while the incidence of lacking vascular access (p<0.05) and alternative drug administration routes (p<0.001) continuously decreased. The IOI technique has not only been assigned a high priority in the guidelines for pediatric emergency care of critically ill children with difficult or failed venous access but has also significantly influenced current prehospital care. The introduction of the IOI technique in our prehospital pediatric emergency system has markedly reduced the number of critically ill or severely injured pediatric patients without vascular access or with less reliable alternative administration routes in the last 20 years.

  5. [Prehospital emergency care of patients with acute heart failure in Spain: the SEMICA study (Emergency Medical Response Systems for Patients with Acute Heart Failure)].

    PubMed

    Miró, Òscar; Llorens, Pere; Escalada, Xavier; Herrero, Pablo; Jacob, Javier; Gil, Víctor; Xipell, Carolina; Sánchez, Carolina; Aguiló, Sira; Martín-Sánchez, Francisco J

    2017-07-01

    To study the means of emergency transport used to bring patients with acute heart failure (AHF) to hospital emergency departments (EDs) and explore associations between factors, type of transport, and prehospital care received. We gathered the following information on patients treated for AHF at 34 Spanish hospital EDs: means of transport used (medicalized ambulance [MA], nonmedicalized ambulance [NMA], or private vehicle) and treatments administered before arrival at the hospital. Twenty-seven independent variables potentially related to type of transport used were also studied. Indicators of AHF severity were triage level assigned in the ED, need for admission, need for intensive care, in-hospital mortality, and 30-day mortality. A total of 6106 patients with a mean (SD) age of 80 years were included; 56.5% were women, 47.2% arrived in PVs, 37.8% in NMAs, and 15.0% in MAs. Use of an ambulance was associated with female sex, age over 80 years, chronic obstructive pulmonary disease, a history of AHF, functional dependency, New York Heart Association class III-IV, sphincteral incontinence, labored breathing, orthopnea, cold skin, and sensory depression or restlessness. Assignment of a MA was directly associated with living alone, a history of ischemic heart disease, cold skin, sensory depression or restlessness, and high temperature; it was inversely associated with a history of falls. The rates of receipt of prehospital treatments and AHF severity level increased with use of MAs vs. NMAs vs. PV. Seventy-three percent of patients transported in MAs received oxygen, 29% received a diuretic, 13.5% a vasodilator, and 4.7% noninvasive ventilation. Characteristics of the patient with AHF are associated with the assignment of type of transport to a hospital ED. Assignment appears to be related to severity. Treatment given during MA transport could be increased.

  6. Patient-directed intelligent and interactive computer medical history-gathering systems: a utility and feasibility study in the emergency department.

    PubMed

    Benaroia, Mark; Elinson, Roman; Zarnke, Kelly

    2007-04-01

    Patients can be used as a resource to enter their own pertinent medical information. This study will evaluate the feasibility of an intelligent computer medical history-taking device directed at patients in the emergency department (ED). Two of the authors (MB, RE) developed an expert system that can take patient-directed medical histories. Patients interacted with the computer in the ED waiting room while it gathered a medical history based on chief complaint (CC). A survey was completed post history. A sub-study assessed the computer's ability to take an adequate history for an index CC. We compared the computer and emergency physician histories for the presence or absence of important historical elements. Sixty-seven patients used the interactive computer system. The mean time to complete the history was 5 min and 32s +/- 1 min and 21s. The patient response rate was 97%. Over 83% felt that the computer was very easy to use and over 92% would very much use the computer again. A total of 15 patients with abdominal pain (index CC) were evaluated for the sub-study. The computer history asked 90+/-7%, and the emergency physician asked 55+/-18%, of the important historical elements. These groups were statistically different with a p-value of <0.00001. This feasibility study has shown that the computer history-taking device is well accepted by patients and that such a system can be integrated into the normal process of patient triage without delaying patient care. Such a system can serve as an initial mode for documentation and data acquisition directly from the patient.

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

    PubMed

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

    2016-01-01

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

  8. Emerging medical informatics with case-based reasoning for aiding clinical decision in multi-agent system.

    PubMed

    Shen, Ying; Colloc, Joël; Jacquet-Andrieu, Armelle; Lei, Kai

    2015-08-01

    This research aims to depict the methodological steps and tools about the combined operation of case-based reasoning (CBR) and multi-agent system (MAS) to expose the ontological application in the field of clinical decision support. The multi-agent architecture works for the consideration of the whole cycle of clinical decision-making adaptable to many medical aspects such as the diagnosis, prognosis, treatment, therapeutic monitoring of gastric cancer. In the multi-agent architecture, the ontological agent type employs the domain knowledge to ease the extraction of similar clinical cases and provide treatment suggestions to patients and physicians. Ontological agent is used for the extension of domain hierarchy and the interpretation of input requests. Case-based reasoning memorizes and restores experience data for solving similar problems, with the help of matching approach and defined interfaces of ontologies. A typical case is developed to illustrate the implementation of the knowledge acquisition and restitution of medical experts.

  9. Emergency Department Medical Clearance of Patients with Psychiatric or Behavioral Emergencies, Part 1.

    PubMed

    Tucci, Veronica Theresa; Moukaddam, Nidal; Alam, Al; Rachal, James

    2017-09-01

    Patients presenting to the emergency department with mental illness or behavioral complaints merit workup for underlying physical conditions that can trigger, mimic, or worsen psychiatric symptoms. However, interdisciplinary consensus on medical clearance is lacking, leading to wide variations in quality of care and, quite often, poor medical care. Psychiatry and emergency medicine specialty guidelines support a tailored, customized approach. This article summarizes best-practice approaches to the medical clearance of patients with psychiatric illness, tips on history taking, system reviews, clinical or physical examination, and common pitfalls in the medical clearance process. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Effect of private versus emergency medical systems transportation in motor vehicle accident victims: Trauma Center Experience in Saudi Arabia

    PubMed Central

    Alshahrani, Mohammed S.

    2017-01-01

    OBJECTIVE: To assess the effect of the mode of transportation of trauma patients (emergency medical service [EMS] vs. non-EMS) on their final clinical outcome in terms of mortality and length of hospital stay. MATERIALS AND METHODS: A retrospective study included all patients who were involved in motor vehicle crashes, and who were transferred immediately to an emergency department of a trauma care center from December 2008 to December 2012. Patients were classified into two groups: those brought through EMS and those brought by non-EMS (private transport). Information on demographic characteristics including age and gender was recorded and medical data such as blood pressure, pulse, oxygen saturation, temperature, initial Glasgow Coma Score (GCS), saturation, temperature, initial Glasgow Coma Score (GCS), injury severity score (ISS), and final outcome (discharged or expired) were obtained. Descriptive statistics, mean and standard deviation (SD) were computed for continuous variables and statistical significance was tested by t-test or Mann-Whitney U-test. Categorical variables were described by frequency distribution and percentages; Chi-square or Fisher's exact test as appropriate were employed to test for statistical significance. Logistics regression was performed with mortality as dependent variable and mode of transport and all demographic and prehospital variables as independent variables. A general linear model analysis was performed to test whether the mode of transport was significant to length of hospital stay in EMS and non-EMS clients. RESULTS: Out of 308 patients identified during the study period, 232 were transported through EMS and 76 through non-EMS. The two groups were similar with regard to mortality and length of stay. The crude mortality rate was 30.6% (95% confidence interval [CI]: 24.64–36.53) in the EMS group and 28.9% (95% CI: 18.44–38.76) in the non-EMS group (p = 0.785). The average length of hospital stay was 9 days (interquartile

  11. 75 FR 49507 - Recovery Policy, RP9525.4, Emergency Medical Care and Medical Evacuations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-13

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

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

    ERIC Educational Resources Information Center

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

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

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

    PubMed

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

    2016-12-01

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

  14. 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.

  15. Systems With Emergent Dynamics

    NASA Astrophysics Data System (ADS)

    Stewart, Ian

    2002-09-01

    Evolutionary biologists often reject deterministic models of evolutionary processes because they equate `deterministic' with `goal-seeking', and have learned the hard way not to trust goal-seeking explanations of evolutionary adaptations. On the other hand, the general theory of dynamical systems potentially has much to offer for evolutionary biology— for example, as a resolution of the conflict between gradualism and punctuated equilibrium. The concept of a system with emergent dynamics retains the deterministic nature of dynamical systems, while eliminating any goal-seeking interpretation. Define an emergent property of a complex system to be a property whose computation from the entity-level rules of the system is intractable (in some reasonable sense). Say that a dynamical system has emergent dynamics if the computation of trajectories is intractable. Then systems with emergent dynamics are deterministic but not goal-seeking. As such, they offer a sensible way to use dynamical systems as models for evolutionary processes in biology, and in other areas. We discuss these issues and examine a few simple aspects of emergence in dynamical systems.

  16. 78 FR 59623 - Emergency Medical Equipment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-27

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

  17. Basic Emergency Medical Technician Skills Manual.

    ERIC Educational Resources Information Center

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

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

  18. Emergency Medical Technician Series. Duty Task List.

    ERIC Educational Resources Information Center

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

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

  19. Basic Emergency Medical Technician Skills Manual.

    ERIC Educational Resources Information Center

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

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

  20. 38 CFR 1.485 - Medical emergencies.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

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

  1. 38 CFR 1.485 - Medical emergencies.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

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

  2. 38 CFR 1.485 - Medical emergencies.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

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

  3. 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…

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

    ERIC Educational Resources Information Center

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

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

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

    ERIC Educational Resources Information Center

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

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

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

    PubMed

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

    2014-12-01

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

  7. 5 CFR 630.1010 - Termination of medical emergency.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... under the Civil Service Retirement System or the Federal Employees Retirement System. (b) The leave bank....1010 Section 630.1010 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS ABSENCE AND LEAVE Voluntary Leave Bank Program § 630.1010 Termination of medical emergency. (a)...

  8. Development of the Inventory Management and Tracking System (IMATS) to Track the Availability of Public Health Department Medical Countermeasures During Public Health Emergencies

    PubMed Central

    Sahar, Liora; Faler, Guy; Hristov, Emil; Hughes, Susan; Lee, Leslie; Westnedge, Caroline; Erickson, Benjamin; Nichols, Barbara

    2015-01-01

    Objective To bridge gaps identified during the 2009 H1N1 influenza pandemic by developing a system that provides public health departments improved capability to manage and track medical countermeasures at the state and local levels and to report their inventory levels to the Centers for Disease Control and Prevention (CDC). Materials and Methods The CDC Countermeasure Tracking Systems (CTS) program designed and implemented the Inventory Management and Tracking System (IMATS) to manage, track, and report medical countermeasure inventories at the state and local levels. IMATS was designed by CDC in collaboration with state and local public health departments to ensure a “user-centered design approach.” A survey was completed to assess functionality and user satisfaction. Results IMATS was deployed in September 2011 and is provided at no cost to public health departments. Many state and local public health departments nationwide have adopted IMATS and use it to track countermeasure inventories during public health emergencies and daily operations. Discussion A successful response to public health emergencies requires efficient, accurate reporting of countermeasure inventory levels. IMATS is designed to support both emergency operations and everyday activities. Future improvements to the system include integrating barcoding technology and streamlining user access. To maintain system readiness, we continue to collect user feedback, improve technology, and enhance its functionality. Conclusion IMATS satisfies the need for a system for monitoring and reporting health departments’ countermeasure quantities so that decision makers are better informed. The “user-centered design approach” was successful, as evident by the many public health departments that adopted IMATS. PMID:26392843

  9. 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...

  10. 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...

  11. 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...

  12. 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...

  13. 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...

  14. Strategies for reducing medication errors in the emergency department

    PubMed Central

    Weant, Kyle A; Bailey, Abby M; Baker, Stephanie N

    2014-01-01

    Medication errors are an all-too-common occurrence in emergency departments across the nation. This is largely secondary to a multitude of factors that create an almost ideal environment for medication errors to thrive. To limit and mitigate these errors, it is necessary to have a thorough knowledge of the medication-use process in the emergency department and develop strategies targeted at each individual step. Some of these strategies include medication-error analysis, computerized provider-order entry systems, automated dispensing cabinets, bar-coding systems, medication reconciliation, standardizing medication-use processes, education, and emergency-medicine clinical pharmacists. Special consideration also needs to be given to the development of strategies for the pediatric population, as they can be at an elevated risk of harm. Regardless of the strategies implemented, the prevention of medication errors begins and ends with the development of a culture that promotes the reporting of medication errors, and a systematic, nonpunitive approach to their elimination. PMID:27147879

  15. Addressing barriers to emergency anaphylaxis care: from emergency medical services to emergency department to outpatient follow-up.

    PubMed

    Fineman, Stanley M; Bowman, Steven H; Campbell, Ronna L; Dowling, Paul; O'Rourke, Dianne; Russell, W Scott; Sublett, J Wesley; Wallace, Dana

    2015-10-01

    Anaphylaxis is a systemic life-threatening allergic reaction that presents unique challenges for emergency care practitioners. Allergists and emergency physicians have a history of collaborating to promote an evidence-based, multidisciplinary approach to improve the emergency management and follow-up of patients with or at risk of anaphylaxis. To review recent scientific literature about anaphylaxis, discuss barriers to care, and recommend strategies to support improvement in emergency anaphylaxis care. An expert panel of allergists and emergency physicians was convened by the American College of Allergy, Asthma and Immunology in November 2014 to discuss current knowledge about anaphylaxis, identify opportunities for emergency practitioners and allergists to partner to address barriers to care, and recommend strategies to improve medical management of anaphylaxis along the continuum of care: from emergency medical systems and emergency department practitioners for acute management through appropriate outpatient follow-up with allergists to confirm diagnosis, identify triggers, and plan long-term care. The panel identified key barriers to anaphylaxis care, including difficulties in making an accurate diagnosis, low rates of epinephrine administration during acute management, and inadequate follow-up. Strategies to overcome these barriers were discussed and recommendations made for future allergist/emergency physician collaborations, and key messages to be communicated to emergency practitioners were proposed. The panel recommended that allergists and emergency physicians continue to work in partnership, that allergists be proactive in outreach to emergency care practitioners, and that easy-to-access educational programs and materials be developed for use by emergency medical systems and emergency department practitioners in the training environment and in practice. Copyright © 2015 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All

  16. Emergency medical training for dental students.

    PubMed Central

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

    1996-01-01

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

  17. Emergency Lightning System

    NASA Technical Reports Server (NTRS)

    1980-01-01

    Super Vacuum Manufacturing Company's Stem-Lite Emergency Lighting System is widely used by fire, police, ambulance and other emergency service departments. The lights -- four floodlights which provide 2,000 watts of daytime equivalent visibility and a high-intensity flashing beacon can be elevated 10 feet above the roof of an emergency vehicle by means of an extendible mast. The higher elevation expands the effective radius of the floodlights and increases the beacon's visibility to several miles affording extra warning time to approaching traffic. When not in use, the light can be retracted into the compact rooftop housing. Stem-Lite also includes a generator which can serve to power such emergency equipment as pumps and drills, and a dashboard-mounted control panel for switching the lights and extending or retracting the mast.

  18. Medical emergency announcements on cruise ships: an audit of outcome.

    PubMed

    Taylor, Christopher James

    2015-01-01

    Public address announcements are an effective way of alerting staff on cruise ships to life -threatening medical emergencies on-board, but should only be used when truly necessary. An audit to investigate the outcome following this method of activating the medical emergency response team (MERT) suggested system flaws. A new elementary first aid training programme for the crew was then developed, emphasising patient assessment and the correct determination of appropriate levels of response. Following fleet-wide implementation, post-intervention audits were performed on two other company ships to evaluate the impact of the new approach. Data from all MERT activations initiated by public address announcement were prospectively collected during the audit periods, including subsequent means of transfer to the ship's medical centre and duration of medical intervention as indicators of clinical severity. After changing the training programme the overall rate of public announcements for medical emergencies fell by 43%. The proportion of patients requiring transfer by stretcher increased from 5% to 33%, whilst the proportion of patients requiring ≥ 4 h of medical intervention increased from 5% to 44%. The audits suggest that the new training programme may have improved the first aid responders' decision-making as there were fewer inappropriate emergency announcements over the public address system. However, two-thirds of all MERT activations were still for patients either well enough to walk or only needing a wheelchair for subsequent transfer, indicating ongoing opportunity for improvement.

  19. Customer satisfaction measurement in emergency medical services.

    PubMed

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

    2003-07-01

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

  20. 5 CFR 630.910 - Termination of medical emergency.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false Termination of medical emergency. 630.910... AND LEAVE Voluntary Leave Transfer Program § 630.910 Termination of medical emergency. (a) The medical... that the leave recipient is no longer affected by a medical emergency; (3) At the end of the biweekly...

  1. 5 CFR 630.910 - Termination of medical emergency.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

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

  2. An evaluation of the professional, social and demographic profile and quality of life of physicians working at the Prehospital Emergency Medical System (SAMU) in Brazil

    PubMed Central

    Tallo, Fernando Sabia; de Campos Vieira Abib, Simone; Baitello, André Luciano; Lopes, Renato Delascio

    2014-01-01

    OBJECTIVE: To describe the profile of physicians working at the Prehospital Emergency Medical System (SAMU) in Brazil and to evaluate their quality of life. METHODS: Both a semi-structured questionnaire with 57 questions and the SF-36 questionnaire were sent to research departments within SAMU in the Brazilian state capitals, the Federal District and inland towns in Brazil. RESULTS: Of a total of 902 physicians, including 644 (71.4%) males, 533 (59.1%) were between 30 and 45 years of age and 562 (62.4%) worked in a state capital. Regarding education level, 45.1% had graduated less than five years before and only 43% were specialists recognized by the Brazilian Medical Association. Regarding training, 95% did not report any specific training for their work at SAMU. The main weaknesses identified were psychiatric care and surgical emergencies in 57.2 and 42.9% of cases, respectively; traumatic pediatric emergencies, 48.9%; and medical emergencies, 42.9%. As for procedure-related skills, the physicians reported difficulties in pediatric advanced support (62.4%), airway surgical access (45.6%), pericardiocentesis (64.4%) and thoracentesis (29.9%). Difficulties in using an artificial ventilator (43.3%) and in transcutaneous pacing (42.2%) were also reported. Higher percentages of young physicians, aged 25-30 years (26.7 vs 19.0%; p<0.01), worked exclusively in prehospital care (18.0 vs 7.7%; p<0.001), with workloads >48 h per week (12.8 vs 8.6%; p<0.001), and were non-specialists with the shortest length of service (<1 year) at SAMU (30.1 vs 18.2%; p<0.001) who were hired without having to pass public service exams* (i.e., for a temporary job) (61.8 vs 46.2%; p<0.001). Regarding quality of life, the pain domain yielded the worst result among physicians at SAMU. CONCLUSIONS: The doctors in this sample were young and within a few years of graduation, and they had no specific training in prehospital emergencies. Deficiencies were mostly found in pediatrics and psychiatry

  3. Knowledge translation in international emergency medical care.

    PubMed

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

    2007-11-01

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

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

    PubMed

    Dick, W

    1994-01-01

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

  5. The Integration of Electronic Medical Student Evaluations Into an Emergency Department Tracking System is Associated With Increased Quality and Quantity of Evaluations.

    PubMed

    Chiu, David T; Solano, Joshua J; Ullman, Edward; Pope, Jennifer; Tibbles, Carrie; Horng, Steven; Nathanson, Larry A; Fisher, Jonathan; Rosen, Carlo L

    2016-10-01

    Medical student evaluations are essential for determining clerkship grades. Electronic evaluations have various advantages compared to paper evaluations, such as increased ease of collection, asynchronous reporting, and decreased likelihood of becoming lost. To determine whether electronic medical student evaluations (EMSEs) provide more evaluations and content when compared to paper shift card evaluations. This before and after cohort study was conducted over a 2.5-year period at an academic hospital affiliated with a medical school and emergency medicine residency program. EMSEs replaced the paper shift evaluations that had previously been used halfway through the study period. A random sample of the free text comments on both paper and EMSEs were blindly judged by medical student clerkship directors for their helpfulness and usefulness. Logistic regression was used to test for any relationship between quality and quantity of words. A total of 135 paper evaluations for 30 students and then 570 EMSEs for 62 students were collected. An average of 4.8 (standard deviation [SD] 3.2) evaluations were completed per student using the paper version compared to 9.0 (SD 3.8) evaluations completed per student electronically (p < 0.001). There was an average of 8.8 (SD 8.5) words of free text evaluation on paper evaluations when compared to 22.5 (SD 28.4) words for EMSEs (p < 0.001). A statistically significant (p < 0.02) association between quality of an evaluation and the word count existed. EMSEs that were integrated into the emergency department tracking system significantly increased the number of evaluations completed compared to paper evaluations. In addition, the EMSEs captured more "helpful/useful" information about the individual students as evidenced by the longer free text entries per evaluation. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. 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…

  7. Mission Medical Information System

    NASA Technical Reports Server (NTRS)

    Johnson-Throop, Kathy A.; Joe, John C.; Follansbee, Nicole M.

    2008-01-01

    This viewgraph presentation gives an overview of the Mission Medical Information System (MMIS). The topics include: 1) What is MMIS?; 2) MMIS Goals; 3) Terrestrial Health Information Technology Vision; 4) NASA Health Information Technology Needs; 5) Mission Medical Information System Components; 6) Electronic Medical Record; 7) Longitudinal Study of Astronaut Health (LSAH); 8) Methods; and 9) Data Submission Agreement (example).

  8. Teaching Emergency Care to First-Year Medical Students

    ERIC Educational Resources Information Center

    McCally, Michael; And Others

    1977-01-01

    At the George Washington University School of Medicine a 52-hour course in emergency care was adapted for first-year medical students from an 81-hour program for training emergency medical technicians. (Author/LBH)

  9. Review on emergency medical response against terrorist attack.

    PubMed

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

    2014-01-01

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

  10. Mammalian synthetic biology: emerging medical applications.

    PubMed

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

    2015-05-06

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

  11. 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

  12. Emergency Medical Service Personnel Recognize Pediatric Concussions.

    PubMed

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

    2017-01-01

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

  13. Mammalian synthetic biology: emerging medical applications

    PubMed Central

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

    2015-01-01

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

  14. 32 CFR 1656.20 - Expenses for emergency medical care.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  15. 5 CFR 630.1010 - Termination of medical emergency.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false Termination of medical emergency. 630... ABSENCE AND LEAVE Voluntary Leave Bank Program § 630.1010 Termination of medical emergency. (a) The medical emergency affecting a leave recipient shall terminate— (1) When the leave recipient's Federal...

  16. 22 CFR 71.10 - Emergency medical assistance.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Emergency medical assistance. 71.10 Section 71... ESTATES PROTECTION AND WELFARE OF CITIZENS AND THEIR PROPERTY Emergency Medical/Dietary Assistance for U.S. Nationals Incarcerated Abroad § 71.10 Emergency medical assistance. (a) Eligibility criteria. A U.S...

  17. 22 CFR 71.10 - Emergency medical assistance.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Emergency medical assistance. 71.10 Section 71... ESTATES PROTECTION AND WELFARE OF CITIZENS AND THEIR PROPERTY Emergency Medical/Dietary Assistance for U.S. Nationals Incarcerated Abroad § 71.10 Emergency medical assistance. (a) Eligibility criteria. A U.S...

  18. 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...

  19. 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...

  20. 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...

  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 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...

  7. 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...

  8. 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...

  9. 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...

  10. 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...

  11. 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...

  12. 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...

  13. 22 CFR 71.10 - Emergency medical assistance.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Emergency medical assistance. 71.10 Section 71... ESTATES PROTECTION AND WELFARE OF CITIZENS AND THEIR PROPERTY Emergency Medical/Dietary Assistance for U.S. Nationals Incarcerated Abroad § 71.10 Emergency medical assistance. (a) Eligibility criteria. A U.S...

  14. 5 CFR 630.1010 - Termination of medical emergency.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

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

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

    NASA Technical Reports Server (NTRS)

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

    1987-01-01

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

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

    PubMed

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

    2013-01-01

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

  17. Emerging medical technologies and emerging conceptions of health.

    PubMed

    Stempsey, William E

    2006-01-01

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

  18. 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.

  19. [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.

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

    ERIC Educational Resources Information Center

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

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

  1. Comparison of Emergency Medical Services and Trauma Care Systems Among Pan-Asian Countries: An International, Multicenter, Population-Based Survey.

    PubMed

    Sun, Kyong Min; Song, Kyoung Jun; Shin, Sang Do; Tanaka, Hideharu; Shaun, Goh E; Chiang, Wen-Chu; Kajino, Kentaro; Jamaluddin, Sabariah Faizah; Kimura, Akio; Ro, Young Sun; Wi, Dae Han; Park, Ju Ok; Moon, Sung Woo; Jung, Young Hee; Kim, Min Jung; Holmes, James F

    2017-01-01

    Knowledge on the current trauma systems in Asian countries is limited. The objective of this study was to describe the emergency medical services (EMS) and trauma care systems among countries participating in the Pan-Asian Trauma Outcomes Study (PATOS) Clinical Research Network. The PATOS network consists of 33 participating sites from 14 countries. Standardized data was collected from each site using an EMS survey form and included general information (population, population density, urbanization, EMS service fee, etc.), dispatcher system, trauma care practice, trauma education program, existence of a trauma registry, and data on EMS transfers. Data is described with simple descriptive statistics. All countries included urban sites. Nine countries included rural sites and only one country included wilderness site. Of the 33 sties, 18 sites had physician-based EMS systems. EMS services were free in 9 countries. Twelve sites had dispatch centers operated by government health departments. EMS dispatcher certification was required in 29 sites. Thirty-two sites had EMS documented protocols for trauma and 31 sites had field triage tools. Thirty sites had designated trauma centers. Twenty-one sites had helicopter EMS systems. Thirty-one sites require certification for trauma education programs. Only 23 sites maintained EMS-based trauma registries. In 20 sites, EMS medical directors reviewed and assured trauma registry quality. Of patients transported by EMS rate of injured patients ranged from 15% to 59%. Substantial variability exists in EMS systems in Asia, especially for injured patients. Futures studies are required to assess the impact of this variability on patient outcomes.

  2. Emerging 21st Century Medical Technologies

    PubMed Central

    Bajwa, Mohammad

    2014-01-01

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

  3. Emergency medical dispatching by general practitioners in Brussels.

    PubMed

    Renier, W; Seys, B

    1995-09-01

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

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

    PubMed Central

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

    2009-01-01

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

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

    PubMed

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

    2009-05-12

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

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

    PubMed

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

    2005-01-01

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

  7. Emergent behaviors of classifier systems

    SciTech Connect

    Forrest, S.; Miller, J.H.

    1989-01-01

    This paper discusses some examples of emergent behavior in classifier systems, describes some recently developed methods for studying them based on dynamical systems theory, and presents some initial results produced by the methodology. The goal of this work is to find techniques for noticing when interesting emergent behaviors of classifier systems emerge, to study how such behaviors might emerge over time, and make suggestions for designing classifier systems that exhibit preferred behaviors. 20 refs., 1 fig.

  8. 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.

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

    PubMed

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

    2010-06-01

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

  10. Implementation of Emergency Medical Text Classifier for Syndromic Surveillance

    PubMed Central

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

    2013-01-01

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

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

    PubMed

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

    2013-01-01

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

  12. Civilian exposure to toxic agents: emergency medical response.

    PubMed

    Baker, David

    2004-01-01

    Civilian populations are at risk from exposure to toxic materials as a result of accidental or deliberate exposure. In addition to industrial hazards, toxic agents designed for use in warfare now are a potential hazard in everyday life through terrorist action. Civil emergency medical responders should be able to adapt their plans for dealing with casualties from hazardous materials (HazMat) to deal with the new threat. Chemical and biological warfare (CBW) and HazMat agents can be viewed as a continuous spectrum. Each of these hazards is characterized by qualities of toxicity, latency of action, persistency, and transmissibility. The incident and medical responses to release of any agent is determined by these characteristics. Chemical and biological wardare agents usually are classified as weapons of mass destruction, but strictly, they are agents of mass injury. The relationship between mass injury and major loss of life depends very much on the protection, organization, and emergency care provided. Detection of a civil toxic agent release where signs and symptoms in casualties may be the first indicator of exposure is different from the military situation where intelligence information and tuned detection systems generally will be available. It is important that emergency medical care should be given in the context of a specific action plan. Within an organized and protected perimeter, triage and decontamination (if the agent is persistent) can proceed while emergency medical care is provided at the same time. The provision of advanced life support (TOXALS) in this zone by protected and trained medical responders now is technically feasible using specially designed ventilation equipment. Leaving life support until after decontamination may have fatal consequences. Casualties from terrorist attacks also may suffer physical as well as toxic trauma and the medical response also should be capable of dealing with mixed injuries.

  13. Hand hygiene in emergency medical services.

    PubMed

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

    2015-01-01

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

  14. Emergency Medical Service Personnel Recognize Pediatric Concussions

    PubMed Central

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

    2017-01-01

    Concussions are a major cause of morbidity in pediatrics. Many concussions occur during activities with emergency medical service (EMS) providers present to determine if a higher level of care is needed. Data are limited on how capable these providers are. We assessed the ability of EMS providers to recognize pediatric concussions. Fifty-six total responses were included, 38 from EMS and 18 from our MD/RN (medical doctor/registered nurse) group. No statistical differences were found between the 2 groups when adjusted for age, gender, number of years in practice, and number of pediatric concussions managed. This first of its kind pilot study was designed to assess EMS personnel’s ability to recognize and triage pediatric concussions. Our findings show EMS providers are statistically identical in their ability to recognize and triage concussions to physicians. The performance of our MD participants was lower than expected. Larger studies are needed to further investigate EMS providers’ ability to recognize a concussion. PMID:28812053

  15. [The organizational technologies of quality support of emergency and acute medical care in megalopolis: Moscow case].

    PubMed

    2011-01-01

    The article deals with the issues of emergency medical care in conditions of megalopolis on the example of the Moscow A.S. Putchkov emergency and acute medical care station. The analysis is applied to such new organizational technologies as the automatic navigational dispatcher system of field brigades 'management, the zoning of transport mains according accessibility of emergency medical are stations, the organization of emergency medical posts on the most conducive to accident areas of megalopolis, the integrated municipal inter-warning system in case of road accidents.

  16. [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.

  17. 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...

  18. 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...

  19. 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...

  20. 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...

  1. 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...

  2. 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...

  3. 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...

  4. 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...

  5. 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...

  6. 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...

  7. 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...

  8. 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...

  9. 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...

  10. 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...

  11. 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...

  12. 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...

  13. 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...

  14. 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...

  15. 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...

  16. 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...

  17. Electronic medical records in humanitarian emergencies – the development of an Ebola clinical information and patient management system

    PubMed Central

    Jobanputra, Kiran; Greig, Jane; Shankar, Ganesh; Perakslis, Eric; Kremer, Ronald; Achar, Jay; Gayton, Ivan

    2017-01-01

    By November 2015, the West Africa Ebola epidemic had caused 28598 infections and 11299 deaths in the three countries most affected. The outbreak required rapid innovation and adaptation. Médecins sans Frontières (MSF) scaled up its usual 20-30 bed Ebola management centres (EMCs) to 100-300 beds with over 300 workers in some settings. This brought challenges in patient and clinical data management resulting from the difficulties of working safely with high numbers of Ebola patients. We describe a project MSF established with software developers and the Google Social Impact Team to develop context-adapted tools to address the challenges of recording Ebola clinical information. We share the outcomes and key lessons learned in innovating rapidly under pressure in difficult environmental conditions. Information on adoption, maintenance, and data quality was gathered through review of project documentation, discussions with field staff and key project stakeholders, and analysis of tablet data. In March 2015, a full prototype was deployed in Magburaka EMC, Sierra Leone. Inpatient data were captured on 204 clinical interactions with 34 patients from 5 March until 10 April 2015. Data continued to also be recorded on paper charts, creating theoretically identical record “pairs” on paper and tablet. 83 record pairs for 33 patients with 22 data items (temperature and symptoms) per pair were analysed. The overall Kappa coefficient for agreement between sources was 0.62, but reduced to 0.59 when rare bleeding symptoms were excluded, indicating moderate to good agreement. The time taken to deliver the product was more than that anticipated by MSF (7 months versus 6 weeks). Deployment of the tablet coincided with a dramatic drop in patient numbers and thus had little impact on patient care. We have identified lessons specific to humanitarian-technology collaborative projects and propose a framework for emergency humanitarian innovation. Time and effort is required to bridge

  18. Electronic medical records in humanitarian emergencies - the development of an Ebola clinical information and patient management system.

    PubMed

    Jobanputra, Kiran; Greig, Jane; Shankar, Ganesh; Perakslis, Eric; Kremer, Ronald; Achar, Jay; Gayton, Ivan

    2016-01-01

    By November 2015, the West Africa Ebola epidemic had caused 28598 infections and 11299 deaths in the three countries most affected. The outbreak required rapid innovation and adaptation. Médecins sans Frontières (MSF) scaled up its usual 20-30 bed Ebola management centres (EMCs) to 100-300 beds with over 300 workers in some settings. This brought challenges in patient and clinical data management resulting from the difficulties of working safely with high numbers of Ebola patients. We describe a project MSF established with software developers and the Google Social Impact Team to develop context-adapted tools to address the challenges of recording Ebola clinical information. We share the outcomes and key lessons learned in innovating rapidly under pressure in difficult environmental conditions. Information on adoption, maintenance, and data quality was gathered through review of project documentation, discussions with field staff and key project stakeholders, and analysis of tablet data. In March 2015, a full prototype was deployed in Magburaka EMC, Sierra Leone. Inpatient data were captured on 204 clinical interactions with 34 patients from 5 March until 10 April 2015. Data continued to also be recorded on paper charts, creating theoretically identical record "pairs" on paper and tablet. 83 record pairs for 33 patients with 22 data items (temperature and symptoms) per pair were analysed. The overall Kappa coefficient for agreement between sources was 0.62, but reduced to 0.59 when rare bleeding symptoms were excluded, indicating moderate to good agreement. The time taken to deliver the product was more than that anticipated by MSF (7 months versus 6 weeks). Deployment of the tablet coincided with a dramatic drop in patient numbers and thus had little impact on patient care. We have identified lessons specific to humanitarian-technology collaborative projects and propose a framework for emergency humanitarian innovation. Time and effort is required to bridge

  19. Emergency medical kits on board commercial aircraft: a comparative study.

    PubMed

    Sand, Michael; Gambichler, Thilo; Sand, Daniel; Thrandorf, Christina; Altmeyer, Peter; Bechara, Falk G

    2010-11-01

    In cases of critical medical situations on board commercial aircraft, access to emergency medical kits can be lifesaving. Thus, this comparative study investigated acute care medication and equipment supplied in emergency medical kits on board both low-cost carriers and full-service carriers. Thirty-two European airlines (sixteen low-cost carriers and sixteen full-service-carriers) were asked to provide anonymous data on the contents of their emergency medical kits. All emergency medical equipment and medication carried on board were subject to a descriptive analysis with regards to International Civil Aviation Organization (ICAO) standards for emergency medical kits, as well as variation and differences between low-cost carriers and full-service carriers. A total of twelve airlines (seven full-service carriers and five low-cost carriers) participated in this study. None complied with ICAO standards. Emergency medical kits from both full-service carriers and low-cost carriers exhibited a high degree of variability. Two European low-cost carriers were assessed as being insufficiently equipped for a medical emergency requiring acute care. This study demonstrates the high degree of variability in the contents of emergency medical kits. Additionally, some airlines were equipped insufficiently for a critical medical situation on board their aircraft. Frequent checks of national authorities and further evaluation of acute care equipment are required to prepare for potentially life-threatening critical conditions occurring in special environments, such as in airplane during flight. Copyright © 2010 Elsevier Ltd. All rights reserved.

  20. 14 CFR 1250.103-6 - Medical emergencies.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 5 2012-01-01 2012-01-01 false Medical emergencies. 1250.103-6 Section... Medical emergencies. Notwithstanding the provisions of §§ 1250.103 to 1250.103-5, a recipient of Federal... impairment of his health, and such service or other benefit cannot be provided except by or through a medical...

  1. 14 CFR 1250.103-6 - Medical emergencies.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 5 2013-01-01 2013-01-01 false Medical emergencies. 1250.103-6 Section... Medical emergencies. Notwithstanding the provisions of §§ 1250.103 to 1250.103-5, a recipient of Federal... impairment of his health, and such service or other benefit cannot be provided except by or through a medical...

  2. 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...

  3. 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...

  4. 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...

  5. 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…

  6. 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...

  7. 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...

  8. 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...

  9. 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...

  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 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...

  12. 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...

  13. 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...

  14. 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...

  15. 14 CFR 1250.103-6 - Medical emergencies.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

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

  16. 14 CFR 1250.103-6 - Medical emergencies.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  17. Medical imaging systems

    DOEpatents

    Frangioni, John V

    2013-06-25

    A medical imaging system provides simultaneous rendering of visible light and diagnostic or functional images. The system may be portable, and may include adapters for connecting various light sources and cameras in open surgical environments or laparascopic or endoscopic environments. A user interface provides control over the functionality of the integrated imaging system. In one embodiment, the system provides a tool for surgical pathology.

  18. Emergency core cooling system

    DOEpatents

    Schenewerk, William E.; Glasgow, Lyle E.

    1983-01-01

    A liquid metal cooled fast breeder reactor provided with an emergency core cooling system includes a reactor vessel which contains a reactor core comprising an array of fuel assemblies and a plurality of blanket assemblies. The reactor core is immersed in a pool of liquid metal coolant. The reactor also includes a primary coolant system comprising a pump and conduits for circulating liquid metal coolant to the reactor core and through the fuel and blanket assemblies of the core. A converging-diverging venturi nozzle with an intermediate throat section is provided in between the assemblies and the pump. The intermediate throat section of the nozzle is provided with at least one opening which is in fluid communication with the pool of liquid sodium. In normal operation, coolant flows from the pump through the nozzle to the assemblies with very little fluid flowing through the opening in the throat. However, when the pump is not running, residual heat in the core causes fluid from the pool to flow through the opening in the throat of the nozzle and outwardly through the nozzle to the assemblies, thus providing a means of removing decay heat.

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

    PubMed

    Glover, Nancy

    2013-03-01

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

  20. Interprofessional education of medical students and paramedics in emergency medicine.

    PubMed

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

    2007-03-01

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

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

    PubMed

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

    2013-04-18

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

  2. 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

  3. An economic toolkit for identifying the cost of emergency medical services (EMS) systems: detailed methodology of the EMS Cost Analysis Project (EMSCAP).

    PubMed

    Lerner, E Brooke; Garrison, Herbert G; Nichol, Graham; Maio, Ronald F; Lookman, Hunaid A; Sheahan, William D; Franz, Timothy R; Austad, James D; Ginster, Aaron M; Spaite, Daniel W

    2012-02-01

    Calculating the cost of an emergency medical services (EMS) system using a standardized method is important for determining the value of EMS. This article describes the development of a methodology for calculating the cost of an EMS system to its community. This includes a tool for calculating the cost of EMS (the "cost workbook") and detailed directions for determining cost (the "cost guide"). The 12-step process that was developed is consistent with current theories of health economics, applicable to prehospital care, flexible enough to be used in varying sizes and types of EMS systems, and comprehensive enough to provide meaningful conclusions. It was developed by an expert panel (the EMS Cost Analysis Project [EMSCAP] investigator team) in an iterative process that included pilot testing the process in three diverse communities. The iterative process allowed ongoing modification of the toolkit during the development phase, based upon direct, practical, ongoing interaction with the EMS systems that were using the toolkit. The resulting methodology estimates EMS system costs within a user-defined community, allowing either the number of patients treated or the estimated number of lives saved by EMS to be assessed in light of the cost of those efforts. Much controversy exists about the cost of EMS and whether the resources spent for this purpose are justified. However, the existence of a validated toolkit that provides a standardized process will allow meaningful assessments and comparisons to be made and will supply objective information to inform EMS and community officials who are tasked with determining the utilization of scarce societal resources.

  4. Medical Imaging System

    NASA Technical Reports Server (NTRS)

    1991-01-01

    The MD Image System, a true-color image processing system that serves as a diagnostic aid and tool for storage and distribution of images, was developed by Medical Image Management Systems, Huntsville, AL, as a "spinoff from a spinoff." The original spinoff, Geostar 8800, developed by Crystal Image Technologies, Huntsville, incorporates advanced UNIX versions of ELAS (developed by NASA's Earth Resources Laboratory for analysis of Landsat images) for general purpose image processing. The MD Image System is an application of this technology to a medical system that aids in the diagnosis of cancer, and can accept, store and analyze images from other sources such as Magnetic Resonance Imaging.

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

    PubMed

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

    2017-01-01

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

  6. Emergency medical support system for extravehicular activity training held at weightless environment test building (WETS) of the Japan Aerospace Exploration Agency (JAXA) : future prospects and a look back over the past decade.

    PubMed

    Nakajima, Isao; Tachibana, Masakazu; Ohashi, Noriyoshi; Imai, Hiroshi; Asari, Yasushi; Matsuyama, Shigenori

    2011-12-01

    The Japan Aerospace Exploration Agency (JAXA) provides extravehicular activity (EVA) training to astronauts in a weightless environment test building (WETS) located in Tsukuba City. For EVA training, Tsukuba Medial Center Hospital (TMCH) has established an emergency medical support system, serving as operations coordinator. Taking the perspective of emergency physicians, this paper provides an overview of the medical support system and examines its activities over the past decade as well as future issues. Fortunately, no major accident has occurred during the past 10 years of NBS. Minor complaints (external otitis, acute otitis media, transient dizziness, conjunctival inflammation, upper respiratory inflammation, dermatitis, abraded wounds, etc.) among the support divers have been addressed onsite by attending emergency physicians. Operations related to the medical support system at the WETS have proceeded smoothly for the former NASDA and continue to proceed without event for JAXA, providing safe, high-quality emergency medical services. If an accident occurs at the WETS, transporting the patient by helicopter following initial treatment by emergency physicians can actually exacerbate symptoms, since the procedure exposes a patient who was recently within a hyperbaric environment to the low-pressure environment involved in air transportation. If a helicopter is used, the flight altitude should be kept as low as possible by taking routes over the river.

  7. Physician staffed helicopter emergency medical service dispatch via centralised control or directly by crew – case identification rates and effect on the Sydney paediatric trauma system

    PubMed Central

    2012-01-01

    Background Severe paediatric trauma patients benefit from direct transport to dedicated Paediatric Trauma Centres (PTC). Parallel case identification systems utilising paramedics from a centralised dispatch centre versus the crew of a physician staffed Helicopter Emergency Medical Service (HEMS) allowed comparison of the two systems for case identification rates and subsequent timeliness of direct transfer to a PTC. Methods Paediatric trauma patients over a two year period from the Sydney region with an Injury Severity Score (ISS) > 15 were retrospectively identified from a state wide trauma registry. Overall paediatric trauma system performance was assessed by comparisons of the availability of the physician staffed HEMS for patient characteristics, transport mode (direct versus indirect) and the times required for the patient to arrive at the paediatric trauma centre. The proportion of patients transported directly to a PTC was compared between the times that the HEMS service was available versus the time that it was unavailable to determine if the HEMS system altered the rate of direct transport to a PTC. Analysis of variance was used to compare the identifying systems for various patient characteristics when the HEMS was available. Results Ninety nine cases met the inclusion criteria, 44 when the HEMS system was operational. Patients identified for physician response by the HEMS system were significantly different to those that were not identified with higher median ISS (25 vs 18, p = 0.011), and shorter times to PTC (67 vs 261mins, p = 0.015) and length of intensive care unit stays (2 vs 0 days, p = 0.045). Of the 44 cases, 21 were not identified, 3 were identified by the paramedic system and 20 were identified by the HEMS system, (P < 0.001). Direct transport to a PTC was more likely to occur when the HEMS dispatch system was available (RR 1.81, 95% CI 1.20-2.73). The median time (minutes) to arrival at the PTC was shorter when HEMS

  8. Understanding Safety in Prehospital Emergency Medical Services for Children

    PubMed Central

    Cottrell, Erika K.; O’Brien, Kerth; Curry, Merlin; Meckler, Garth D.; Engle, Philip P.; Jui, Jonathan; Summers, Caitlin; Lambert, William; Guise, Jeanne-Marie

    2014-01-01

    Objective For over a decade, the field of medicine has recognized the importance of studying and designing strategies to prevent safety issues in hospitals and clinics. However, there has been less focus on understanding safety in prehospital emergency medical services, particularly in regard to children. Roughly 27.7 million (or 27%) of the annual ED visits are by children under the age of 19, and about 2 million of these children reach the hospital via EMS. This paper adds to our qualitative understanding of the nature and contributors to safety events in the prehospital emergency care of children. Methods We conducted four 8–12 person focus groups among paid and volunteer Emergency Medical Services providers to understand: 1) patient safety issues that occur in the prehospital care of children, and 2) factors that contribute to these safety issues (e.g. patient, family, systems, environmental, or individual provider factors). Focus groups were conducted in rural and urban settings. Interview transcripts were coded for overarching themes. Results Key factors and themes identified in the analysis were grouped into categories using an ecological approach that distinguishes between systems, team, child and family, and individual provider level contributors. At the systems level, focus group participants cited challenges such as lack of appropriately sized equipment or standardized pediatric medication dosages, insufficient human resources, limited pediatric training and experience, and aspects of emergency medical services culture. EMS team level factors centered on communication with other EMS providers (both prehospital and hospital). Family and child factors included communication barriers and challenging clinical situations or scene characteristics. Finally, focus group participants highlighted a range of provider level factors including heightened levels of anxiety, insufficient experience and training with children and errors in assessment and decision

  9. Terrorism and the ethics of emergency medical care.

    PubMed

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

    2001-06-01

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

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

    PubMed

    Frydshou, Andreas; Gillesberg, Inger

    2013-02-18

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

  11. 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.

  12. Emergency Medical Science (T-139). Curriculum Models, Guidelines, and Outcome-Competencies.

    ERIC Educational Resources Information Center

    Lovin, Barbara Keelor

    Developed for use by curriculum planners in Emergency Medical Science (EMS) programs throughout the North Carolina Community College System (NCCCS), and by evaluators in their reviews of existing programs, this manual provides a model set of guidelines for the education and training of the Emergency Medical Technician-Paramedic (EMT-P) in…

  13. National Training Course. Emergency Medical Technician. Paramedic. Instructor's Lesson Plans. Module XV. Telemetry and Communications.

    ERIC Educational Resources Information Center

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

    This instructor's lesson plan guide on telemetry and communications is one of fifteen modules designed for use in the training of emergency medical technicians (paramedics). Two units of study are presented: (1) emergency medical services communications systems (items of equipment and such radio communications concepts as frequency allocation,…

  14. Emergency department visits by adults for psychiatric medication adverse events.

    PubMed

    Hampton, Lee M; Daubresse, Matthew; Chang, Hsien-Yen; Alexander, G Caleb; Budnitz, Daniel S

    2014-09-01

    In 2011, an estimated 26.8 million US adults used prescription medications for mental illness. To estimate the numbers and rates of adverse drug event (ADE) emergency department (ED) visits involving psychiatric medications among US adults between January 1, 2009, and December 31, 2011. Descriptive analyses of active, nationally representative surveillance of ADE ED visits using the National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance system and of drug prescribing during outpatient visits using the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey. Medical records from national probability samples of ED and outpatient visits by adults 19 years or older were reviewed and analyzed. Antidepressants, antipsychotics, lithium salts, sedatives and anxiolytics, and stimulants. National estimates of ADE ED visits resulting from therapeutic psychiatric medication use and of psychiatric medication ADE ED visits per 10,000 outpatient visits at which psychiatric medications were prescribed. From 2009 through 2011, there were an estimated 89,094 (95% CI, 68,641-109,548) psychiatric medication ADE ED visits annually, with 19.3% (95% CI, 16.3%-22.2%) resulting in hospitalization and 49.4% (95% CI, 46.5%-52.4%) involving patients aged 19 to 44 years. Sedatives and anxiolytics, antidepressants, antipsychotics, lithium salts, and stimulants were implicated in an estimated 30,707 (95% CI, 23,406-38,008), 25,377 (95% CI, 19,051-31,704), 21,578 (95% CI, 16,599-26,557), 3620 (95% CI, 2311-4928), and 2779 (95% CI, 1764-3794) respective ADE ED visits annually. Antipsychotics and lithium salts were implicated in 11.7 (95% CI, 10.1-13.2) and 16.4 (95% CI, 13.0-19.9) ADE ED visits per 10,000 outpatient prescription visits, respectively, compared with 3.6 (95% CI, 3.2-4.1) for sedatives and anxiolytics, 2.9 (95% CI, 2.3-3.5) for stimulants, and 2.4 (95% CI, 2.1-2.7) for antidepressants. The commonly used

  15. Emergency Medicine Resident Perceptions of Medical Professionalism

    PubMed Central

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

    2016-01-01

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

  16. Emergency Medical Considerations in a Space-Suited Patient.

    PubMed

    Garbino, Alejandro; Nusbaum, Derek M; Buckland, Daniel M; Menon, Anil S; Clark, Jonathan B; Antonsen, Erik L

    The Stratex Project is a high altitude balloon flight that culminated in a freefall from 41,422 m (135,890 ft), breaking the record for the highest freefall to date. Crew recovery operations required an innovative approach due to the unique nature of the event as well as the equipment involved. The parachutist donned a custom space suit similar to a NASA Extravehicular Mobility Unit (EMU), with life support system mounted to the front and a parachute on the back. This space suit had a metal structure around the torso, which, in conjunction with the parachute and life support assembly, created a significant barrier to extraction from the suit in the event of a medical emergency. For this reason the Medical Support Team coordinated with the pressure suit assembly engineer team for integration, training in suit removal, definition of a priori contingency leadership on site, creation of color-coded extraction scenarios, and extraction drills with a suit mock-up that provided insight into limitations to immediate access. This paper discusses novel extraction processes and contrasts the required medical preparation for this type of equipment with the needs of the prior record-holding jump that used a different space suit with easier immediate access. Garbino A, Nusbaum DM, Buckland DM, Menon AS, Clark JB, Antonsen EL. Emergency medical considerations in a space-suited patient. Aerosp Med Hum Perform. 2016; 87(11):958-962.

  17. Association of Prehospital Mode of Transport With Mortality in Penetrating Trauma: A Trauma System-Level Assessment of Private Vehicle Transportation vs Ground Emergency Medical Services.

    PubMed

    Wandling, Michael W; Nathens, Avery B; Shapiro, Michael B; Haut, Elliott R

    2017-09-20

    Time to definitive care following injury is important to the outcomes of trauma patients. Prehospital trauma care is provided based on policies developed by individual trauma systems and is an important component of the care of injured patients. Given a paucity of systems-level trauma research, considerable variability exists in prehospital care policies across trauma systems, potentially affecting patient outcomes. To evaluate whether private vehicle prehospital transport confers a survival advantage vs ground emergency medical services (EMS) transport following penetrating injuries in urban trauma systems. Retrospective cohort study of data included in the National Trauma Data Bank from January 1, 2010, through December 31, 2012, comprising 298 level 1 and level 2 trauma centers that contribute data to the National Trauma Data Bank that are located within the 100 most populous metropolitan areas in the United States. Of 2 329 446 patients assessed for eligibility, 103 029 were included in this study. All patients were 16 years or older, had a gunshot wound or stab wound, and were transported by ground EMS or private vehicle. In-hospital mortality. Of the 2 329 446 records assessed for eligibility, 103 029 individuals at 298 urban level 1 and level 2 trauma centers were included in the analysis. The study population was predominantly male (87.6%), with a mean age of 32.3 years. Among those included, 47.9% were black, 26.3% were white, and 18.4% were Hispanic. Following risk adjustment, individuals with penetrating injuries transported by private vehicle were less likely to die than patients transported by ground EMS (odds ratio [OR], 0.38; 95% CI, 0.31-0.47). This association remained statistically significant on stratified analysis of the gunshot wound (OR,  0.45; 95% CI, 0.36-0.56) and stab wound (OR,  0.32; 95% CI, 0.20-0.52) subgroups. Private vehicle transport is associated with a significantly lower likelihood of death when compared with

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

    PubMed

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

    1989-10-14

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

  19. 22 CFR 71.10 - Emergency medical assistance.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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

  20. 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 in...

  1. 14 CFR 121.803 - Emergency medical equipment.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... container, or the item itself, must be marked as to date of last inspection. (c) For treatment of injuries... first-aid kits. (2) In airplanes for which a flight attendant is required, an approved emergency medical kit. (3) In airplanes for which a flight attendant is required, an approved emergency medical kit...

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

    ERIC Educational Resources Information Center

    DeGraffenreid, Jeff Gordon

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

  3. 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…

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

    DTIC Science & Technology

    2013-03-01

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

  5. Employability Competencies for Entry Level Emergency Medical Aides.

    ERIC Educational Resources Information Center

    Werner, Claire

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

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

    ERIC Educational Resources Information Center

    Fucigna, Joseph T.; And Others

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

  7. Employability Competencies for Entry Level Emergency Medical Aides.

    ERIC Educational Resources Information Center

    Werner, Claire

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

  8. 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...

  9. 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 ...

  10. 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…

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

    PubMed Central

    Holmboe, Eric S.

    2015-01-01

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

  12. Mortality-related factors disparity among Iranian deceased children aged 1-59 months according to the medical activities in emergency units: National mortality surveillance system.

    PubMed

    Kelishadi, Roya; Barakati, Sayyed-Hamed; Lornejad, Hamid Reza; Amiri, Masoud; Motlagh, Mohammad Esmaeil

    2012-12-01

    To determine disparity in mortality-related factors in 1-59 months children across Iran using hospital records of emergency units. After designing and validating a national questionnaire for mortality data collection of children 1-59 months, all 40 medical universities has been asked to fill in the questionnaires and return to the main researcher in the Ministry of Health and Medical Education. Age and sex of deceased children, the type of health center, staying more than 2 h in emergency unit, the reason of prolonged stay in emergency, having emergency (risk) signs, vaccination, need to blood transfusion, need to electroshock and so on have also been collected across the country. There was also a comparison of children based on their BMI. Chi-square test has been applied for nominal and ordinal variables. ANOVA and t-student test have been used for measuring the difference of continuous variables among groups. Mortality in 1-59 months children was unequally distributed across Iran. The average month of entrance to hospital was June, the average day was 16(th) of month, and the average hour of entrance to hospital was 14:00. The average of month, day and hour for discharge was July, 16, and 14:00, respectively. The hour of discharge was statistically significant between children with and without risk signs. More than half (54%) of patients had referred to educational hospital emergency units. There were no statistically significant differences between children with and without emergency signs. There were statistically significant differences between children with and without emergency signs in age less than 24 months (0.034), nutrition situation (P = 0.031), recommendation for referring (P = 0.013), access to electroshock facilities (P = 0.026), and having successful cardiopulmonary resuscitation (P = 0.01). This study is one of the first to show the distribution of the disparity of early childhood mortality-related factors within a developing country. Our results

  13. Instrumentation in medical systems

    SciTech Connect

    Chu, W.T.

    1995-05-01

    The demand for clinical use of accelerated heavy charged-particle (proton and light-ion) beams for cancer treatment is now burgeoning worldwide. Clinical trials are underway at more than a dozen accelerators. Several hospital-based accelerator facilities dedicated to radiation treatment of human cancer have been constructed, and their number is growing. Many instruments in medical systems have been developed for modifying extracted particle beams for clinical application, monitoring the delivery of the treatment beams, and controlling the treatment processes to ensure patient safety. These in turn demand new developments of instruments in controlling beam extraction, beam tuning, and beam transportation at the medical systems.

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

    PubMed

    Hendler, B H; Rose, L F

    1975-09-01

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

  15. 14 CFR § 1250.103-6 - Medical emergencies.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 5 2014-01-01 2014-01-01 false Medical emergencies. § 1250.103-6 Section... § 1250.103-6 Medical emergencies. Notwithstanding the provisions of §§ 1250.103 to 1250.103-5, a... through a medical institution which refuses or fails to comply with § 1250.103-1. ...

  16. 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.

  17. Withholding and withdrawing medical treatment: an emergency medicine perspective.

    PubMed

    Iserson, K V

    1996-07-01

    In emergency medicine, a significant difference rightfully persists between the withholding and withdrawal of life-sustaining medical treatment. The justification for this difference stems part from the nature of emergency medical practice and the unique manner in which clinicians apply many ethical principles. In the usual setting, the decision to withhold further medical treatment is done quietly, often without input from the patients surrogate decisionmaker, whereas withdrawal of ongoing medical treatment can be more obvious and difficult. This situation is reversed in the emergency medicine setting. The withholding of emergency medical treatment is much more problematic than later withdrawal of unwanted or useless interventions. Emergency physicians and prehospital providers often lack vital information about their patients' identities, medical conditions, and wishes. Society also has specific expectations of emergency physicians. Because of the nature of emergency medicine, both in the prehospital and the emergency department settings, the distinction between withdrawal and withholding of medical treatment has never disappeared and is not likely to do so in the future.

  18. 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.

  19. A geographic information system analysis of the impact of a statewide acute stroke emergency medical services routing protocol on community hospital bypass.

    PubMed

    Asimos, Andrew W; Ward, Shana; Brice, Jane H; Enright, Dianne; Rosamond, Wayne D; Goldstein, Larry B; Studnek, Jonathan

    2014-01-01

    Our goal was to determine if a statewide Emergency Medical Services (EMSs) Stroke Triage and Destination Plan (STDP), specifying bypass of hospitals unable to routinely treat stroke patients with thrombolytics (community hospitals), changed bypass frequency of those hospitals. Using a statewide EMS database, we identified stroke patients eligible for community hospital bypass and compared bypass frequency 1-year before and after STDP implementation. Symptom onset time was missing for 48% of pre-STDP (n = 2385) and 29% of post-STDP (n = 1612) cases. Of the remaining cases with geocodable scene addresses, 58% (1301) in the pre-STDP group and 61% (2,078) in the post-STDP group were ineligible for bypass, because a community hospital was not the closest hospital to the stroke event location. Because of missing data records for some EMS agencies in 1 or both study periods, we included EMS agencies from only 49 of 100 North Carolina counties in our analysis. Additionally, we found conflicting hospital classifications by different EMS agencies for 35% of all hospitals (n = 38 of 108). Given these limitations, we found similar community hospital bypass rates before and after STDP implementation (64%, n = 332 of 520 vs. 63%, n = 345 of 552; P = .65). Missing symptom duration time and data records in our state's EMS data system, along with conflicting hospital classifications between EMS agencies limit the ability to study statewide stroke routing protocols. Bypass policies may apply to a minority of patients because a community hospital is not the closest hospital to most stroke events. Given these limitations, we found no difference in community hospital bypass rates after implementation of the STDP. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  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. A strategy to implement and support pre-hospital emergency medical systems in developing, resource-constrained areas of South Africa.

    PubMed

    Sun, Jared H; Shing, Rachel; Twomey, Michele; Wallis, Lee A

    2014-01-01

    Resource-constrained countries are in extreme need of pre-hospital emergency care systems. However, current popular strategies to provide pre-hospital emergency care are inappropriate for and beyond the means of a resource-constrained country, and so new ones are needed-ones that can both function in an under-developed area's particular context and be done with the area's limited resources. In this study, we used a two-location pilot and consensus approach to develop a strategy to implement and support pre-hospital emergency care in one such developing, resource-constrained area: the Western Cape province of South Africa. Local community members are trained to be emergency first aid responders who can provide immediate, on-scene care until a Transporter can take the patient to the hospital. Management of the system is done through local Community Based Organizations, which can adapt the model to their communities as needed to ensure local appropriateness and feasibility. Within a community, the system is implemented in a graduated manner based on available resources, and is designed to not rely on the whole system being implemented first to provide partial function. The University of Cape Town's Division of Emergency Medicine and the Western Cape's provincial METRO EMS intend to follow this model, along with sharing it with other South African provinces. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. 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.

  3. Real-time multimedia communications in medical emergency - the CONCERTO project solution.

    PubMed

    Martini, Maria G; Iacobelli, Lorenzo; Bergeron, Cyril; Hewage, Chaminda T; Panza, Gianmarco; Piri, Esa; Vehkapera, Janne; Amon, Peter; Mazzotti, Matteo; Savino, Ketty; Bokor, Laszlo

    2015-01-01

    The management of medical emergency, in particular cardiac emergency, requests prompt intervention and the possibility to communicate in real time from the emergency area / ambulance to the hospital as much diagnostic information as possible about the patient. This would enable a prompt emergency diagnosis and operation and the possibility to prepare the appropriate actions in the suitable hospital department. To address this scenario, the CONCERTO European project proposed a wireless communication system based on a novel cross-layer architecture, including the integration of building blocks for medical media content fusion, delivery and access. This paper describes the proposed system architecture, outlining the developed components and mechanisms, and the evaluation of the proposed system, carried out in a hospital with the support of medical staff. The technical results and the feedback received highlight the impact of the CONCERTO approach in the healthcare domain, in particular in enabling a prompt and reliable diagnosis in challenging medical emergency scenarios.

  4. Information Systems Coordinate Emergency Management

    NASA Technical Reports Server (NTRS)

    2012-01-01

    The rescue crews have been searching for the woman for nearly a week. Hurricane Katrina devastated Hancock County, the southernmost point in Mississippi, and the woman had stayed through the storm in her beach house. There is little hope of finding her alive; the search teams know she is gone because the house is gone. Late at night in the art classroom of the school that is serving as the county s emergency operations center, Craig Harvey is discussing the search with the center s commander. Harvey is the Chief Operating Officer of a unique company called NVision Solutions Inc., based at NASA s Stennis Space Center in Bay St. Louis, only a couple of miles away. He and his entire staff have set up a volunteer operation in the art room, supporting the emergency management efforts using technology and capabilities the company developed through its NASA partnerships. As he talks to the commander, Harvey feels an idea taking shape that might lead them to the woman s location. Working with surface elevation data and hydrological principles, Harvey creates a map showing how the floodwaters from the storm would have flowed along the topography of the region around the woman s former home. Using the map, search crews find the woman s body in 15 minutes. Recovering individuals who have been lost is a sad reality of emergency management in the wake of a disaster like Hurricane Katrina in 2005. But the sooner answers can be provided, the sooner a community s overall recovery can take place. When damage is extensive, resources are scattered, and people are in dire need of food, shelter, and medical assistance, the speed and efficiency of emergency operations can be the key to limiting the impact of a disaster and speeding the process of recovery. And a key to quick and effective emergency planning and response is geographic information. With a host of Earth-observing satellites orbiting the globe at all times, NASA generates an unmatched wealth of data about our ever

  5. Computer-Based Medical System

    NASA Technical Reports Server (NTRS)

    1998-01-01

    SYMED, Inc., developed a unique electronic medical records and information management system. The S2000 Medical Interactive Care System (MICS) incorporates both a comprehensive and interactive medical care support capability and an extensive array of digital medical reference materials in either text or high resolution graphic form. The system was designed, in cooperation with NASA, to improve the effectiveness and efficiency of physician practices. The S2000 is a MS (Microsoft) Windows based software product which combines electronic forms, medical documents, records management, and features a comprehensive medical information system for medical diagnostic support and treatment. SYMED, Inc. offers access to its medical systems to all companies seeking competitive advantages.

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

    PubMed

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

    2016-01-01

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

  7. Why and when citizens call for emergency help: an observational study of 211,193 medical emergency calls.

    PubMed

    Møller, Thea Palsgaard; Ersbøll, Annette Kjær; Tolstrup, Janne Schurmann; Østergaard, Doris; Viereck, Søren; Overton, Jerry; Folke, Fredrik; Lippert, Freddy

    2015-11-04

    A medical emergency call is citizens' access to pre-hospital emergency care and ambulance services. Emergency medical dispatchers are gatekeepers to provision of pre-hospital resources and possibly hospital admissions. We explored causes for access, emergency priority levels, and temporal variation within seasons, weekdays, and time of day for emergency calls to the emergency medical dispatch center in Copenhagen in a two-year study period (December 1(st), 2011 to November 30(th), 2013). Descriptive analysis was performed for causes for access and emergency priority levels. A Poisson regression model was used to calculate adjusted ratio estimates for the association between seasons, weekdays, and time of day overall and stratified by emergency priority levels. We analyzed 211,193 emergency calls for temporal variation. Of those, 167,635 calls were eligible for analysis of causes and emergency priority level. "Unclear problem" was the most frequent category (19%). The five most common causes with known origin were categorized as "Wounds, fractures, minor injuries" (13%), "Chest pain/heart disease" (11%), "Accidents" (9%), "Intoxication, poisoning, drug overdose" (8%), and "Breathing difficulties" (7%). The highest emergency priority levels (Emergency priority level A and B) were assigned in 81% of calls. In the analysis of temporal variation, the total number of calls peaked at wintertime (26%), Saturdays (16%), and during daytime (39%). The pattern of citizens' contact causes fell into four overall categories: unclear problems, medical problems, intoxication and accidents. The majority of calls were urgent. The magnitude of unclear problems represents a modifiable factor and highlights the potential for further improvement of supportive dispatch priority tools or educational interventions at dispatch centers. Temporal variation was identified within seasons, weekdays and time of day and reflects both system load and disease occurrence. Data on contact patterns

  8. Nanotechnology of emerging targeting systems

    PubMed Central

    SMITH, S. S.

    2011-01-01

    Recent developments in the design and testing of complex nanoscale payload-carrying systems (i.e. systems with payloads that do not exceed 100 nm in size) are the focus of this brief review. Emerging systems include targeted single-walled nanotubes, viral capsids, dendrimers, gold nanoparticles, milled boron carbide nanoparticles, and protein nucleic acid assemblies. Significant advances are emerging with each of these bionanotechnological approaches to cellular targeting. PMID:21687833

  9. National Hospital Ambulatory Medical Care Survey: 1992 Emergency Department Summary.

    PubMed

    Schappert, S M

    1997-03-01

    This report presents data on the provision and utilization of ambulatory medical care services in hospital emergency departments during 1992. Ambulatory medical care services are described in terms of patient, visit, and facility characteristics. Among these are the patient's reason for the visit, diagnostic and screening services ordered or provided, diagnosis, and medications provided or prescribed. Cause of injury data are presented for injury-related visits. Data presented in this report are from the 1992 National Hospital Ambulatory Medical Care Survey (NHAMCS), a national survey of non-Federal, general and short-stay hospitals, conducted by the Division of Health Care Statistics, National Center for Health Statistics, Centers for Disease Control and Prevention. This report reflects the survey's first year of data collection. A four-stage probability sample design was used, resulting in a sample of 524 non-Federal, general and short-stay hospitals. Ninety-two percent of eligible facilities participated in the survey. Hospital staff were asked to complete Patient Record forms for a systematic random sample of patient visits occurring during a randomly assigned 4-week reporting period, and 36,271 forms were completed by participating emergency departments. Diagnosis and cause of injury were coded according to the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM). Reason for visit and medications were coded according to systems developed by the National Center for Health Statistics. An estimated 89.8 million visits were made to the emergency departments of non-Federal, general and short-stay hospitals in the United States during 1992-357.1 visits per 1,000 persons. Persons 75 years of age and over had a higher visit rate than persons in five other age categories. White persons accounted for 78.5 percent of all visits. However, the visit rate for black persons was significantly higher than for white persons overall and for

  10. Toward Ubiquitous Communication Platform for Emergency Medical Care

    NASA Astrophysics Data System (ADS)

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

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

  11. Description of Medication Administration by Emergency Medical Services during Mass-casualty Incidents in the United States.

    PubMed

    El Sayed, Mazen; Tamim, Hani; Mann, N Clay

    2016-04-01

    Emergency Medical Services (EMS) preparedness and availability of essential medications are important to reduce morbidity and mortality from mass-casualty incidents (MCIs). This study describes prehospital medication administration during MCIs by different EMS service levels. The US National EMS Public-Release Research Dataset maintained by the National Emergency Medical Services Information System (NEMSIS) was used to carry out the study. Emergency Medical Services activations coded as MCI at dispatch, or by EMS personnel, were included. The Center for Medicare and Medicaid Services (CMS) service level was used for the level of service provided. A descriptive analysis of medication administration by EMS service level was carried out. Among the 19,831,189 EMS activations, 53,334 activations had an MCI code, of which 26,110 activations were included. There were 8,179 (31.3%) Advanced Life Support (ALS), 5,811 (22.3%) Basic Life Support (BLS), 399 (1.5%) Air Medical Transport (AMT; fixed or rotary), and 38 (0.2%) Specialty Care Transport (SCT) activations. More than 80 different medications from 18 groups were reported. Seven thousand twenty-one activations (26.9%) had at least one medication administered. Oxygen was most common (16.3%), followed by crystalloids (6.9%), unknown (5.2%), analgesics (3.2%) mainly narcotics, antiemetics (1.5%), cardiac/vasopressors/inotropes (0.9%), bronchodilators (0.9%), sedatives (0.8%), and vasodilators/antihypertensives (0.7%). Overall, medication administration rates and frequencies of medications groups significantly varied between EMS service levels (P<.01) except for "Analgesia (other)" (P=.40) and "Pain medications (nonsteroidal anti-inflammatory drug; NSAID)" (P=.07). Medications are administered frequently in MCIs, mainly Oxygen, crystalloids, and narcotic pain medications. Emergency Medical Services systems can use the findings of this study to better prepare their stockpiles for MCIs.

  12. Outcomes of medical emergencies on commercial airline flights.

    PubMed

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

    2013-05-30

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

  13. Outcomes of Medical Emergencies on Commercial Airline Flights

    PubMed Central

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

    2013-01-01

    Background Worldwide, 2.75 billion passengers fly on commercial airlines annually. When inflight medical emergencies occur, access to care is limited. We describe in-flight medical emergencies and the outcomes of these events. Methods We reviewed records of in-flight medical emergency calls from five domestic and international airlines to a physician-directed medical communications center from January 1, 2008, through October 31, 2010. We characterized the most common medical problems and the type of on-board assistance rendered. We determined the incidence of and factors associated with unscheduled aircraft diversion, transport to a hospital, and hospital admission, and we determined the incidence of death. Results There were 11,920 in-flight medical emergencies resulting in calls to the center (1 medical emergency per 604 flights). The most common problems were syncope or presyncope (37.4% of cases), respiratory symptoms (12.1%), and nausea or vomiting (9.5%). Physician passengers provided medical assistance in 48.1% of in-flight medical emergencies, and aircraft diversion occurred in 7.3%. Of 10,914 patients for whom postflight follow-up data were available, 25.8% were transported to a hospital by emergency-medical-service personnel, 8.6% were admitted, and 0.3% died. The most common triggers for admission were possible stroke (odds ratio, 3.36; 95% confidence interval [CI], 1.88 to 6.03), respiratory symptoms (odds ratio, 2.13; 95% CI, 1.48 to 3.06), and cardiac symptoms (odds ratio, 1.95; 95% CI, 1.37 to 2.77). Conclusions Most in-flight medical emergencies were related to syncope, respiratory symptoms, or gastrointestinal symptoms, and a physician was frequently the responding medical volunteer. Few in-flight medical emergencies resulted in diversion of aircraft or death; one fourth of passengers who had an in-flight medical emergency underwent additional evaluation in a hospital. (Funded by the National Institutes of Health.) PMID:23718164

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

    PubMed

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

    2014-01-01

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

  15. Does Medical Emergency Team Intervention Reduce the Prevalence of Emergency Endotracheal Intubation Complications?

    PubMed Central

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

    2014-01-01

    Purpose Emergency endotracheal intubation (EEI) is a complex process that leads to various complications. Previous studies mainly demonstrated that the Medical Emergency Team (MET) intervention reduced the incidence of cardiac arrest, however, the impact of a MET on airway management has not been investigated in detail. Our purpose was to confirm the impact of a MET on airway management and compare the incidence of complications of EEI before and after MET intervention in a general ward. Materials and Methods We performed an observational study and reviewed 318 patients intubated by a MET in a general ward. Results The patients enrolled during the control (2007) and study (2009) periods were 103 and 215, respectively. Cardiopulmonary resuscitation requiring emergency intubation in a general ward was reduced after MET intervention at the Asan Medical Center (39.8% vs. 19.1%, p<0.001). Pre-intubation and post-intubation oxygen saturation levels were higher after MET intervention (pre-intubation, 80% before vs. 92% after MET, p<0.001; post-intubation, 95% before vs. 99% after MET, p<0.001). The use of vasopressors after intubation decreased as a result of MET intervention (62.1% before vs. 36.7% after MET, p<0.001). Hypotension was also reduced (34% before vs. 8.8% after MET, p<0.001). Conclusion Early interventions of a MET changed the causes of emergency intubation in a general ward from cardiopulmonary resuscitation to respiratory distress or shock and improved hypoxemia and hypotension related to emergency intubation. The MET intervention is safe and effective system for emergency intubation in a general ward. PMID:24339292

  16. Accuracy of emergency medical dispatchers' subjective ability to identify when higher dispatch levels are warranted over a Medical Priority Dispatch System automated protocol's recommended coding based on paramedic outcome data

    PubMed Central

    Clawson, Jeff; Olola, Christopher H O; Heward, Andy; Scott, Greg; Patterson, Brett

    2007-01-01

    Objectives To establish the accuracy of the emergency medical dispatcher's (EMD's) decisions to override the automated Medical Priority Dispatch System (MPDS) logic‐based response code recommendations based on at‐scene paramedic‐applied transport acuity determinations (blue‐in) and cardiac arrest (CA) findings. Methods A retrospective study of a 1 year dataset from the London Ambulance Service (LAS) National Health Service (NHS) Trust was undertaken. We compared all LAS “bluing in” frequency (BIQ) and cardiac arrest quotient (CAQ) outcomes of the incidents automatically recommended and accepted as CHARLIE‐level codes, to those receiving EMD DELTA‐overrides from the auto‐recommended CHARLIE‐level. We also compared the recommended DELTA‐level outcomes to those in the higher ECHO‐override cases. Results There was no significant association between outcome (CA/Blue‐in) and the determinant codes (DELTA‐override and CHARLIE‐level) for both CA (odds ratio (OR) 0, 95% confidence interval (CI) 0 to 41.14; p = 1.000) and Blue‐in categories (OR 0.89, 95% CI 0.34 to 2.33; p = 1.000). Similar patterns were observed between outcome and all DELTA‐level and ECHO‐override codes for both CA (OR 0, 95% CI 0 to 70.05; p = 1.000) and Blue‐in categories (OR 1.17, 95% CI 0 to 7.12; p = 0.597). Conclusion This study contradicts the belief that EMDs can accurately perceive when a patient or situation requires more resources than the MPDS's structured interrogation process logically indicates. This further strengthens the concept that automated, protocol‐based call taking is more accurate and consistent than the subjective, anecdotal or experience‐based determinations made by individual EMDs. PMID:17652678

  17. Emergency ignition shutoff system

    SciTech Connect

    Gomes, L.R. Jr.

    1987-01-13

    An emergency shut-off mechanism is described for a racing car having a roll bar framework forming a driver's cage. The mechanism comprises, in combination, a toggle switch wired in series with an ignition switch of the car, the toggle switch being mounted on a dashboard of the car, one end of a flexible cord being connected to the toggle switch, and an ''L''-shaped conduit affixed to the driver's cage through which the cord slidably extends. A snap hook is affixed to an opposite end of the cord and a ring is affixed to a rear portion of a driver's helmet for detachable attachment to the snap hook. The conduit extends from the dashboard to a position rearward of a driver's seat and of the helmet. Sufficient movement of the helmet pulls the cord, thereby actuating the switch and shutting off the car.

  18. 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

  19. An emergency medical planning guide for commercial spaceflight events.

    PubMed

    Law, Jennifer; Vanderploeg, James

    2012-09-01

    Commercial spaceflight events transporting paying passengers into space will begin to take place at various spaceports around the country within the next few years. Many spaceports are located in remote areas that are far from major hospitals and trauma centers. Spaceport medical directors should develop emergency medical plans (EMPs) to prepare for potential medical contingencies that may occur during commercial spaceflight events. The aim of this article is to guide spaceport medical directors in emergency medical planning for commercial spaceflight events. This guide is based on our experience and a recently developed EMP for Spaceport America which incorporated a literature review of mass gathering medicine, existing planning guides for mass gathering events, and EMPs for analogous aerospace events. We propose a multipronged approach to emergency medical planning, consisting of event planning, medical reconnaissance, medical personnel, protocols, physical facility and hardware, and documentation. Medical directors should use this guide to develop an emergency medical plan tailored to the resources and constraints specific to their events.

  20. Comparison of the Fluid Resuscitation Rate with and without External Pressure Using Two Intraosseous Infusion Systems for Adult Emergencies, the CITRIN (Comparison of InTRaosseous infusion systems in emergency medicINe)-Study

    PubMed Central

    Gries, André; Hossfeld, Björn; Bechmann, Ingo; Bernhard, Michael

    2015-01-01

    Introduction Intraosseous infusion is recommended if peripheral venous access fails for cardiopulmonary resuscitation or other medical emergencies. The aim of this study, using body donors, was to compare a semi-automatic (EZ-IO®) device at two insertion sites and a sternal intraosseous infusion device (FASTR™). Methods Twenty-seven medical students being inexperienced first-time users were randomized into three groups using EZ-IO and FASTR. The following data were evaluated: attempts required for successful placement, insertion time and flow rates with and without external pressure to the infusion. Results The first-pass insertion success of the EZ-IO tibia, EZ-IO humerus and FASTR was 91%, 77%, and 95%, respectively. Insertion times (MW±SD) did not show significant differences with 17±7 (EZ-IO tibia) vs. 29±42 (EZ-IO humerus) vs. 33±21 (FASTR), respectively. One-minute flow rates using external pressures between 0 mmHg and 300 mmHg ranged between 27±5 to 69±54 ml/min (EZ-IO tibia), 16±3 to 60±44 ml/min (EZ-IO humerus) and 53±2 to 112±47 ml/min (FASTR), respectively. Concerning pressure-related increases in flow rates, negligible correlations were found for the EZ-IO tibia in all time frames (c = 0.107–0.366; p≤0.013), moderate positive correlations were found for the EZ-IO humerus after 5 minutes (c = 0.489; p = 0.021) and strong positive correlations were found for the FASTR in all time frames (c = 0.63–0.80; p≤0.007). Post-hoc statistical power was 0.62 with the given sample size. Conclusions The experiments with first-time users applying EZ-IO and FASTR in body donors indicate that both devices may be effective intraosseous infusion devices, likely suitable for fluid resuscitation using a pressure bag. Variations in flow rate may limit their reliability. Larger sample sizes will prospectively be required to substantiate our findings. PMID:26630579

  1. Comparison of the Fluid Resuscitation Rate with and without External Pressure Using Two Intraosseous Infusion Systems for Adult Emergencies, the CITRIN (Comparison of InTRaosseous infusion systems in emergency medicINe)-Study.

    PubMed

    Hammer, Niels; Möbius, Robert; Gries, André; Hossfeld, Björn; Bechmann, Ingo; Bernhard, Michael

    2015-01-01

    Intraosseous infusion is recommended if peripheral venous access fails for cardiopulmonary resuscitation or other medical emergencies. The aim of this study, using body donors, was to compare a semi-automatic (EZ-IO®) device at two insertion sites and a sternal intraosseous infusion device (FASTR™). Twenty-seven medical students being inexperienced first-time users were randomized into three groups using EZ-IO and FASTR. The following data were evaluated: attempts required for successful placement, insertion time and flow rates with and without external pressure to the infusion. The first-pass insertion success of the EZ-IO tibia, EZ-IO humerus and FASTR was 91%, 77%, and 95%, respectively. Insertion times (MW ± SD) did not show significant differences with 17 ± 7 (EZ-IO tibia) vs. 29 ± 42 (EZ-IO humerus) vs. 33 ± 21 (FASTR), respectively. One-minute flow rates using external pressures between 0 mmHg and 300 mmHg ranged between 27 ± 5 to 69 ± 54 ml/min (EZ-IO tibia), 16 ± 3 to 60 ± 44 ml/min (EZ-IO humerus) and 53 ± 2 to 112 ± 47 ml/min (FASTR), respectively. Concerning pressure-related increases in flow rates, negligible correlations were found for the EZ-IO tibia in all time frames (c = 0.107-0.366; p ≤ 0.013), moderate positive correlations were found for the EZ-IO humerus after 5 minutes (c = 0.489; p = 0.021) and strong positive correlations were found for the FASTR in all time frames (c = 0.63-0.80; p ≤ 0.007). Post-hoc statistical power was 0.62 with the given sample size. The experiments with first-time users applying EZ-IO and FASTR in body donors indicate that both devices may be effective intraosseous infusion devices, likely suitable for fluid resuscitation using a pressure bag. Variations in flow rate may limit their reliability. Larger sample sizes will prospectively be required to substantiate our findings.

  2. Emergency Department Medical Clearance of Patients with Psychiatric or Behavioral Emergencies, Part 2: Special Psychiatric Populations and Considerations.

    PubMed

    Alam, Al; Rachal, James; Tucci, Veronica Theresa; Moukaddam, Nidal

    2017-09-01

    Patients who present to the emergency department (ED) with mental illness or behavioral complaints merit workup for underlying physical conditions that can trigger, mimic, or worsen psychiatric symptoms. However, there are wide variations in quality of care for these individuals. Psychiatry and emergency medicine specialty guidelines support a tailored, customized approach to patients. Our group has long advocated a dynamic comanagement approach for medical clearance in the ED, and this article summarizes best-practice approaches to the medical clearance of patients with psychiatric illness, tips on history taking, system reviews, clinical/physical examination, and common pitfalls in the medical clearance process. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Understanding of sepsis among emergency medical services: a survey study.

    PubMed

    Seymour, Christopher W; Carlbom, David; Engelberg, Ruth A; Larsen, Jonathan; Bulger, Eileen M; Copass, Michael K; Rea, Thomas D

    2012-06-01

    Emergency medical services (EMS) personnel commonly encounter sepsis, yet little is known about their understanding of sepsis. To determine the awareness, knowledge, current practice, and attitudes about sepsis among EMS personnel. We performed an anonymous, multi-agency, online survey of emergency medical technicians (EMTs), firefighter-emergency medical technicians (FF-EMTs), and paramedics in a metropolitan, 2-tier EMS system. We compared responses according to the level of EMS training and used multivariable logistic regression to determine the odds of correctly identifying the definition of sepsis, independent of demographic and professional factors. Overall response rate of study participants was 57% (786/1390), and was greatest among EMTs (79%; 276/350). A total of 761 respondents (97%) had heard of the term "sepsis." EMTs and FF-EMTs were at significantly reduced odds of correctly defining sepsis compared to paramedics, independent of age, sex, and years of experience (EMTs: odds ratio 0.44, 95% confidence interval 0.3-0.8; FF-EMTs: odds ratio 0.32, 95% confidence interval 0.2-0.6. Overall, knowledge of the clinical signs and symptoms and recommended treatments for sepsis was typically>75%, though better among paramedics than EMTs or FF-EMTs (p<0.01). The majority of respondents believed sepsis is not recognized by EMS "some" or "a lot" of the time (76%, 596/786). EMS personnel demonstrated an overall sound awareness of sepsis. Knowledge of sepsis was less among FF-EMTs and EMTs compared to paramedics. These results suggest that paramedics could be integrated into strategies of early identification and treatment of sepsis, and EMTs may benefit from focused education and training. Copyright © 2012 Elsevier Inc. All rights reserved.

  4. Exploration Medical System Technical Development

    NASA Technical Reports Server (NTRS)

    McGuire, K.; Middour, C.; Cerro, J.; Burba, T.; Hanson, A.; Reilly, J.; Mindock, J.

    2017-01-01

    The Exploration Medical Capability (ExMC) Element systems engineering goals include defining the technical system needed to implement exploration medical capabilities for Mars. This past year, scenarios captured in the medical system concept of operations laid the foundation for systems engineering technical development work. The systems engineering team analyzed scenario content to identify interactions between the medical system, crewmembers, the exploration vehicle, and the ground system. This enabled the definition of functions the medical system must provide and interfaces to crewmembers and other systems. These analyses additionally lead to the development of a conceptual medical system architecture. The work supports the ExMC community-wide understanding of the functional exploration needs to be met by the medical system, the subsequent development of medical system requirements, and the system verification and validation approach utilizing terrestrial analogs and precursor exploration missions.

  5. 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...

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

    PubMed

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

    2016-11-01

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

  7. 76 FR 29131 - Emergency Medical Services Week, 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-19

    ... death. Emergency medical technicians (EMTs), paramedics, and first responders serve on the front lines.... As a Nation, we must never forget the selfless courage demonstrated by the EMTs, paramedics, and...

  8. Mentoring medical students in academic emergency medicine.

    PubMed

    Garmel, Gus M

    2004-12-01

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

  9. Preparing for medical emergencies in the dental office.

    PubMed

    Morrison, A D; Goodday, R H

    1999-05-01

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

  10. Toxicologic Emergencies in Patients with Mental Illness: When Medications Are No Longer Your Friends.

    PubMed

    Greene, Spencer; AufderHeide, Erin; French-Rosas, Lindsay

    2017-09-01

    Patients with psychiatric disorders are at risk for toxicologic emergencies. Psychotropic medications have numerous effects on the neurologic, cardiac, and other organ systems and interact with other medications, potentially leading to further side effects. It is important to become familiar with accepted psychiatric practice guidelines, common toxidromes, medical sequelae associated with prescribed medications, and the specific workup and treatment of overdoses of frequently prescribed psychotropics. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. The emerging Medical and Geological Association.

    USGS Publications Warehouse

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

    2005-01-01

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

  12. The Emerging Medical and Geological Association

    PubMed Central

    Finkelman, Robert B; Centeno, Jose A; Selinus, Olle

    2005-01-01

    The impact on human health by natural materials such as water, rocks, and minerals has been known for thousands of years but there have been few systematic, multidisciplinary studies on the relationship between geologic materials and processes and human health (the field of study commonly referred to as medical geology). In the past few years, however, there has been a resurgence of interest in medical geology. Geoscientists working with medical researchers and public health scientists have made important contributions to understanding novel exposure pathways and causes of a wide range of environmental health problems such as: exposure to toxic levels of trace essential and non-essential elements such as arsenic and mercury; trace element deficiencies; exposure to natural dusts and to radioactivity; naturally occurring organic compounds in drinking water; volcanic emissions, etc. By linking with biomedical/public health researchers geoscientists are finally taking advantage of this age-old opportunity to help mitigate environmental health problems. The International Medical Geology Association has recently been formed to support this effort. PMID:16555612

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

    PubMed

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

    2016-01-01

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

  14. Emergency Supply Expert System

    DTIC Science & Technology

    1993-04-01

    Supply Expert System (ESEX) is one of three studies being provided to the Defense Logistics Agency (DLA) under KPMG Peat Marwick delivery order F7-04...benefits of implementing ESEX. The sources of this data included an ESEX Executive Summary Report/Business Case dated February 1992, historical budget...individual AVRS engines. Methodology The study team gathered statistical data from the three sites currently operating ESEX within DLA. Through trips to two

  15. 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...

  16. 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...

  17. 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...

  18. 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...

  19. 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...

  20. 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...

  1. 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...

  2. 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...

  3. 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...

  4. 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...

  5. 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...

  6. 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...

  7. 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...

  8. 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...

  9. 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...

  10. 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...

  11. 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...

  12. 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...

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

    ERIC Educational Resources Information Center

    Cleven, Arlene

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

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

    PubMed

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

    2016-09-01

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

  15. Retention, learning by doing, and performance in emergency medical services.

    PubMed

    David, Guy; Brachet, Tanguy

    2009-06-01

    To examine the strength of the volume-outcome relationship among paramedics, a group of providers that has not been previously studied in this context. By identifying the effects of individual learning on performance, we also assess the value of paramedics' retention. The prehospital emergency medical services (EMS) setting allows us to interpret any volume-outcome relationship as learning by doing, uncontaminated by reputation-based referrals because ambulance units are dispatched based on proximity. Incident-level EMS data spanning 1991 to 2005 from the Mississippi Emergency Medical Services Information System collected by the Mississippi Department of Health. Using linear and quantile methods with and without provider fixed effects, we estimate the relationship between experience accumulation and performance using the universe of trauma incidents involving injured patients (including motor vehicle crashes, falls, stabbings, and shootings). We find that greater individual volume is robustly related to improved performance. In addition, we find that the benefit of learning operates through both recent and past experiences, accrues differentially across tenure groups, and operates on both mean performance and the upper quantiles of the performance distribution. Persistent past and current volume effects suggest that policy and managerial implications in EMS should be directed at retention efforts to take advantage of individual learning by paramedics.

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

    PubMed

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

    2017-01-01

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

  17. Rapid infectious disease screening for field medical emergencies

    NASA Astrophysics Data System (ADS)

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

    2000-08-01

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

  18. 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 night...

  19. Emergency Lighting System

    NASA Technical Reports Server (NTRS)

    1994-01-01

    When power outages occurred at Landmark Plastic Corporation, it took seven to twelve minutes for the primary mercury lamps to cool down enough to relight and two to seven minutes for the ELS incandescent lamps to relight. Production could not resume for as much as seven minutes. An article in NASA Tech Briefs describing the capabilities of photosensing devices led Landmark employee, Steve Keller to design a system now activated by any voltage loss in the main lamp circuit and coupled with photosensing devices used to keep them on until the primary mercury lamps reach full brightness.

  20. Thyroid storm during pregnancy. A medical emergency.

    PubMed

    Waltman, Patricia A; Brewer, Joyce M; Lobert, Sharon

    2004-04-01

    Thyroid storm is the major risk to pregnant women with thyrotoxicosis. This life-threatening condition is more likely to occur with another precipitating factor such as labor and delivery, surgical delivery, infection, or trauma. Thyroid storm most often occurs in patients with undertreated or undiagnosed hyperthyroidism. As many as 20% to 30% of cases can end in maternal and fetal mortality. Therefore, critical care nurses must be able to recognize and initiate proper medical and nursing interventions promptly.

  1. Medical ultrasound systems.

    PubMed

    Powers, Jeff; Kremkau, Frederick

    2011-08-06

    Medical ultrasound imaging has advanced dramatically since its introduction only a few decades ago. This paper provides a short historical background, and then briefly describes many of the system features and concepts required in a modern commercial ultrasound system. The topics addressed include array beam formation, steering and focusing; array and matrix transducers; echo image formation; tissue harmonic imaging; speckle reduction through frequency and spatial compounding, and image processing; tissue aberration; Doppler flow detection; and system architectures. It then describes some of the more practical aspects of ultrasound system design necessary to be taken into account for today's marketplace. It finally discusses the recent explosion of portable and handheld devices and their potential to expand the clinical footprint of ultrasound into regions of the world where medical care is practically non-existent. Throughout the article reference is made to ways in which ultrasound imaging has benefited from advances in the commercial electronics industry. It is meant to be an overview of the field as an introduction to other more detailed papers in this special issue.

  2. Linking medical records to an expert system

    NASA Technical Reports Server (NTRS)

    Naeymi-Rad, Frank; Trace, David; Desouzaalmeida, Fabio

    1991-01-01

    This presentation will be done using the IMR-Entry (Intelligent Medical Record Entry) system. IMR-Entry is a software program developed as a front-end to our diagnostic consultant software MEDAS (Medical Emergency Decision Assistance System). MEDAS (the Medical Emergency Diagnostic Assistance System) is a diagnostic consultant system using a multimembership Bayesian design for its inference engine and relational database technology for its knowledge base maintenance. Research on MEDAS began at the University of Southern California and the Institute of Critical Care in the mid 1970's with support from NASA and NSF. The MEDAS project moved to Chicago in 1982; its current progress is due to collaboration between Illinois Institute of Technology, The Chicago Medical School, Lake Forest College and NASA at KSC. Since the purpose of an expert system is to derive a hypothesis, its communication vocabulary is limited to features used by its knowledge base. The development of a comprehensive problem based medical record entry system which could handshake with an expert system while creating an electronic medical record at the same time was studied. IMR-E is a computer based patient record that serves as a front end to the expert system MEDAS. IMR-E is a graphically oriented comprehensive medical record. The programs major components are demonstrated.

  3. [Exceptional medical circumstances: interest of an interhospital support strategy within the North Alps emergency trauma network].

    PubMed

    Incagnoli, P; Hacini, R; Gros, I; Rancurel, E; Jacquot, C

    2011-12-01

    The Northern French Alps Emergency Network (RENAU) has a main objective the improvement of the quality of the care in the field of the emergency medical treatment. With this French medical system, we developed a procedure allowing the detachment of a medical-surgical team of the university hospital to help general hospital team in the event of immediate vital emergency situation with untransportable patient. We reported the successful implementation of this support strategy for a 51-year-old patient arrived in a hospital of the network in extremely serious hemodynamic shock due to an important hemorrhagic pericardial effusion with tamponnade 1 day after percutaneous closure of the patent foramen ovale (PFO).

  4. Emergency medical care for spectators attending National Football League games.

    PubMed

    Roberts, D M; Blackwell, T H; Marx, J A

    1997-01-01

    average stadium staffs 8 EMT-Bs, 7 EMT-Ps, 3 registered nurses, and 2 physicians. Nine stadiums pay a predesignated fee per game to an agency to provide emergency care to spectators. Medical personnel are compensated by an hourly rate (n = 15), a fixed rate per event (n = 9), overtime wages (n = 3), or volunteerism (n = 4). Four NFL organizations pay their medical personnel by more than one type of compensation. Courtesy seats are provided to physicians and nurses in 1 stadium and to just physicians in 8 stadiums, with a range of 2 to 6 and a mean of 3.3 +/- 1.3. All stadiums use two-way radios for the communication and coordination of medical care in the stadium. Additionally, 20 use fixed telephones in the first aid rooms, 3 use cellular telephones, and 2 incorporate a pager system to dispatch personnel within the stadium. A wide variety of system designs, facilities, and personnel configurations are used to provide emergency medical care for spectators attending NFL games. This information may be useful for assisting those individuals responsible for organizing stadium medical coverage.

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

    PubMed

    Schenkel, S

    2000-11-01

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

  6. 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...

  7. 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...

  8. 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,...

  9. 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...

  10. 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...

  11. 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,...

  12. 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....

  13. 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...

  14. 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...

  15. Emergent Propulsion Systems

    NASA Astrophysics Data System (ADS)

    El-Fakdi Sencianes, Andres

    2002-01-01

    almost an Engineer (2002 will be my last year as student) and the studies that I'm now ending here, in Girona, are closely related not only with science and technology subjects but with optimization and economic result obtention, too. Huge distances that separate us from everything in space have launched scientists and engineers into a new challenge: How to reach maximum speeds keeping high ratios payload/total spacecraft mass? The key limitation of chemical rockets is that their exhaust velocity is relatively low. Because achieving Earth orbit requires a high velocity change a rocket must carry far more propellant than payload. The answer to all this complications seems to stare in one way: electric propulsion systems and the possibility of taking advantatge of solar winds to thrust our crafts. possible solutions, some of them have been studied for years and now they are not a project but a reality; also newest theories bring us the possibility of dream. Improve of commom propellants, search of new ones: Investigators continued research on use of atomic species as high-energy-density propellants, which could increase the specific impulse of hydrogen/oxygen rockets by 50-150%. Nuclear fission propulsion: Centered in development of reactors for nearterm nuclear electric propulsion aplications. Multimegawatt systems based on vapor core reactors and magnetohydrodynamic power conversion. Engineers investigated new fuels for compact nuclear thermal propulsion systems. What is called plasma state?: When a gas is heated to tens of thousands or millions of degrees, atoms lose their electrons. The result is a "soup" of charged particles, or plasma, made up of negatively charged electrons and positively charged ions. No known material can contain the hot plasma necessary for rocket propulsion, but specially designed magnetic fields can. Plasma rockets: This rockets are not powered by conventional chemical reactions as today's rockets are, but by electrical energy that heats

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

    PubMed

    Janchar, T; Samaddar, C; Milzman, D

    2000-01-01

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

  17. 3D Medical Collaboration Technology to Enhance Emergency Healthcare

    PubMed Central

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

    2009-01-01

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

  18. Implantable medical sensor system

    DOEpatents

    Darrow, Christopher B.; Satcher, Jr., Joe H.; Lane, Stephen M.; Lee, Abraham P.; Wang, Amy W.

    2001-01-01

    An implantable chemical sensor system for medical applications is described which permits selective recognition of an analyte using an expandable biocompatible sensor, such as a polymer, that undergoes a dimensional change in the presence of the analyte. The expandable polymer is incorporated into an electronic circuit component that changes its properties (e.g., frequency) when the polymer changes dimension. As the circuit changes its characteristics, an external interrogator transmits a signal transdermally to the transducer, and the concentration of the analyte is determined from the measured changes in the circuit. This invention may be used for minimally invasive monitoring of blood glucose levels in diabetic patients.

  19. [Medical emergencies following dermatological injections and infusions].

    PubMed

    Dill-Müller, D

    2006-03-01

    Emergency situations following appropriately administered injections and infusions are an uncommon dermatologic problem. Embolia cutis medicamentosa is an uncommon complication following intramuscular injection which leads to infarct-like cutaneous necrosis. It may develop after gluteal injection of corticosteroids, anti-inflammatory agents and antibiotics and has rarely been described following venous sclerotherapy with polidocanol. Hoigné syndrome is a pseudoanaphylactic or pseudoallergic reaction following intramuscular injection of procaine penicillin, with neuropsychiatric problems developing immediately after the injection. Subacute forms following intramuscular or oral administration of structurally-related antibiotics. The intraoperative use of patent blue dye has a 1-2% risk of allergic reactions. The patient must be monitored carefully following injection for the onset the life-threatening immediate reaction. Extravasation of cytostatic agents is a critical iatrogenic problem in oncology with an incidence of up to 6.5%. Every oncologic department should have an understanding of necrotic risk of the various agents and an emergency kit with instructions for immediate steps, also including agent-specific antidotes as available.

  20. 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

  1. Medical imaging systems

    SciTech Connect

    Frangioni, John V

    2012-07-24

    A medical imaging system provides simultaneous rendering of visible light and fluorescent images. The system may employ dyes in a small-molecule form that remains in a subject's blood stream for several minutes, allowing real-time imaging of the subject's circulatory system superimposed upon a conventional, visible light image of the subject. The system may also employ dyes or other fluorescent substances associated with antibodies, antibody fragments, or ligands that accumulate within a region of diagnostic significance. In one embodiment, the system provides an excitation light source to excite the fluorescent substance and a visible light source for general illumination within the same optical guide that is used to capture images. In another embodiment, the system is configured for use in open surgical procedures by providing an operating area that is closed to ambient light. More broadly, the systems described herein may be used in imaging applications where a visible light image may be usefully supplemented by an image formed from fluorescent emissions from a fluorescent substance that marks areas of functional interest.

  2. Very serious and non-ignorable problem: Crisis in emergency medical response in catastrophic event.

    PubMed

    Shen, Weifeng; Jiang, Libing; Zhang, Mao; Ma, Yuefeng; Jiang, Guanyu; He, Xiaojun

    2015-12-01

    The crisis of medical response caused by catastrophic events might significantly affect emergency response, and might even initiate more serious social crisis. Therefore, early identification and timely blocking the formation of crisis in the early phase after a major disaster will improve the efficiency of medical response in a major disaster and avoid serious consequences. In the present paper, we described the emergency strategy to crisis management of medical response after a major disaster. Major catastrophic events often lead to various crises, including excess demand, the crisis of response in barrier and the structural crisis in response. The corresponding emergency response strategies include: (i) shunt of catastrophic medical surge; (ii) scalability of medical surge capacity; (iii) matching of the structural elements of response; (iv) maintaining the functions of support system for medical response and maximising the operation of the integrated response system; and (v) selection of appropriate care 'standard' in extreme situations of overload of disaster medical surge. In conclusion, under the impact of a major catastrophic event, medical response is often complex and the medical surge beyond the conventional response capacity and it is easy to be in crisis. In addition to the current consensus of disaster response, three additional aspects should be considered. First, all relevant society forces led by the government and military should be linkages. Second, a powerful medical response system must be based on a strong support system. Third, countermeasures of medical surge should be applied flexibly to the special and specific disaster environment, to promote the effective medical response force. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  3. 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

  4. The implementation of the Medical Regulation Office and Mobile Emergency Attendance System and its impact on the gravity profile of non-traumatic afflictions treated in a University Hospital: a research study

    PubMed Central

    Lopes, Sérgio LB; dos Santos, José Sebastião; Scarpelini, Sandro

    2007-01-01

    Background The public health system of Brazil is structured by a network of increasing complexity, but the low resolution of emergency care at pre-hospital units and the lack of organization of patient flow overloaded the hospitals, mainly the ones of higher complexity. The knowledge of this phenomenon induced Ribeirão Preto to implement the Medical Regulation Office and the Mobile Emergency Attendance System. The objective of this study was to analyze the impact of these services on the gravity profile of non-traumatic afflictions in a University Hospital. Methods The study conducted a retrospective analysis of the medical records of 906 patients older than 13 years of age who entered the Emergency Care Unit of the Hospital of the University of São Paulo School of Medicine at Ribeirão Preto. All presented acute non-traumatic afflictions and were admitted to the Internal Medicine, Surgery or Neurology Departments during two study periods: May 1996 (prior to) and May 2001 (after the implementation of the Medical Regulation Office and Mobile Emergency Attendance System). Demographics and mortality risk levels calculated by Acute Physiology and Chronic Health Evaluation II (APACHE II) were determined. Results From 1996 to 2001, the mean age increased from 49 ± 0.9 to 52 ± 0.9 (P = 0.021), as did the percentage of co-morbidities, from 66.6 to 77.0 (P = 0.0001), the number of in-hospital complications from 260 to 284 (P = 0.0001), the mean calculated APACHE II mortality risk increased from 12.0 ± 0.5 to 14.8 ± 0.6 (P = 0.0008) and mortality rate from 6.1 to 12.2 (P = 0.002). The differences were more significant for patients admitted to the Internal Medicine Department. Conclusion The implementation of the Medical Regulation and Mobile Emergency Attendance System contributed to directing patients with higher gravity scores to the Emergency Care Unit, demonstrating the potential of these services for hierarchical structuring of pre-hospital networks and referrals

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

    PubMed

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

    2011-11-01

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

  6. The emergent neural modeling system.

    PubMed

    Aisa, Brad; Mingus, Brian; O'Reilly, Randy

    2008-10-01

    Emergent (http://grey.colorado.edu/emergent) is a powerful tool for the simulation of biologically plausible, complex neural systems that was released in August 2007. Inheriting decades of research and experience in network algorithms and modeling principles from its predecessors, PDP++ and PDP, Emergent has been redesigned as an efficient workspace for academic research and an engaging, easy-to-navigate environment for students. The system provides a modern and intuitive interface for programming and visualization centered around hierarchical, tree-based navigation and drag-and-drop reorganization. Emergent contains familiar, high-level simulation constructs such as Layers and Projections, a wide variety of algorithms, general-purpose data handling and analysis facilities and an integrated virtual environment for developing closed-loop cognitive agents. For students, the traditional role of a textbook has been enhanced by wikis embedded in every project that serve to explain, document, and help newcomers engage the interface and step through models using familiar hyperlinks. For advanced users, the software is easily extensible in all respects via runtime plugins, has a powerful shell with an integrated debugger, and a scripting language that is fully symmetric with the interface. Emergent strikes a balance between detailed, computationally expensive spiking neuron models and abstract, Bayesian or symbolic systems. This middle level of detail allows for the rapid development and successful execution of complex cognitive models while maintaining biological plausibility.

  7. Rural Emergency Medical Services (EMS) and Trauma

    MedlinePlus

    ... deaths, and rural areas have higher rates of passenger vehicle and large truck occupant deaths. In 2014, ... uses data from the National Electronic Injury Surveillance System, and includes information about what types of nonfatal injuries are treated ...

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

    PubMed Central

    2012-01-01

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

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

    PubMed

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

    2012-12-12

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

  10. An overview of revolutionary advances in emergency medical care in the United States.

    PubMed

    Edlich, Richard F; Wish, John R; Britt, L D

    2004-01-01

    One of the goals of this manuscript is to celebrate the influential and productive careers of three leaders in Emergency Medical Systems: Drs. James Mills, R Adams Cowley, and David Boyd. Through his courageous efforts, Dr. James Mills established the specialty of emergency medicine, with its own educational training programs, credentialing process, as well as a recognized society, the American College of Emergency Physicians. Dr. R Adams Cowley was the preeminent leader in developing an organized approach in trauma care in the State of Maryland, with the creation of the R Adams Cowley Shock Trauma Center. Many of the components of his comprehensive trauma program in the State of Maryland have been replicated in every state in our nation. Dr. David Boyd championed the development of emergency medical systems throughout our nation as he served as Director of the Office of Emergency Medical Service Systems in the Department of Health, Education, and Welfare. Under the guidance of Drs. Mills, Cowley, and Boyd, Dr. Edlich was a leader in developing emergency medical systems in the Commonwealth of Virginia. Unlike the comprehensive trauma system in the State of Maryland, the Commonwealth of Virginia, as well as other states in our nation, still lack statewide helicopter aviation services that bring critically ill patients throughout the state from the scene of injury to separate and distinct trauma facilities in which life saving trauma care can be initiated without admission to an emergency department.

  11. Multilocation teleradiology system for emergency triage consultation

    NASA Astrophysics Data System (ADS)

    Herron, John M.; Yonas, Howard

    1996-05-01

    A remote consultation system is available at the University of Pittsburgh Medical Center (UPMC) which links four outlying hospitals in Western Pennsylvania and Eastern Ohio. This system has the potential to improve short and long term clinical outcomes and to reduce overall medical care cost by establishing improved emergency triage capability. An EMED, Inc. teleradiology system permits rapid, high-quality transfer of digitized film and CT images from the remote sites to the tertiary care center (UPMC). The images are sent over dial-on- demand ISDN and SW56 lines from the remote hospitals to a central server where they are transmitted to a dual 2K monitor workstation in the Emergency Department, thirteen Eastman Kodak PDS workstations within UPMC, and to three physician homes. Transmission to a workstation at each of the physician homes over ISDN lines enables `after hours' consultation. The radiographic images along with voice and fax communications provide a technique where physicians in outlying hospitals will be able to consult with specialists at any time. A study is in progress to evaluate the effectiveness of this system in terms of perception of utility and its potential to improve emergency triage capability, as well as selection of the appropriate transportation mode (helicopter versus ambulance).

  12. Systems biology, emergence and antireductionism.

    PubMed

    Kesić, Srdjan

    2016-09-01

    This study explores the conceptual history of systems biology and its impact on philosophical and scientific conceptions of reductionism, antireductionism and emergence. Development of systems biology at the beginning of 21st century transformed biological science. Systems biology is a new holistic approach or strategy how to research biological organisms, developed through three phases. The first phase was completed when molecular biology transformed into systems molecular biology. Prior to the second phase, convergence between applied general systems theory and nonlinear dynamics took place, hence allowing the formation of systems mathematical biology. The second phase happened when systems molecular biology and systems mathematical biology, together, were applied for analysis of biological data. Finally, after successful application in science, medicine and biotechnology, the process of the formation of modern systems biology was completed. Systems and molecular reductionist views on organisms were completely opposed to each other. Implications of systems and molecular biology on reductionist-antireductionist debate were quite different. The analysis of reductionism, antireductionism and emergence issues, in the era of systems biology, revealed the hierarchy between methodological, epistemological and ontological antireductionism. Primarily, methodological antireductionism followed from the systems biology. Only after, epistemological and ontological antireductionism could be supported.

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

    PubMed Central

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

    2016-01-01

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

  14. Use of an intubating laryngeal mask airway on out-of-hospital cardiac arrest patients in a developing emergency medical service system.

    PubMed

    Chien, Li-Chien; Hsu, Hsiang-Chin; Lin, Chih-Hao; Cheng, Ching-Fa; Tung, Yung-Chuang; Hung, Hsien-Cheng; Yeh, Yu-Ching; Tsai, Ming-Che

    2012-01-01

    An intubating laryngeal mask airway (ILMA) is an alternative device for airway control, capable of providing effective ventilation in various situations. The purpose of this study is to compare the effects of the ILMA and bag-valve-mask (BVM) ventilation devices on out-of-hospital cardiac arrest (OHCA) patients. An ILMA training course was conducted by emergency medical technicians (EMTs). Before training, OHCA patients had received BVM ventilation; these patients were defined as the BVM group. After training, all EMTs in the area being served were instructed to immediately use an ILMA on OHCA patients when possible; these patients were defined as the ILMA group. Demographics, transport time, first arterial blood gas data, and the short-term outcomes of these two groups were analyzed. A total of 398 OHCA patients (89 in the BVM group and 309 in the ILMA group) were analyzed. All of the EMTs passed the training course, and ILMAs were used in the emergency settings. The ILMA was applied to each OHCA patient for a longer-than-average field time than the BVM (9.5 vs. 7.8 minutes, p = 0.006). The 24-hour survival rate of the ILMA-treated patients was significantly higher than BVM-treated patients (36.2% vs. 24.7%, p = 0.033). Well-trained EMTs were able to insert the ILMA and ventilate OHCA patients properly in prehospital settings, and ILMA-treated OHCA patients had better short-term outcomes than BVM-treated patients. Copyright © 2012. Published by Elsevier B.V.

  15. Evaluation of EMERGE, a Medical Decision Making Aid for Analysis of Chest Pain

    PubMed Central

    Hudson, Donna L.; Cohen, Moses E.; Deedwania, Prakash C.; Watson, Patricia E.

    1983-01-01

    EMERGE, a rule-based medical decision making aid for analysis of chest pain in the emergency room, was evaluated using retrospective patient data. The analysis consisted of two phases. In the initial phase, patient cases were run in order to make minor modifications and adjustments in the criteria used for determination of admission. In the second phase, patient cases were analyzed to determine the effectiveness of the EMERGE system in arriving at the proper conclusion.

  16. Medical Research System

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Based on Johnson Space Flight Center's development of a rotating bioreactor cell culture apparatus for Space Shuttle medical research, Johnson Space Flight Center engineers who worked on the original project formed a company called Synthecon, with the intention of commercializing the bioreactor technology. Synthecon grows three dimensional tissues in the bioreactor. These are superior to previous two-dimensional tissue samples in the study of human cell growth. A refined version of the Johnson Space Center technology, Synthecon's Rotary Cell Culture System includes a cell culture chamber that rotates around a horizontal axis. The cells establish an orbit that approximates free fall through the liquid medium in the chamber. The technology has significant applications for cancer research and treatment as well as AIDS research.

  17. Medical Emergency Team Tutored Learning Environment

    DTIC Science & Technology

    2008-05-01

    80 Figure 43. METTLE Reference Section, Conditions Tab with Focus on Brucellosis ...Agent,” versus “Bacterial Agent,” versus specific bacterial Agents like “Anthrax,” “ Brucellosis ,” etc. We have found it useful to adopt this middle...Scenario Player’s ‘Reference’ button and then selecting Brucellosis . The system has links to three different sources of information on Brucellosis : a

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

    PubMed Central

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

    2012-01-01

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

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

    PubMed

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

    2012-05-01

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

  20. Usefulness of emergency medical teams in sport stadiums.

    PubMed

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

    2008-03-01

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

  1. Measuring Quality in Emergency Medical Services: A Review of Clinical Performance Indicators

    PubMed Central

    El Sayed, Mazen J.

    2012-01-01

    Measuring quality in Emergency Medical Services (EMSs) systems is challenging. This paper reviews the current approaches to measuring quality in health care and EMS with a focus on currently used clinical performance indicators in EMS systems (US and international systems). The different types of performance indicators, the advantages and limitations of each type, and the evidence-based prehospital clinical bundles are discussed. This paper aims at introducing emergency physicians and health care providers to quality initiatives in EMS and serves as a reference for tools that EMS medical directors can use to launch new or modify existing quality control programs in their systems. PMID:22046554

  2. [Introduction of Prehospital Emergency Ultrasound into an Emergency Medical Service Area].

    PubMed

    Weilbach, C; Kobiella, A; Rahe-Meyer, N; Johanning, K

    2017-01-01

    Emergency ultrasound as part of the provision of emergency medical services using mobile devices offers great benefits regarding to some important questions related to the management of critically ill and injured patients in the prehospital situation where diagnostic resources are limited. The aim of this study is to determine whether the comprehensive introduction of prehospital emergency ultrasound examinations into a German Emergency Medical Services ("rescue services") area is both feasible and beneficial for patients. All emergency physicians at a rural emergency physician base were trained in emergency ultrasound scanning techniques (FAST, FEEL, 14 h of instruction), followed by regular weekly training sessions of approximately 30 min. Over a period of 12 months, prehospital ultrasound examinations performed during emergency physician callouts at this base were documented and analysed. A total of 87 emergency ultrasound examinations were performed during 1343 callouts. Among these, focussed assessment with sonography for trauma (FAST) was performed in 35 patients (40.2%) and focused echocardiography in emergency life support (FEEL) in 41 patients (47.1%). In 11 patients (12.6%), ultrasound scans were performed for other indications (e. g. to rule out urinary tract obstruction in a case of flank pain). One trauma patient's life was saved by the decision to transport him to the nearest hospital and once there directly to the operating room, based on the ultrasound finding of significant free intra-abdominal fluid (ruptured spleen and liver). Prehospital emergency ultrasound can be introduced into an emergency medical service area as a diagnostic modality that provides benefits to patients. Emergency physicians have to be specifically trained and to participate in continuous education activities. Especially in rural areas with longer transport routes and journey times, the early diagnosis of for example massive intra-abdominal bleeding is

  3. RME 1327 - Crew Medical Restraint System (CMRS)

    NASA Image and Video Library

    1997-02-18

    STS081-318-031 (12-22 Jan. 1997) --- Astronauts Brent W. Jett, Jr. (left), STS-81 pilot, and John E. Blaha in the Spacehab Double Module (DM) evaluate the Crew Medical Restraint System (CMRS) carrier, onboard the Space Shuttle Atlantis. The device is an emergency aid forerunner for hardware on the International Space Station (ISS).

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

    PubMed

    Mancini, Michelino

    2014-11-01

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

  5. Medical Identity Theft in the Emergency Department: Awareness is Crucial

    PubMed Central

    Mancini, Michelino

    2014-01-01

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

  6. Emergency vehicle alert system (EVAS)

    NASA Technical Reports Server (NTRS)

    Reed, Bill; Crump, Roger; Harper, Warren; Myneni, Krishna

    1995-01-01

    The Emergency Vehicle Alert System (EVAS) program is sponsored by the NASA/MSFC Technology Utilization (TU) office. The program was conceived to support the needs of hearing impaired drivers. The objective of the program is to develop a low-cost, small device which can be located in a personal vehicle and warn the driver, via a visual means, of the approach of an emergency vehicle. Many different technologies might be developed for this purpose and each has its own advantages and drawbacks. The requirements for an acoustic detection system, appear to be pretty stringent and may not allow the development of a reliable, low-cost device in the near future. The problems include variations in the sirens between various types of emergency vehicles, distortions due to wind and surrounding objects, competing background noise, sophisticated signal processing requirements, and omni-directional coverage requirements. Another approach is to use a Radio Frequency (RF) signal between the Emergency Vehicle (EV) and the Personal Vehicle (PV). This approach requires a transmitter on each EV and a receiver in each PV, however it is virtually assured that a system can be developed which works. With this approach, the real technology issue is how to make a system work as inexpensively as possible. This report gives a brief summary of the EVAS program from its inception and concentrates on describing the activities that occurred during Phase 4. References 1-3 describe activities under Phases 1-3. In the fourth phase of the program, the major effort to be expended was in development of the microcontroller system for the PV, refinement of some system elements and packaging for demonstration purposes. An EVAS system was developed and demonstrated which used standard spread spectrum modems with minor modifications.

  7. Personal medical information system using laser card

    NASA Astrophysics Data System (ADS)

    Cho, Seong H.; Kim, Keun Ho; Choi, Hyung-Sik; Park, Hyun Wook

    1996-04-01

    The well-known hospital information system (HIS) and the picture archiving and communication system (PACS) are typical applications of multimedia to medical area. This paper proposes a personal medical information save-and-carry system using a laser card. This laser card is very useful, especially in emergency situations, because the medical information in the laser card can be read at anytime and anywhere if there exists a laser card reader/writer. The contents of the laser card include the clinical histories of a patient such as clinical chart, exam result, diagnostic reports, images, and so on. The purpose of this system is not a primary diagnosis, but emergency reference of clinical history of the patient. This personal medical information system consists of a personal computer integrated with laser card reader/writer, color frame grabber, color CCD camera and a high resolution image scanner optionally. Window-based graphical user interface was designed for easy use. The laser card has relatively sufficient capacity to store the personal medical information, and has fast access speed to restore and load the data with a portable size as compact as a credit card. Database items of laser card provide the doctors with medical data such as laser card information, patient information, clinical information, and diagnostic result information.

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

    PubMed

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

    2017-08-15

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

  9. Blood cultures in emergency medical admissions: a key patient cohort.

    PubMed

    Chotirmall, Sanjay H; Callaly, Elizabeth; Lyons, Judith; O'Connell, Brian; Kelleher, Mary; Byrne, Declan; O'Riordan, Deirdre; Silke, Bernard

    2016-02-01

    Blood cultures are performed in the emergency room when sepsis is suspected, and a cohort of patients is thereby identified. The present study investigated the outcomes (mortality and length of hospital stay) in this group following an emergency medical admission. Prospective assessment of all emergency medical admissions presenting to the emergency department at St James's Hospital, Dublin, over an 11-year period (2002-2012) was carried out. Outcomes including 30-day in-hospital mortality and length of stay were explored in the context of an admission blood culture. Generalized estimating equations, logistic or zero-truncated Poisson multivariate models were used, with adjustment for confounding variables including illness severity, comorbidity, and chronic disabling disease, to assess the effect of an urgent blood culture on mortality and length of stay. A total of 60 864 episodes were recorded in 35 168 patients admitted over the time period assessed. Patients more likely to undergo blood cultures in the emergency department were male, younger, and had more comorbidity. Univariate and multivariate analyses showed that those who had a blood culture, irrespective of result, had increased mortality and a longer in-hospital stay. This was highest for those with a positive culture, irrespective of the organism isolated. A clinical decision to request a blood culture identified a subset of emergency admissions with markedly worse outcomes. This patient cohort warrants close monitoring in the emergency setting.

  10. Emergency medical kit for commercial airlines: an update.

    PubMed

    Thibeault, Claude

    2002-06-01

    As expected, the issue of medical kits for commercial airlines continues to attract attention, especially in light of the recent United States regulation on the subject. As promised in its first recommendation in 1998, the Air Transport Medicine (ATM) Committee has continued to monitor medical kit usage as well as pharmaceutical scientific developments and wishes to propose an update to its 1998 recommendation. Lists of contents are provided for emergency medical kits of two types: 1) those without defibrillator/monitor or monitor; and 2) those with defibrillator/monitor or monitor alone. Follow up and updates on this issue will be an ongoing task of the ATM Committee.

  11. 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

  12. Emergency medical support for a manned stratospheric balloon test program.

    PubMed

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

    2014-10-01

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

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

    ERIC Educational Resources Information Center

    Frazier, William H.; Cannon, Joseph F.

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

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

    ERIC Educational Resources Information Center

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

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

  15. 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...

  16. 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...

  17. 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...

  18. 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...

  19. 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...

  20. 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...

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

    ERIC Educational Resources Information Center

    Spotts, Sue Ann

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

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

    PubMed

    Ribeaucoup, Luc; Roche, Blandine

    2015-11-01

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

  3. 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…

  4. 30 CFR 47.83 - Disclosure in a medical emergency.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

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

  5. 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...

  6. 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...

  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 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 §...

  11. 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 §...

  12. 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...

  13. 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...

  14. 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...

  15. 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 §...

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

    ERIC Educational Resources Information Center

    Mahoney, Dan

    2012-01-01

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

  17. 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…

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

    ERIC Educational Resources Information Center

    Spotts, Sue Ann

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

  19. [The nurse within emergency medical-psychological units].

    PubMed

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

    2017-04-01

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

  20. 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…