INMARSAT-C SafetyNET

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Tsunamis 406 EPIRB's National Weather Service Marine Forecasts INMARSAT-C SafetyNET Marine Forecast Offices greater danger near shore or any shallow waters? NATIONAL WEATHER SERVICE PRODUCTS VIA INMARSAT-C SafetyNET Inmarsat-C SafetyNET is an internationally adopted, automated satellite system for promulgating

NREL Partners with California's Santa Clara Valley Transportation Authority

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Automotive Systems Technology Simulator (FASTSim) - a high-level simulation tool for estimating the impact of , manager of the Transportation Systems Group in NREL's Transportation and Hydrogen Systems Center. " ;NREL will provide modeling and analytics on the potential scope of energy services associated with VGI

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.

EMS provider determinations of necessity for transport and reimbursement for EMS response, medical care, and transport: combined resource document for the National Association of EMS Physicians position statements.

PubMed

Millin, Michael G; Brown, Lawrence H; Schwartz, Brian

2011-01-01

With increasing demands for emergency medical services (EMS), many EMS jurisdictions are utilizing EMS provider-initiated nontransport policies as a method to offload potentially nonemergent patients from the EMS system. EMS provider determination of medical necessity, resulting in nontransport of patients, has the potential to avert unnecessary emergency department visits. However, EMS systems that utilize these policies must have additional education for the providers, a quality improvement process, and active physician oversight. In addition, EMS provider determination of nontransport for a specific situation should be supported by evidence in the peer-reviewed literature that the practice is safe. Further, EMS systems that do not utilize these programs should not be financially penalized. Payment for EMS services should be based on the prudent layperson standard. EMS systems that do utilize nontransport policies should be appropriately reimbursed, as this represents potential cost savings to the health care system.

Southwest U.S. Imagery (GOES-WEST) - Satellite Services Division / Office

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of Satellite Data Processing and Distribution Skip Navigation Link NESDIS banner image and link Information Service Home Page Default Office of Satellite and Product Operations banner image and link to OSPO Color -- Sea/Lake Ice -- Sea Surface Height -- Sea Surface Temperatures -- Tropical Systems Product List

Pediatric emergency care capabilities of Indian Health Service emergency medical service agencies serving American Indians/Alaska Natives in rural and frontier areas.

PubMed

Genovesi, A L; Hastings, B; Edgerton, E A; Olson, L M

2014-01-01

In the USA, the emergency medical services (EMS) system is vital for American Indians and Alaska Natives, who are disproportionately burdened by injuries and diseases and often live in rural areas geographically far from hospitals. In rural areas, where significant health disparities exist, EMS is often a primary source of healthcare providing a safety net for uninsured individuals or families who otherwise lack access to health-related services. EMS is frequently the first entry point for children and their families into the healthcare system. The Indian Health Service (IHS) supports the federally funded, tribally operated EMS agencies to help meet the affiliated American Indian and Alaska Natives' pre-hospital needs. While periodic assessments of state EMS agencies capabilities to care for children occur, it appears a systematic assessment of IHS EMS agencies in regards to children had not been previously conducted. A consensus process, involving stakeholders, was used to identify topic areas for a survey for assessing the pediatric capabilities of IHS EMS. The survey was sent to 75 of 88 IHS EMS agency contacts. Sixty-one agencies (81%) responded. Nine agencies (15%) did not have a medical director. Agencies without a medical director were less likely to report the availability of online (p=0.1) or offline (p<0.01) pediatric medical direction. Half (51%) of the agencies had a mass casualties plan; however, 29% reported responding to a mass casualty incident, involving a large number of pediatric patients, that overwhelmed their service. Most agencies were well integrated with their state EMS system with almost all (95%) collecting EMS patient care data and 47% using national standard data elements. In some areas, IHS EMS agencies did not have the infrastructure to treat pediatric patients during day-to-day operations as well as disasters. Similar to operational challenges faced by rural EMS agencies, the IHS agencies lacked a medical director, were unable to provide pediatric continuing education, and were overwhelmed during mass casualty incidents. Moreover, the overall ratio of IHS EMS to service population is almost double that for other EMS agencies. In other areas, agencies were well integrated with their state EMS system. One possible solution to increase capabilities to care for pediatric patients is combining and sharing of common resources including medical directors with their state EMS systems and authorities.

Home Page: NYS Government Information Locator Service: New York State

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Constitution external link - from the New York State Department of State NYS Judicial System (NYS Unified Courts System) Unified Court System external link - the main resource for information about New York's decisions of the New York courts in the Official Reports. The searchable Legal Research Portal external link

Energy Systems Integration News | Energy Systems Integration Facility |

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NREL January 2018 Blockchain concept demonstrated Blockchain to Enable Energy Market in BlockCypher Partnership NREL is partnering with BlockCypher, a blockchain Web services provider, to demonstrate how blockchain technology can support distributed energy markets. For some, the language and

Energy Systems Integration News | Energy Systems Integration Facility |

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us at the ESIF. NREL Releases High-Pen PV Handbook for Distribution Engineers As solar photovoltaic PV for Ancillary Services NREL, AES, the Puerto Rico Electric Power Authority, First Solar, and the technologies, such as solar, demand response, and smart consumer appliances Advances in grid design and

NOAAPORT

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satellite communications utilizing the C-band. It's primary purpose is for providing internal communications services. The NOAAPORT satellite communications system is operated by GTE Corp., under contract to the NWS . The system uses satellite transmitting (i.e. "uplink") equipment at NWS forecast offices

DoD ESI

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Information Management, Microsoft Platform Management, Identity & Access Management, Endpoint Systems /2016-24054/category-management). OMB released this IT Success Story for "Information Sharing Management of Common Information Technology: Mobile Devices and Services 7/1/2016 Category Management Policy

Climate Forecast System

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Skip Navigation Links www.nws.noaa.gov NOAA logo - Click to go to the NOAA home page National Weather Service NWS logo - Click to go to the NWS home page Climate Forecast System Home News Organization Search : Go Search Go CFS Home CFS version 2 News Documentation Downloads Reanalysis CFSv2 at CPC CFS

Data Services - Naval Oceanography Portal

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section Advanced Search... Sections Home Time Earth Orientation Astronomy Meteorology Oceanography Ice You the Earth's surface for any date and time. Apparent Disk of Solar System Object Creates a synthetic image of the telescopic appearance of the Moon or other solar system object for specified date and time

Improving rural emergency medical services (EMS) through transportation system enhancements.

DOT National Transportation Integrated Search

2014-05-01

Improved emergency medical services (EMS) will impact traffic safety and public health in rural : communities. Better planned, designed, and operated roadway networks that connect hospitals with : communities in need will enhance EMS performance. To ...

Global Real-Time Ocean Forecast System

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services. Marine Modeling and Analysis Branch Logo Click here to go to the MMAB home page Global Real-Time 17 Oct 2017 at 0Z, the Global RTOFS model has been upgraded to version 1.1.2. Changes include: The ). The global operational Real-Time Ocean Forecast System (Global RTOFS) at the National Centers for

Comparison of emergency medical services systems in the pan-Asian resuscitation outcomes study countries: Report from a literature review and survey.

PubMed

Ong, Marcus E H; Cho, Jungheum; Ma, Matthew Huei-Ming; Tanaka, Hideharu; Nishiuchi, Tatsuya; Al Sakaf, Omer; Abdul Karim, Sarah; Khunkhlai, Nalinas; Atilla, Ridvan; Lin, Chih-Hao; Shahidah, Nur; Lie, Desiree; Shin, Sang Do

2013-02-01

Asia-Pacific countries have unique prehospital emergency care or emergency medical services (EMS) systems, which are different from European or Anglo-American models. We aimed to compare the EMS systems of eight Asia-Pacific countries/regions as part of the Pan Asian Resuscitation Outcomes Study (PAROS), to provide a basis for future comparative studies across systems of care. In the first phase, a systematic literature review of EMS system within the eight PAROS countries/regions of interest was conducted. In the second phase, PAROS site directors were surveyed for additional information about the demographics and characteristics of EMS services at their sites. The database and bibliography search identified 25 eligible articles. The survey of EMS systems was completed by seven PAROS directors. By combining information sources from phases 1 and 2, we found that all PAROS EMS systems were single-tiered, and most were public (vs private) and fire-based (Thailand, Malaysia, Singapore, Taiwan, Japan, Korea). Ambulance personnel were primarily emergency medical technicians and paramedics, except for Thailand and Turkey, whose personnel include nurses and physicians. Personnel were trained to use automated external defibrillators and have basic cardiac life support certification. The service capability of each EMS system in terms of dispatch, airway management and medications, for example, varied greatly. We found variation in the EMS systems across the eight Asia-Pacific countries/regions studied. The findings will inform the construction of a multinational Asia-Pacific research network for future comparative studies and could serve as a model for international research networks. © 2012 The Authors. EMA © 2012 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Hurricane Products

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HOME PAGE Image of NCEP Logo WHERE AMERICA'S CLIMATE AND WEATHER SERVICES BEGIN NCEP Products Inventory Image of horizontal rule Hurricane Products Updated: 6/09/2015 Geophysical fluid dynamics laboratory Hurricane Model (GHM) Hurricane Weather Research and Forecast System (HWRF) * Products Information

NOAASIS (NOAA Satellite Information System) Home Page - Office of Satellite

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and Product Operations » DOC » NOAA » NESDIS » NOAASIS NOAA Satellite Information System Organizational Links National Environmental Satellite, Data, and Information Service (NESDIS) Office of Satellite ): Information and specific ground project support data for the Direct Broadcast Community from JPSS supported

Improving Rural Emergency Medical Services (EMS) through transportation system enhancements Phase II.

DOT National Transportation Integrated Search

2015-12-01

Providing acute medical care outside of the hospital, Emergency Medical Services (EMS) is crucial in rural environments where hospitals are not close by and are difficult to access. Establishing EMS performance measures is critical in improving a rur...

Sandia National Laboratories: About Sandia: Environmental Responsibility:

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Environmental Management: Sandia Sandia National Laboratories Exceptional service in the Environmental Responsibility Environmental Management System Pollution Prevention History 60 impacts Diversity ; Verification Research Research Foundations Bioscience Computing & Information Science Electromagnetics

Home - DOG

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Division of Oil & Gas logo Alaska Department of Natural Resources Division of Oil & Gas About Access well information Find Gas Pipeline project info Access oil & gas regulations Popular Services Applications Land Administration System Lease Sale Results Maps Oil & gas production data Mission Statement

Improving Rural Emergency Medical Services (EMS) through transportation system enhancements Phase II : project brief.

DOT National Transportation Integrated Search

2015-12-01

This study used the National EMS Information System (NEMSIS) South Dakota data to develop datadriven performance metrics for EMS. Researchers used the data for three tasks: geospatial analysis of EMS events, optimization of station locations, and ser...

NAEFS Products

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HOME PAGE Image of NCEP Logo WHERE AMERICA'S CLIMATE AND WEATHER SERVICES BEGIN NCEP Products Inventory Image of horizontal rule North American Ensemble Forecast System (NAEFS) Products Updated: 02/27 /2014 * Products Information about the NAEFS Models CC is the model cycle runtime (i.e. 00, 06, 12, 18

DoD Component Privacy Impact Assessments

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of Defense Chief Information Officer Home About DoD CIO Bios Organization DCIO C4&IIC DCIO IE Resources Activity (DHRA) Defense Manpower Data Center Defense Information Systems Agency (DISA) Defense ) Washington Headquarters Services (WHS) DoD Chief Information Officer DoD Use of Third-Party Websites and

NOAA WEATHER SATELLITES

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extent of snow cover. In addition, satellite sensors detect ice fields and map the movement of sea and greater danger near shore or any shallow waters? NATIONAL WEATHER SERVICE SATELLITE PRODUCTS NOAA's operational weather satellite system is composed of two types of satellites: geostationary operational

Alaska Department of Labor and Workforce Development

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Market Information Alaska Job Centers Hot Topics Get Paid to Learn a Trade! Apprenticeship Alaska Career USAJOBS - Federal Gov. Jobs Apprenticeship Alaska Career Information System Veterans' Services Youth

USCG AIS Broadcast

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these cooler months. Did you know your body can cool 25 times faster in water than in air? That water Traffic Service began broadcasting Automatic Identification System (AIS) test messages to select test participants in the area via standard AIS channels. These broadcasts-originating from MMSI 003660471-are less

The Organization and Structure to Areas of NWS Headquarters - NOAA's

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homepage National Oceanic and Atmospheric Administration's Select to go to the NWS homepage National ; Technology | Office of Hydrologic Development | Office of Operational Systems | Office of Climate, Water Atmospheric Administration Biography Headquarters National Weather Service Headquarters Structure Assistant

NREL, NYSERDA, and Con Edison Partner on Home Energy Management Systems |

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at large scale, the overall impact could be a win-win for both homeowners and utilities, which could sources. Founded in 1823, Con Edison provides electric, gas, and steam service to 10 million people who

National Centers for Environmental Prediction

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/ VISION | About EMC EMC > GEFS > COLLABORATORS Home Operational Products Experimental Data ENSEMBLE FORECAST SYSTEM MSC NAEFS Products CPC NAEFS Experimental 8 to 14 Day Temperature Guidance CPC NAEFS Experimental 8 to 14 Day Precip Guidance NOAA / National Weather Service National Centers for

The effects of expanding outpatient and inpatient evaluation and management services in a pediatric interventional radiology practice.

PubMed

Edalat, Faramarz; Lindquester, Will S; Gill, Anne E; Simoneaux, Stephen F; Gaines, Jennifer; Hawkins, C Matthew

2017-03-01

Despite a continuing emphasis on evaluation and management clinical services in adult interventional radiology (IR) practice, the peer-reviewed literature addressing these services - and their potential economic benefits - is lacking in pediatric IR practice. To measure the effects of expanding evaluation and management (E&M) services through the establishment of a dedicated pediatric interventional radiology outpatient clinic and inpatient E&M reporting system. We collected and analyzed E&M current procedural terminology (CPT) codes from all patients seen in a pediatric interventional radiology outpatient clinic between November 2014 and August 2015. We also calculated the number of new patients seen in the clinic who had a subsequent procedure (procedural conversion rate). For comparison, we used historical data comprising pediatric patients seen in a general interventional radiology (IR) clinic for the 2 years immediately prior. An inpatient E&M reporting system was implemented and all inpatient E&M (and subsequent procedural) services between July 2015 and September 2015 were collected and analyzed. We estimated revenue for both outpatient and inpatient services using the Medicare Physician Fee Schedule global non-facility price as a surrogate. Following inception of a pediatric IR clinic, the number of new outpatients (5.5/month; +112%), procedural conversion rate (74.5%; +19%), estimated E&M revenue (+158%), and estimated procedural revenue from new outpatients (+228%) all increased. Following implementation of an inpatient clinic reporting system, there were 8.3 consults and 7.3 subsequent hospital encounters per month, with a procedural conversion rate of 88%. Growth was observed in all meaningful metrics following expansion of outpatient and inpatient pediatric IR E&M services.

Dan Olis | NREL

Science.gov Websites

| 303-384-7398 Dan Olis is a mechanical engineer with experience in mechanical and systems design, plant for the U.S. Department of Defense, Department of the Interior, National Park Service, and the

Indiana | Solar Research | NREL

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Incentive Programs Indiana exempts solar PV modules, racking, and inverter from state sales and use taxes . The entire solar generating system is exempt from property taxation. Utility Incentive Programs Utility Incentive Limitations Northern Indiana Public Service Company (Solar PV feed-in-tariff) $0.1564

Emergency medical services key performance measurement in Asian cities.

PubMed

Rahman, Nik Hisamuddin; Tanaka, Hideharu; Shin, Sang Do; Ng, Yih Yng; Piyasuwankul, Thammapad; Lin, Chih-Hao; Ong, Marcus Eng Hock

2015-01-01

One of the key principles in the recommended standards is that emergency medical service (EMS) providers should continuously monitor the quality and safety of their services. This requires service providers to implement performance monitoring using appropriate and relevant measures including key performance indicators. In Asia, EMS systems are at different developmental phases and maturity. This will create difficultly in benchmarking or assessing the quality of EMS performance across the region. An attempt was made to compare the EMS performance index based on the structure, process, and outcome analysis. The data was collected from the Pan-Asian Resuscitation Outcome Study (PAROS) data among few Asian cities, namely, Tokyo, Osaka, Singapore, Bangkok, Kuala Lumpur, Taipei, and Seoul. The parameters of inclusions were broadly divided into structure, process, and outcome measurements. The data was collected by the site investigators from each city and keyed into the electronic web-based data form which is secured strictly by username and passwords. Generally, there seems to be a more uniformity for EMS performance parameters among the more developed EMS systems. The major problem with the EMS agencies in the cities of developing countries like Bangkok and Kuala Lumpur is inadequate or unavailable data pertaining to EMS performance. There is non-uniformity in the EMS performance measurement across the Asian cities. This creates difficulty for EMS performance index comparison and benchmarking. Hopefully, in the future, collaborative efforts such as the PAROS networking group will further enhance the standardization in EMS performance reporting across the region.

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

PubMed Central

Garg, Rajesh H

2012-01-01

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

Texas | Solar Research | NREL

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per non-residential customer (equivalent to a 25-kW system) Maximum $81,450 per service provider or megawatts in 2015, to 10,000 megawatts in 2030. Carve-out: Goal of voluntary 500 MW of non-wind generation target was already achieved by 2009, mostly through wind energy. The voluntary carve-out for non-wind

South Carolina | Midmarket Solar Policies in the United States | Solar

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voluntary renewable energy goal of 2% distributed energy in 2021. Carve-out: 0.25% of total generation from energy portfolio standard, but a goal for distributed generation by 2021. The Distributed Energy Resource Fast Track Process Study Process System size limit: Not specified; South Carolina Public Service

Climate Prediction Center - NCEP Global Ocean Data Assimilation System:

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home page National Weather Service NWS logo - Click to go to the NWS home page Climate Prediction Monthly in NetCDF Other formats Links NOAA Ocean Climate Observation Program (OCO) Climate Test Bed About Prediction (NCEP) are a valuable community asset for monitoring different aspects of ocean climate

Advanced Power Electronics and Smart Inverters | Grid Modernization | NREL

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provide grid services such as voltage and frequency regulation, ride-through, dynamic current injection impacts of smart inverters on distribution systems. These activities are focused on enabling high combines high-voltage silicon carbide with revolutionary concepts such as additive manufacturing and multi

Checkbook Online

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Search the Division of Finance site DOF State of Alaska Finance Home Content Area Accounting Charge Cards Checkbook Online Overview The State of Alaska is publishing information from the statewide accounting system mission of the Division of Finance is to provide accounting, payroll, and travel services for State

Emergency medical services capacity for prehospital stroke care in North Carolina.

PubMed

Patel, Mehul D; Brice, Jane H; Evenson, Kelly R; Rose, Kathryn M; Suchindran, Chirayath M; Rosamond, Wayne D

2013-09-05

Prior assessments of emergency medical services (EMS) stroke capacity found deficiencies in education and training, use of protocols and screening tools, and planning for the transport of patients. A 2001 survey of North Carolina EMS providers found many EMS systems lacked basic stroke services. Recent statewide efforts have sought to standardize and improve prehospital stroke care. The objective of this study was to assess EMS stroke care capacity in North Carolina and evaluate statewide changes since 2001. In June 2012, we conducted a web-based survey on stroke education and training and stroke care practices and policies among all EMS systems in North Carolina. We used the McNemar test to assess changes from 2001 to 2012. Of 100 EMS systems in North Carolina, 98 responded to our survey. Most systems reported providing stroke education and training (95%) to EMS personnel, using a validated stroke scale or screening tool (96%), and having a hospital prenotification policy (98%). Many were suboptimal in covering basic stroke educational topics (71%), always communicating stroke screen results to the destination hospital (46%), and always using a written destination plan (49%). Among 70 EMS systems for which we had data for 2001 and 2012, we observed significant improvements in education on stroke scales or screening tools (61% to 93%, P < .001) and use of validated stroke scales or screening tools (23% to 96%, P < .001). Major improvements in EMS stroke care, especially in prehospital stroke screening, have occurred in North Carolina in the past decade, whereas other practices and policies, including use of destination plans, remain in need of improvement.

Lost and Found

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Packard Operating Manual HP-IB System DC Power Supplies HP Models 6632A, 6633A, 6634A National Instruments LabView2 User Manual (Jan 1993 Edition) Hewlett Packard Operating and Service Manual HP-IB Isolated DAC

NREL Leads Effort to Get Traffic Moving in the Right Direction | News |

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fuels. This emerging approach to sustainable transportation augments ongoing work by NREL that is aimed at taking a systems approach to the broader network of travelers, services, and environments in order

GLCF: Services

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Services Contact Site Map Go Services GLCF General Services Contact us with the online form. Answer classification Special Group Services Special workspaces for groups accessing datasets Data Ordering Services Click here to proceed to Data Ordering Service Hard Media Orders Metrics Services ESDS Metrics

Well-Designed Wholesale Electricity Markets Support System Flexibility |

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electricity markets drive efficient solutions to meet reliability needs in a least-cost manner, and they can service (which is typically provided by conventional generators as a part of interconnection through cost variable generation and load (net load) economically and reducing use of regulating reserves-cost

Smith and Navistar Electric and Plug-In Hybrid Vehicle Testing |

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plug-in hybrid electric vehicles operated by a variety of companies in diverse climates across the plug-in hybrid electric drive systems in medium-duty trucks operating in fleet service across the nation. U.S. companies agreeing to participate in this evaluation project received funding from the

Corporate Services | College of Engineering & Applied Science

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A B C D E F G H I J K L M N O P Q R S T U V W X Y Z D2L PAWS Email My UW-System About UWM UWM Jobs D2L PAWS Email My UW-System University of Wisconsin-Milwaukee College ofEngineering & Olympiad Girls Who Code Club FIRST Tech Challenge NSF I-Corps Site of Southeastern Wisconsin UW-Milwaukee

Cooperation. An alternative to consolidation or bankruptcy.

PubMed

Cady, G

1994-04-01

With all the recent consolidation and doomsaying within the EMS industry, the music from the movie "Jaws" is likely playing a constant refrain in the minds of many smaller EMS providers. The word from the consolidators--those large companies buying up small and midsized ambulance services--is that health maintenance organizations (HMOs) soon will be purchasing EMS and other "out-of-hospital" services and that since HMOs are for-profit institutions, they will be looking for the least expensive EMS delivery system. The consolidators and others with a stake in the new order assert that cost-effective services can only be produced by large national EMS companies; smaller companies will be left out in the cold. But will they?

Characterizing local EMS systems.

DOT National Transportation Integrated Search

2013-08-01

Emergency medical services (EMS) systems are configured differently depending on several factors, including the size, demographics, geography, and politics of the local communities they serve. Although some information exists about the organization, ...

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.

DefenseLink.mil - Special Report - 35 Years of Volunteer Forces - July 1,

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force, when many in the military were convinced the system would fail. Yet after the volunteer military volunteer service Our nation is fortunate that so many talented and patriotic young people have stepped Photo of Gen. George W. Casey Jr. When Gen. George W. Casey Jr. became chief of staff of the Army in

Emergency Medical Services Capacity for Prehospital Stroke Care in North Carolina

PubMed Central

Brice, Jane H.; Evenson, Kelly R.; Rose, Kathryn M.; Suchindran, Chirayath M.; Rosamond, Wayne D.

2013-01-01

Introduction Prior assessments of emergency medical services (EMS) stroke capacity found deficiencies in education and training, use of protocols and screening tools, and planning for the transport of patients. A 2001 survey of North Carolina EMS providers found many EMS systems lacked basic stroke services. Recent statewide efforts have sought to standardize and improve prehospital stroke care. The objective of this study was to assess EMS stroke care capacity in North Carolina and evaluate statewide changes since 2001. Methods In June 2012, we conducted a web-based survey on stroke education and training and stroke care practices and policies among all EMS systems in North Carolina. We used the McNemar test to assess changes from 2001 to 2012. Results Of 100 EMS systems in North Carolina, 98 responded to our survey. Most systems reported providing stroke education and training (95%) to EMS personnel, using a validated stroke scale or screening tool (96%), and having a hospital prenotification policy (98%). Many were suboptimal in covering basic stroke educational topics (71%), always communicating stroke screen results to the destination hospital (46%), and always using a written destination plan (49%). Among 70 EMS systems for which we had data for 2001 and 2012, we observed significant improvements in education on stroke scales or screening tools (61% to 93%, P < .001) and use of validated stroke scales or screening tools (23% to 96%, P < .001). Conclusion Major improvements in EMS stroke care, especially in prehospital stroke screening, have occurred in North Carolina in the past decade, whereas other practices and policies, including use of destination plans, remain in need of improvement. PMID:24007677

Ag Data Commons Monthly Metrics | National Agricultural Library

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and Nutrition Service(84)","value":"Food and Nutrition Service(84)"," and Nutrition Service(84)","value":"Food and Nutrition Service(84)"," and Nutrition Service(84)","value":"Food and Nutrition Service(84)","

Navigation Systems « Coast Guard Maritime Commons

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number rollover event This post provides information on the possible effects of the April 6, 2019 GPS safety services Editor's note: This post was updated April 10, 2018 to reflect that Inmarsat will begin information, visit the Inmarsat website provided in our blog post. Inmarsat announced that it will migrate

Data Services

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Moon Data for One Day Rise/Set/Twilight Table for an Entire Year What the Moon Looks Like Now Dates of Contact more... Sitemap Rise/Set/Transit/Twilight Data Complete Sun and Moon Data for One Day Table of Solar System Objects and Bright Stars Duration of Daylight/Darkness Table for One Year Phases of the

Traffic safety facts : feasibility for an EMS workforce safety and health surveillance system

DOT National Transportation Integrated Search

2007-05-01

Emergency Medical Services (EMS) personnel treat an estimated : 22 million patients a year (Maguire and Walz, 2004). : While on duty, EMS workers frequently encounter two : work-related risks: injury and illness. Current research on : EMS workforce i...

Feasibility for an EMS workforce safety and health surveillance system

DOT National Transportation Integrated Search

2007-05-01

Emergency Medical Services (EMS) personnel treat an estimated 22 million patients a year in the United States. Estimates have placed the EMS workforce at around 900,000 workers, but the precise number is unknown because EMS workers include career and...

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. © 2012 by the Society for Academic Emergency Medicine.

Comparison of emergency medical services systems across Pan-Asian countries: a Web-based survey.

PubMed

Shin, Sang Do; Ong, Marcus Eng Hock; Tanaka, Hideharu; Ma, Matthew Huei-Ming; Nishiuchi, Tatsuya; Alsakaf, Omer; Karim, Sarah Abdul; Khunkhlai, Nalinas; Lin, Chih-Hao; Song, Kyoung Jun; Ryoo, Hyun Wook; Ryu, Hyun Ho; Tham, Lai Peng; Cone, David C

2012-01-01

There are great variations in out-of-hospital cardiac arrest (OHCA) survival outcomes among different countries and different emergency medical services (EMS) systems. The impact of different systems and their contribution to enhanced survival are poorly understood. This paper compares the EMS systems of several Asian sites making up the Pan-Asian Resuscitation Outcomes Study (PAROS) network. Some preliminary cardiac arrest outcomes are also reported. This is a cross-sectional descriptive survey study addressing population demographics, service levels, provider characteristics, system operations, budget and finance, medical direction (leadership), and oversight. Most of the systems are single-tiered. Fire-based EMS systems are predominant. Bangkok and Kuala Lumpur have hospital-based systems. Service level is relatively low, from basic to intermediate in most of the communities. Korea, Japan, Singapore, and Bangkok have intermediate emergency medical technician (EMT) service levels, while Taiwan and Dubai have paramedic service levels. Medical direction and oversight have not been systemically established, except in some communities. Systems are mostly dependent on public funding. We found variations in available resources in terms of ambulances and providers. The number of ambulances is 0.3 to 3.2 per 100,000 population, and most ambulances are basic life support (BLS) vehicles. The number of human resources ranges from 4.0 per 100,000 population in Singapore to 55.7 per 100,000 population in Taipei. Average response times vary between 5.1 minutes (Tainan) and 22.5 minutes (Kuala Lumpur). We found substantial variation in 11 communities across the PAROS EMS systems. This study will provide the foundation for understanding subsequent studies arising from the PAROS effort.

The Use of Autonomous Systems in Emergency Medical Services: Bridging Human Intelligence and Technology

DTIC Science & Technology

2015-12-01

significant impact on emergency medical services ( EMS ). EMS provider organizations must be prepared to not only interact with AS by having response... EMS will be high, that the number of opportunities to improve required emergency response and deliver expedient medical care will be diminished, and...that strengths may be nonexistent. The thesis focuses on the analysis of what AS are, how they are used in the provision of EMS today, how they may be

Emergency Medical Services Utilization in EMS Priority Conditions in Beirut, Lebanon.

PubMed

El Sayed, Mazen; Tamim, Hani; Chehadeh, Ahel Al-Hajj; Kazzi, Amin A

2016-12-01

Early activation and use of Emergency Medical Services (EMS) are associated with improved patient outcomes in EMS priority conditions in developed EMS systems. This study describes patterns of EMS use and identifies predictors of EMS utilization in EMS priority conditions in Lebanon METHODS: This was a cross-sectional study of a random sample of adult patients presenting to the emergency department (ED) of a tertiary care center in Beirut with the following EMS priority conditions: chest pain, major trauma, respiratory distress, cardiac arrest, respiratory arrest, and airway obstruction. Patient/proxy survey (20 questions) and chart review were completed. The responses to survey questions were "disagree," "neutral," or "agree" and were scored as one, two, or three with three corresponding to higher likelihood of EMS use. A total scale score ranging from 20 to 60 was created and transformed from 0% to 100%. Data were analyzed based on mode of presentation (EMS vs other). Among the 481 patients enrolled, only 112 (23.3%) used EMS. Mean age for study population was 63.7 years (SD=18.8 years) with 56.5% males. Mean clinical severity score (Emergency Severity Index [ESI]) was 2.5 (SD=0.7) and mean pain score was 3.1 (SD=3.5) at ED presentation. Over one-half (58.8%) needed admission to hospital with 21.8% to an intensive care unit care level and with a mortality rate of 7.3%. Significant associations were found between EMS use and the following variables: severity of illness, degree of pain, familiarity with EMS activation, previous EMS use, perceived EMS benefit, availability of EMS services, trust in EMS response times and treatment, advice from family, and unavailability of immediate private mode of transport (P≤.05). Functional screening, or requiring full assistance (OR=4.77; 95% CI, 1.85-12.29); acute symptoms onset ≤ one hour (OR=2.14; 95% CI, 1.08-4.26); and higher scale scores (OR=2.99; 95% CI, 2.20-4.07) were significant predictors of EMS use. Patients with lower clinical severity (OR=0.53; 95% CI, 0.35-0.81) and those with chest pain (OR=0.05; 95% CI, 0.02-0.12) or respiratory distress (OR=0.15; 95% CI, 0.07-0.31) using cardiac arrest as a reference were less likely to use EMS. Emergency Medical Services use in EMS priority conditions in Lebanon is low. Several predictors of EMS use were identified. Emergency Medical Services initiatives addressing underutilization should result from this proposed assessment of the perspective of the EMS system's end user. El Sayed M , Tamim H , Al-Hajj Chehadeh A , Kazzi AA . Emergency Medical Services utilization in EMS priority conditions in Beirut, Lebanon. Prehosp Disaster Med. 2016;31(6):621-627.

Report on the International Conference on Emergency Health Care Development.

PubMed Central

Dines, G B

1990-01-01

Emergency medical services (EMS) provide rescue, field stabilization, transportation to medical facilities, and definitive care for persons experiencing medical emergencies. In order to advance worldwide development and refinement of EMS systems, and their integration with emergency preparedness and response programs, the International Conference on Emergency Health Care Development was held in Crystal City, Arlington, VA, August 15-19, 1989. The conference was supported by the Department of Health and Human Services and its Health Resources and Services Administration; the Department of Transportation and its National Highway Traffic and Safety Administration; and the Pan American Health Organization. Objectives of the conference were to clarify linkages between various levels of emergency response, to present methods for developing or improving EMS systems within societies with different resources, to demonstrate processes by which EMS systems have been developed, and to propose international emergency health care development goals. Topics included development of services in developing nations, case studies of underdeveloped countries' responses to natural disasters, and a method for updating disaster response through use of available medical resources. PMID:1968669

Configurations of EMS systems : a pilot study

DOT National Transportation Integrated Search

2008-03-01

Emergency medical services (EMS) systems are configured differently depending on several factors, including the size, demographics, geography, and politics of the local communities they serve. Although some information exists about the organization, ...

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.

CAP: Mobile App

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Interpreting Services Training Non-DoD Employees Partner Agencies A - L Partner Agencies M - Z Training Service Service Members Site Map + CAP Customers DoD Employees DoD Agencies Support Services Training Non-DoD Employees Partner Agencies A - L Partner Agencies M - Z Training Service Members Military Treatment

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

NASA Technical Reports Server (NTRS)

Shively, R. J.

1992-01-01

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

Teaching emergency medical services management skills using a computer simulation exercise.

PubMed

Hubble, Michael W; Richards, Michael E; Wilfong, Denise

2011-02-01

Simulation exercises have long been used to teach management skills in business schools. However, this pedagogical approach has not been reported in emergency medical services (EMS) management education. We sought to develop, deploy, and evaluate a computerized simulation exercise for teaching EMS management skills. Using historical data, a computer simulation model of a regional EMS system was developed. After validation, the simulation was used in an EMS management course. Using historical operational and financial data of the EMS system under study, students designed an EMS system and prepared a budget based on their design. The design of each group was entered into the model that simulated the performance of the EMS system. Students were evaluated on operational and financial performance of their system design and budget accuracy and then surveyed about their experiences with the exercise. The model accurately simulated the performance of the real-world EMS system on which it was based. The exercise helped students identify operational inefficiencies in their system designs and highlighted budget inaccuracies. Most students rated the exercise as moderately or very realistic in ambulance deployment scheduling, budgeting, personnel cost calculations, demand forecasting, system design, and revenue projections. All students indicated the exercise was helpful in gaining a top management perspective, and 89% stated the exercise was helpful in bridging the gap between theory and reality. Preliminary experience with a computer simulator to teach EMS management skills was well received by students in a baccalaureate paramedic program and seems to be a valuable teaching tool. Copyright © 2011 Society for Simulation in Healthcare

Barriers in the Delivery of Emergency Obstetric and Neonatal Care in Post-Conflict Africa: Qualitative Case Studies of Burundi and Northern Uganda

PubMed Central

Chi, Primus Che; Bulage, Patience; Urdal, Henrik; Sundby, Johanne

2015-01-01

Objectives Maternal and neonatal mortality and morbidity rates are particularly grim in conflict, post-conflict and other crisis settings, a situation partly blamed on non-availability and/or poor quality of emergency obstetric and neonatal care (EmONC) services. The aim of this study was to explore the barriers to effective delivery of EmONC services in post-conflict Burundi and Northern Uganda, in order to provide policy makers and other relevant stakeholders context-relevant data on improving the delivery of these lifesaving services. Methods This was a qualitative comparative case study that used 42 face-to-face semi-structured in-depth interviews and 4 focus group discussions for data collection. Participants were 32 local health providers and 37 staff of NGOs working in the area of maternal health. Data was analysed using the framework approach. Results The availability, quality and distribution of EmONC services were major challenges across the sites. The barriers in the delivery of quality EmONC services were categorised into two major themes; human resources-related challenges, and systemic and institutional failures. While some of the barriers were similar, others were unique to specific sites. The common barriers included shortage of qualified staff; lack of essential installations, supplies and medications; increasing workload, burn-out and turnover; and poor data collection and monitoring systems. Barriers unique to Northern Uganda were demoralised personnel and lack of recognition; poor referral system; inefficient drug supply system; staff absenteeism in rural areas; and poor coordination among key personnel. In Burundi, weak curriculum; poor harmonisation and coordination of training; and inefficient allocation of resources were the unique challenges. To improve the situation across the sites, efforts are ongoing to improve the training and recruitment of more staff; harmonise and strengthen the curriculum and training; increase the number of EmONC facilities; and improve staff supervision, monitoring and support. Conclusions Post-conflict health systems face different challenges in the delivery of EmONC services and as such require context-specific interventions to improve the delivery of these services. PMID:26405800

Barriers in the Delivery of Emergency Obstetric and Neonatal Care in Post-Conflict Africa: Qualitative Case Studies of Burundi and Northern Uganda.

PubMed

Chi, Primus Che; Bulage, Patience; Urdal, Henrik; Sundby, Johanne

2015-01-01

Maternal and neonatal mortality and morbidity rates are particularly grim in conflict, post-conflict and other crisis settings, a situation partly blamed on non-availability and/or poor quality of emergency obstetric and neonatal care (EmONC) services. The aim of this study was to explore the barriers to effective delivery of EmONC services in post-conflict Burundi and Northern Uganda, in order to provide policy makers and other relevant stakeholders context-relevant data on improving the delivery of these lifesaving services. This was a qualitative comparative case study that used 42 face-to-face semi-structured in-depth interviews and 4 focus group discussions for data collection. Participants were 32 local health providers and 37 staff of NGOs working in the area of maternal health. Data was analysed using the framework approach. The availability, quality and distribution of EmONC services were major challenges across the sites. The barriers in the delivery of quality EmONC services were categorised into two major themes; human resources-related challenges, and systemic and institutional failures. While some of the barriers were similar, others were unique to specific sites. The common barriers included shortage of qualified staff; lack of essential installations, supplies and medications; increasing workload, burn-out and turnover; and poor data collection and monitoring systems. Barriers unique to Northern Uganda were demoralised personnel and lack of recognition; poor referral system; inefficient drug supply system; staff absenteeism in rural areas; and poor coordination among key personnel. In Burundi, weak curriculum; poor harmonisation and coordination of training; and inefficient allocation of resources were the unique challenges. To improve the situation across the sites, efforts are ongoing to improve the training and recruitment of more staff; harmonise and strengthen the curriculum and training; increase the number of EmONC facilities; and improve staff supervision, monitoring and support. Post-conflict health systems face different challenges in the delivery of EmONC services and as such require context-specific interventions to improve the delivery of these services.

Work-family fit: the impact of emergency medical services work on the family system.

PubMed

Roth, Sheila Gillespie; Moore, Crystal Dea

2009-01-01

The stress associated with a career in emergency medical services (EMS) can impact the work-family fit and function of the family system for EMS personnel. Little research has been conducted on how the demands associated with a career in EMS influences family life. Objective. To describe salient EMS work factors that can impact the family system. Twelve family members (11 spouses and one parent) of EMS workers were interviewed using a semistructured qualitative interview guide that explored issues related to their family members' work that could impact the quality of family life. Using a phenomenological approach, transcribed interview data were examined for themes that illuminated factors that influence work-family fit. Data analysis revealed that shift work impacts numerous aspects of family life, including marital and parental roles, leisure and social opportunities, and home schedules and rhythms. Furthermore, families coped with challenges associated with their loved one's EMS work through negotiating role responsibilities, developing their own interests, giving their family member "space," and providing support by listening and helping the EMS worker process his or her reactions to difficult work. In addition, family members reported concern over their EMS worker's physical safety. Implications from the data are discussed vis-a-vis the work-family fit and family systems models. Education, communication, support systems, and individual interests are key ways to promote a healthy work-family fit.

EMS workforce for the 21st century : a national assessment

DOT National Transportation Integrated Search

2008-06-01

Emergency medical technicians (EMTs) and paramedics are a critical component of any communitys Emergency Medical Services (EMS) system. Assuring the continued viability of the prehospital EMS workforce is a key concern for many local, State, Feder...

Influenza Weekly Surveillance Reports - Delaware Health and Social Services

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DPH Disease Information: Tuberculosis - Delaware Health and Social Services

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Use of a geographic information system to assess accessibility to health facilities providing emergency obstetric and newborn care in Bangladesh.

PubMed

Chowdhury, Mahbub E; Biswas, Taposh K; Rahman, Monjur; Pasha, Kamal; Hossain, Mollah A

2017-08-01

To use a geographic information system (GIS) to determine accessibility to health facilities for emergency obstetric and newborn care (EmONC) and compare coverage with that stipulated by UN guidelines (5 EmONC facilities per 500 000 individuals, ≥1 comprehensive). A cross-sectional study was undertaken of all public facilities providing EmONC in 24 districts of Bangladesh from March to October 2012. Accessibility to each facility was assessed by applying GIS to estimate the proportion of catchment population (comprehensive 500 000; basic 100 000) able to reach the nearest facility within 2 hours and 1 hour of travel time, respectively, by existing road networks. The minimum number of public facilities providing comprehensive and basic EmONC services (1 and 5 per 500 000 individuals, respectively) was reached in 16 and 3 districts, respectively. However, after applying GIS, in no district did 100% of the catchment population have access to these services. A minimum of 75% and 50% of the population had accessibility to comprehensive services in 11 and 5 districts, respectively. For basic services, accessibility was much lower. Assessing only the number of EmONC facilities does not ensure universal coverage; accessibility should be assessed when planning health systems. © 2017 International Federation of Gynecology and Obstetrics.

DefenseLink Feature: Berlin Airlift

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Services Open House at Andrews Air Force Base FEATURE STORIES Wiesbaden Celebrates Airlift Anniversary Airlift Anniversary This year's Joint Service Open House commemorates the 60th anniversary of the Berlin Open House 2008 Joint Service Open House This year's Joint Service Open House commemorated the 60th

Senior Benefits

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Alaska Temporary Assistance

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Contemporary evidence-based practice in Canadian emergency medical services: a vision for integrating evidence into clinical and policy decision-making.

PubMed

Jensen, Jan L; Travers, Andrew H

2017-05-01

Nationally, emphasis on the importance of evidence-based practice (EBP) in emergency medicine and emergency medical services (EMS) has continuously increased. However, meaningful incorporation of effective and sustainable EBP into clinical and administrative decision-making remains a challenge. We propose a vision for EBP in EMS: Canadian EMS clinicians and leaders will understand and use the best available evidence for clinical and administrative decision-making, to improve patient health outcomes, the capability and quality of EMS systems of care, and safety of patients and EMS professionals. This vision can be implemented with the use of a structure, process, system, and outcome taxonomy to identify current barriers to true EBP, to recognize the opportunities that exist, and propose corresponding recommended strategies for local EMS agencies and at the national level. Framing local and national discussions with this approach will be useful for developing a cohesive and collaborative Canadian EBP strategy.

Division of Public Assistance

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Child Care Program Office

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Office of Children's Services

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Division of Juvenile Justice

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CIDR

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internal JHU investigators and external scientists on a fee-for-service basis. Whole Exome and Custom Initiation Application Schedule Service Information and Pricing Services Sample Requirements Pricing SNP Us -Privacy Policy -Site Map Search You are here: CIDR>Service Information and Pricing> Pricing

COMMERCIAL SERVICES PROVIDING MARINE FORECASTS VIA SATELLITE

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Tsunamis 406 EPIRB's National Weather Service Marine Forecasts COMMERCIAL SERVICES PROVIDING MARINE forecast seas? And may present an even greater danger near shore or any shallow waters? COMMERCIAL SERVICES commercial product or service does not imply any endorsement by the National Weather Service as to function

The prehospital emergency care system in Mexico City: a system's performance evaluation.

PubMed

Peralta, Luis Mauricio Pinet

2006-01-01

Mexico City has one of the highest mortality rates in Mexico, with non-intentional injuries as a leading cause of death among persons 1-44 years of age. Emergency medical services (EMS) in Mexico can achieve high levels of efficiency by offering high quality medical care at a low cost through adequate system design. The objective of this study was to determine whether the prehospital EMS system in Mexico City meets the criteria standards established by the American Ambulance Association Guide for Contracting Emergency Medical Services (AAA Guide) for highly efficient EMS systems. This retrospective, descriptive study, evaluated the structure of Mexico City's EMS system and analyzed EMS response times, clinical capacity, economic efficiency, and customer satisfaction. These results were compared with the AAA guide, according to the soc ial, economic, and political context in Mexico. This paper describes the healthcare system structure in Mexico, followed by a description of the basic structure of EMS in Mexico City, and of each tenet described in the AAA guide. The p aper includesdata obtained from official documents and databases of government agencies, and operative and administrative data from public and private EMS providers. The quality of the data for response times (RT) were insufficient and widely varied among providers, with a minimum RT of 6.79 minutes (min) and a maximum RT of 61 min. Providers did not define RT clearly, and measured it with averages, which can hide potentially poor performance practices. Training institutions are not required to follow a standardized curriculum. Certifications are the responsibility of the individual training centers and have no government regulation. There was no evidence of active medical control involvement in direct patient care, and providers did not report that quality assurance programs were in place. There also are limited career advancement opportunities for EMS personnel. Small economies of scale may not allow providers to be economically efficient, unit hours are difficult to calculate, and few economic data are available. There is no evidence of customer satisfaction data. Emergency medical services in Mexico City did not meet the AAA requirements for high-quality, prehospital, emergency care. Coordination among EMS providers is difficult to achieve, due, in part, to the lack of: (1) an authoritative structure; (2) sound system design; and (3) appropriate legislation. The government, EMS providers, stakeholders, and community members should work together to build a high quality EMS system at the lowest possible cost.

Resources for Parents, Patients, and HCPs

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The Emergency Medical System in Greece: Opening Aeolus' Bag of Winds.

PubMed

Kotsiou, Ourania S; Srivastava, David S; Kotsios, Panagiotis; Exadaktylos, Aristomenis K; Gourgoulianis, Konstantinos I

2018-04-13

An Emergency Medical Service (EMS) system must encompass a spectrum of care, with dedicated pre-hospital and in-hospital medical facilities. It has to be organised in such a way as to include all necessary services—such as triage accurate initial assessment, prompt resuscitation, efficient management of emergency cases, and transport to definitive care. The global economic downturn has had a direct effect on the health sector and poses additional threats to the healthcare system. Greece is one of the hardest-hit countries. This manuscript aims to present the structure of the Greek EMS system and the impact of the current economic recession on it. Nowadays, primary care suffers major shortages in crucial equipment, unmet health needs, and ineffective central coordination. Patients are also facing economic limitations that lead to difficulties in using healthcare services. The multi-factorial problem of in-hospital EMS overcrowding is also evident and has been linked with potentially poorer clinical outcomes. Furthermore, the ongoing refugee crisis challenges the national EMS. Adoption of a triage scale, expansion of the primary care network, and an effective primary–hospital continuum of care are urgently needed in Greece to provide comprehensive, culturally competent, and high-quality health care.

Orion Service Module Umbilical (OSMU) Installation

NASA Image and Video Library

2017-03-16

A crane lifts the Orion Service Module Umbilical (OSMU) high up for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals, that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. EM-1 is scheduled to launch in 2018. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Navy Directory

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Expansion of U.S. emergency medical service routing for stroke care: 2000-2010.

PubMed

Hanks, Natalie; Wen, Ge; He, Shuhan; Song, Sarah; Saver, Jeffrey L; Cen, Steven; Kim-Tenser, May; Mack, William; Sanossian, Nerses

2014-07-01

Organized stroke systems of care include preferential emergency medical services (EMS) routing to deliver suspected stroke patients to designated hospitals. To characterize the growth and implementation of EMS routing of stroke nationwide, we describe the proportion of stroke hospitalizations in the United States (U.S.) occurring within regions having adopted these protocols. We collected data on ischemic stroke using International Classification of Diseases-9 (ICD-9) coding from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample (NIS) database from the years 2000-2010. The NIS contains all discharge data from 1,051 hospitals located in 45 states, approximating a 20% stratified sample. We obtained data on EMS systems of care from a review of archives, reports, and interviews with state emergency medical services (EMS) officials. A county or state was considered to be in transition if the protocol was adopted in the calendar year, with establishment in the year following transition. Nationwide, stroke hospitalizations remained constant over the course of the study period: 583,000 in 2000 and 573,000 in 2010. From 2000-2003 there were no states or counties participating in the NIS with EMS systems of care. The proportion of U.S. stroke hospitalizations occurring in jurisdictions with established EMS regional systems of acute stroke care increased steadily from 2004 to 2010 (1%, 13%, 28%, 30%, 30%, 34%, 49%). In 2010, 278,538 stroke hospitalizations, 49% of all U.S. stroke hospitalizations, occurred in areas with established EMS routing, with an additional 18,979 (3%) patients in regions undergoing a transition to EMS routing. In 2010, a majority of stroke patients in the U.S. were hospitalized in states with established or transitioning to organized stroke systems of care. This milestone coverage of half the U.S. population is a major advance in systematic stroke care and emphasizes the need for novel approaches to further extend access to stroke center care to all patients.

Health Care Services

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DPH Healthy Living Information: Immunizations - Delaware Health and Social

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2018: 103 Department of Health and Social Services (DHSS) DHSS Home Divisions Aging and Adults with Physical Disabilities Child Support Services Delaware Health Care Commission Developmental Disabilities Services Health Care Quality Management Services Medicaid & Medical Assistance Public Health Social

Alaska Community Transit

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Grant Information Human Services Funding 5310 5316 (Repealed) 5317 (Repealed) Alaska Mental Health Trust . Transit News, Events, & Highlights SFY2019 Public Transit and Human Service Grant Recommendations pdf icon ( 134 KB) SFY2020 Human Service Intent to Apply opens 8/1/2018. Human Service agencies must sumbit

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

Youssef, Tarek A.; El Hariri, Mohamad; Elsayed, Ahmed T.

The smart grid is seen as a power system with realtime communication and control capabilities between the consumer and the utility. This modern platform facilitates the optimization in energy usage based on several factors including environmental, price preferences, and system technical issues. In this paper a real-time energy management system (EMS) for microgrids or nanogrids was developed. The developed system involves an online optimization scheme to adapt its parameters based on previous, current, and forecasted future system states. The communication requirements for all EMS modules were analyzed and are all integrated over a data distribution service (DDS) Ethernet network withmore » appropriate quality of service (QoS) profiles. In conclusion, the developed EMS was emulated with actual residential energy consumption and irradiance data from Miami, Florida and proved its effectiveness in reducing consumers’ bills and achieving flat peak load profiles.« less

Alaska Department of Health and Social Services

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State Employees Health and Social Services DHSS State of Alaska Home Divisions and Agencies Alaska Pioneer Homes Behavioral Health Office of Children's Services Office of the Commissioner Office of Substance Misuse and Addiction Prevention Finance & Management Services Health Care Services Juvenile

Publications - GMC 215 | Alaska Division of Geological & Geophysical

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DGGS GMC 215 Publication Details Title: U.S. Minerals Management Service 1992 Lower Cook Inlet Mesozoic Field Program, Shelikof Strait, Alaska Authors: U.S. Minerals Management Service, and ARCO Publication Reference U.S. Minerals Management Service, and ARCO, 1993, U.S. Minerals Management Service 1992 Lower Cook

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.

HHS Archive Home Page

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Health and Human Service staff. HHS Blog Exit Disclaimer This collection includes HHS blog posts Safety Working Group* Indian Health Service (IHS) Indian Health Service* National Institutes of Health )* HealthIT.gov (ONC)* Office of Minority Health (ASH)* Public Health Emergency (ASPR)* Stopbullying.gov (ASPA

NOAA - National Oceanic and Atmospheric Administration

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Click to look up weather forecast by City, State Active Weather Alerts Home NOAA Corporate Finance and NOAA Corporate Finance and Administrative Services Offices Sapelo Island Lighthouse. Sapelo Island . NOAA Corporate Finance and Administrative Services offices strive to deliver quality services to NOAA's

Division of Alaska Pioneer Homes

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Homes Behavioral Health Office of Children's Services Office of the Commissioner Office of Substance Misuse and Addiction Prevention Finance & Management Services Health Care Services Juvenile Justice Public Assistance Public Health Seniors & Disabilities Services Boards, Councils & Commissions

Getting Ready for Medicare?

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Agencies Alaska Pioneer Homes Behavioral Health Office of Children's Services Office of the Commissioner Office of Substance Misuse and Addiction Prevention Finance & Management Services Health Care Services Juvenile Justice Public Assistance Public Health Seniors & Disabilities Services Boards

Medicare Information Office

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Agencies Alaska Pioneer Homes Behavioral Health Office of Children's Services Office of the Commissioner Office of Substance Misuse and Addiction Prevention Finance & Management Services Health Care Services Juvenile Justice Public Assistance Public Health Seniors & Disabilities Services Boards

Alternative Fuels Data Center: Semi Service Outfits Replica Batmobile to

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Run on Natural Gas Semi Service Outfits Replica Batmobile to Run on Natural Gas to someone by E -mail Share Alternative Fuels Data Center: Semi Service Outfits Replica Batmobile to Run on Natural Gas on Natural Gas on Twitter Bookmark Alternative Fuels Data Center: Semi Service Outfits Replica

History of the National Weather Service - Public Affairs - NOAA's National

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enter or select the go button to submit request City, St Go About NWS -Mission -Strategic Plan -History and local government web resources and services. Home >> History History of the National Weather Service The National Weather Service has its beginnings in the early history of the United States. Weather

European Mobile Satellite Services (EMSS): A regional system for Europe

NASA Technical Reports Server (NTRS)

Loisy, C.; Edin, P.; Benedicto, F. J.

1995-01-01

The European Space Agency is presently procuring two L-band payloads in order to promote a regional system for the provision of European Mobile Satellite Services (EMSS). These are the EMS payload on the Italsat I-F2 satellite and the LLM payload on the ARTEMIS satellite. Telecommunication system studies have been concentrating on mobile applications where full European geographical coverage is required. Potential applications include high priority Private Mobile Radio networks requiring national or European coverage, such as civil security, fire brigades, police and health services, as well as a dedicated system for provision of Air Traffic Services to the civil aviation community. A typical application is an intelligent road traffic management system combining a geographically selective traffic data collection service based on probe vehicles with a geographically selective traffic information broadcast service. Network architectures and bearer services have been developed both for data only and voice/data services. Vehicle mounted mobile transceivers using CDMA access techniques have been developed. The EMSS operational phase will start with the EMS payload in orbit in 1996 and continue with the LLM payload in 1997.

About | DOE Data Explorer

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skip to main content DDE Toggle Navigation Home About DDE FAQs DOE Data ID Service Data ID Service Data ID Service Workshops Contact Us dataexplorer Search For Terms: + Advanced Search × Advanced /Simulations Figures/Plots Genome/Genetics Data Interactive Data Map(s) Multimedia Numeric Data Specialized Mix

Ocean Drilling Program: Drilling Services

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Drilling operations team Material services team Development engineering team ODP/TAMU Science Operator Home Services department consists of three team-oriented project groups, which also work to improve the existing team. A member of this team sails with each cruise to provide expertise for the shipboard scientific

Pre-flight risk assessment in emergency medical service (EMS) helicopters

NASA Technical Reports Server (NTRS)

Shively, Robert J.

1990-01-01

A preflight risk assessment system (SAFE) was developed at NASA-Ames Research Center for civil EMS operations to assist pilots in making a decision objectively to accept or decline a mission. The ability of the SAFE system to predict risk profiles was examined at an EMS operator. Results of this field study showed that the usefulness of SAFE was largely dependent on the type of mission flown.

Statewide Suicide Prevention Council

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Alaska Pioneer Homes Behavioral Health Office of Children's Services Office of the Commissioner Office of Substance Misuse and Addiction Prevention Finance & Management Services Health Care Services Juvenile Justice Public Assistance Public Health Seniors & Disabilities Services Boards, Councils &

The Official Web Site of The United States Navy Judge Advocate General's

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with the very best in legal services: Legal Services Tax Information Claims » Admiralty Claims VWAP to Service, Committed to Excellence framework Home | About Us | News | Careers | Legal Services

DOLWD Division of Employment and Training Services

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State Employees Division of Employment and Training Services Search Labor & Workforce Development ; Department of Labor & Workforce Development > Employment And Training Services > Home Ed Flanagan , Director Mission Statement Provide labor exchange, employment and training services, and unemployment

Advisory Board on Alcoholism and Drug Abuse

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Agencies Alaska Pioneer Homes Behavioral Health Office of Children's Services Office of the Commissioner Office of Substance Misuse and Addiction Prevention Finance & Management Services Health Care Services Juvenile Justice Public Assistance Public Health Seniors & Disabilities Services Boards

What is Medicaid?

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State Employees Health Care Services DHSS State of Alaska Home Divisions and Agencies Alaska Pioneer Homes Behavioral Health Office of Children's Services Office of the Commissioner Office of Substance Misuse and Addiction Prevention Finance & Management Services Health Care Services Juvenile Justice

Denali KidCare

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State Employees Health Care Services DHSS State of Alaska Home Divisions and Agencies Alaska Pioneer Homes Behavioral Health Office of Children's Services Office of the Commissioner Office of Substance Misuse and Addiction Prevention Finance & Management Services Health Care Services Juvenile Justice

NWS Marine, Tropical, and Tsunami Services Branch Feedback

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Service NWS logo - Click to go to the NWS homepage Marine Forecasts Marine Forecasts Home News Organization Search Landlubber's forecast: "City, St" or zip code (Pan/Zoom for Marine) Search by Office Marine, Tropical, and Tsunami Services Branch Items of Interest Marine Forecasts Text, Graphic

Default Parallels Plesk Panel Page

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services that small businesses want and need. Our software includes key building blocks of cloud service virtualized servers Service Provider Products Parallels® Automation Hosting, SaaS, and cloud computing , the leading hosting automation software. You see this page because there is no Web site at this

Orion Service Module Umbilical (OSMU) Installation on Mobile Launcher (ML)

NASA Image and Video Library

2017-03-13

Cranes and rigging are being used to lift the bracket for the Orion Service Module Umbilical (OSMU) up for installation on the mobile launcher tower. The tower will be equipped with a number of lines, called umbilicals, that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. EM-1 is scheduled to launch in 2018. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Orion Service Module Umbilical (OSMU) Lift & Preparation for Ins

NASA Image and Video Library

2017-03-13

Preparations are underway to lift the bracket for the Orion Service Module Umbilical (OSMU) up for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals, that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. EM-1 is scheduled to launch in 2018. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Orion Service Module Umbilical (OSMU) Installation

NASA Image and Video Library

2017-03-16

A crane and rigging are used to lift the Orion Service Module Umbilical (OSMU) up for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals, that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. EM-1 is scheduled to launch in 2018. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Orion Service Module Umbilical (OSMU) Installation

NASA Image and Video Library

2017-03-16

Preparations are underway to lift the Orion Service Module Umbilical (OSMU) up for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals, that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. EM-1 is scheduled to launch in 2018. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Orion Service Module Umbilical (OSMU) Installation

NASA Image and Video Library

2017-03-16

Seeming to hang in midair, the Orion Service Module Umbilical (OSMU) is lifted high up by crane for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals, that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. EM-1 is scheduled to launch in 2018. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Orion Service Module Umbilical (OSMU) Installation

NASA Image and Video Library

2017-03-16

A crane and rigging are used to position the Orion Service Module Umbilical (OSMU) for installation high up on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals, that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. EM-1 is scheduled to launch in 2018. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Orion Service Module Umbilical (OSMU) Lift & Preparation for Ins

NASA Image and Video Library

2017-03-13

A crane positions the bracket for the Orion Service Module Umbilical (OSMU) for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals, that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. EM-1 is scheduled to launch in 2018. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Orion Service Module Umbilical (OSMU) Installation

NASA Image and Video Library

2017-03-16

A crane and rigging are used to lift the Orion Service Module Umbilical (OSMU) high up for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals, that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. EM-1 is scheduled to launch in 2018. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Orion Service Module Umbilical (OSMU) Lift & Preparation for Ins

NASA Image and Video Library

2017-03-13

A crane lifts the bracket for the Orion Service Module Umbilical (OSMU) high up for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals, that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. EM-1 is scheduled to launch in 2018. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

A-Z Directory | The University of Virginia

Science.gov Websites

/cardiovascular-medicine/ Cardiovascular Nutrition (Diet and Cardiovascular Disease) http Medicine) https://med.virginia.edu/ Clinical Nutrition Services https://uvahealth.com/services/nutrition ... Nuclear Medicine, Division of https://med.virginia.edu/radiology/ Nutrition Services (Department of

LMSS - From low data rate to voice services

NASA Astrophysics Data System (ADS)

Rogard, R.

1992-03-01

An overview of ESA's approach towards the introduction of Land Mobile Communications in Europe is presented. Emphasis is placed on a description of the payload called EMS to be launched on a host satellite, the Italsat-F2 spacecraft, and the definition of services which are most appropriate for a first-generation-operating Land Mobile Satellite System, namely, PRODAT, a message-handling system, and Europhone, an original approach to 'voice' systems. Attention is given to the EMS payload, characteristics, and capacity, the IF processor and channelization, and market considerations. It is shown that the optimization of the satellite characteristics and the mix of services to be provided are the key elements of a successful entry into the market.

Governor's Council on Disabilities and Special Education

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Divisions and Agencies Alaska Pioneer Homes Behavioral Health Office of Children's Services Office of the Commissioner Office of Substance Misuse and Addiction Prevention Finance & Management Services Health Care Services Juvenile Justice Public Assistance Public Health Seniors & Disabilities Services Boards

Science Projects | Akron-Summit County Public Library

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Resources Suggest a Purchase Hours & Locations Main Library Mobile Services Ellet Fairlawn-Bath Training Print/Scan/Fax/Copy Assistive Services Borrower Services Library Computers Meeting Rooms Mobile ; Notable Student Resources Suggest a Purchase Hours & Locations Main Library Mobile Services Ellet

A DDS-Based Energy Management Framework for Small Microgrid Operation and Control

DOE PAGES

Youssef, Tarek A.; El Hariri, Mohamad; Elsayed, Ahmed T.; ...

2017-09-26

The smart grid is seen as a power system with realtime communication and control capabilities between the consumer and the utility. This modern platform facilitates the optimization in energy usage based on several factors including environmental, price preferences, and system technical issues. In this paper a real-time energy management system (EMS) for microgrids or nanogrids was developed. The developed system involves an online optimization scheme to adapt its parameters based on previous, current, and forecasted future system states. The communication requirements for all EMS modules were analyzed and are all integrated over a data distribution service (DDS) Ethernet network withmore » appropriate quality of service (QoS) profiles. In conclusion, the developed EMS was emulated with actual residential energy consumption and irradiance data from Miami, Florida and proved its effectiveness in reducing consumers’ bills and achieving flat peak load profiles.« less

NOAA Photo Library - Historical National Weather Service Collection

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weather and climate services to our nation. We hope you enjoy these snapshots of the heritage of the Collections page. Takes you to the search page. Takes you to the Links page. collage banner showing clouds with images of scientific accomplishment, technological innovation and community service. The photos in

Air Force Medical Service > Resources > Suicide Prevention

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Air Force Medical Service Air Force Medical Service Join the Air Force Home Your Healthcare Healthy Videos MHS Genesis AFMS Priorities Trusted Care Vision Air Force Medical Home Full Spectrum Medical ) Air Force EFMP Who is an EFM? Who must enroll? EFMP-Medical EFMP-M Objectives Family Criteria EFMP-M

Public Affairs & Strategic Communications (NGB-PA) - Personal Staff - Joint

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Guard ARNG Media ARNG Public Affairs Family Services Youth Programs Survivor Services Military Funeral General Officer Management Public Affairs Executive Support Services Legislative Liaison Special Staff : Personal Staff : Public Affairs Public Affairs & Strategic Communications (NGB-PA) Mission: Assess

Boverhof's App Earns Honorable Mention in Amazon's Web Services

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» Boverhof's App Earns Honorable Mention in Amazon's Web Services Competition News & Publications News Publications Facebook Google+ Twitter Boverhof's App Earns Honorable Mention in Amazon's Web Services by Amazon Web Services (AWS). Amazon officially announced the winners of its EC2 Spotathon on Monday

Tougher Service Members from the Start

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information so we can address your issue or question. Tougher Service Members From The Start By Jim Garamone American Forces Press Service WASHINGTON -- "Tough" is a subjective word. What's tough for one basic training is, "Without challenge, there is no achievement." The achievement the services

GREAT LAKES FAX-BACK SERVICE

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available to ships participating in the Voluntary Observing Ships (VOS) program. To register as a Fax-Back Tsunamis 406 EPIRB's National Weather Service Marine Forecasts GREAT LAKES FAX-BACK SERVICE Marine Forecast months. Did you know your body can cool 25 times faster in water than in air? That water does not need to

Social Media Sites

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Training Center Advanced Distributed Learning Service (ADLS) AETC/PACE AF Band of the West AF Civil (Videos) DoD Terms Of Service Agreements GSA Terms Of Service Agreements Air Force Web Posting Assessment 127th Wing 128th Air Refueling Wing 129th Rescue Wing 129th Rescue Wing ANG 12th Flying Training Wing

Comparative analysis of three prehospital emergency medical services organizations in India and Pakistan.

PubMed

Sriram, V; Gururaj, G; Razzak, J A; Naseer, R; Hyder, A A

2016-08-01

Strengthened emergency medical services (EMS) are urgently required in South Asia to reduce needless death and disability. Several EMS models have been introduced in India and Pakistan, and research on these models can facilitate improvements to EMS in the region. Our objective was to conduct a cross-case comparative analysis of three EMS organizations in India and Pakistan - GVK EMRI, Aman Foundation and Rescue 1122 - in order to draw out similarities and differences in their models. Case study methodology was used to systematically explore the organizational models of GVK EMRI (Karnataka, India), Aman Foundation (Karachi, Pakistan), and Rescue 1122 (Punjab, Pakistan). Qualitative methods - interviews, document review and non-participant observation - were utilized, and using a process of constant comparison, data were analysed across cases according to the WHO health system 'building blocks'. Emergent themes under each health system 'building block' of service delivery, health workforce, medical products and technology, health information systems, leadership and governance, and financing were described. Cross-cutting issues not applicable to any single building block were further identified. This cross-case comparison, the first of its kind in low- and middle-income countries, highlights key innovations and lessons, and areas of further research across EMS organizations in India, Pakistan and other resource-poor settings. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Ocean Drilling Program: TAMRF Administrative Services: Meeting, Travel, and

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Port-Call Information ODP/TAMU Science Operator Home Mirror sites ODP/TAMU staff Cruise information Science and curation services Publication services and products Drilling services and tools Online ODP Meeting, Travel, and Port-Call Information All ODP meeting and port-call activities are complete

Alternative Fuels Data Center: Hydraulic Hybrid Pressed into Service in

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Refuse Collection Hydraulic Hybrid Pressed into Service in Refuse Collection to someone by E -mail Share Alternative Fuels Data Center: Hydraulic Hybrid Pressed into Service in Refuse Collection on Facebook Tweet about Alternative Fuels Data Center: Hydraulic Hybrid Pressed into Service in Refuse

Project #8, Task 1 - Travel Information Services (TIS), Inventory Of Traveler Information Services And Commercial Opportunities In The I-95 Corridor

DOT National Transportation Integrated Search

1995-12-01

CONTINUED FROM DOCUMENT NUMBER 6303 : RESEARCH AND DEVELOPMENT OR R&D, ELECTRONIC PAYMENT SYSTEMS, AUTOMATED FARE COLLECTION, EMERGENCY MANAGEMENT SERVICES OR EMS, FREEWAY MANAGEMENT SYSTEMS, INCIDENT MANAGEMENT/INCIDENT DETECTION : THE L-95 CORRI...

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.

Weekly Surveillance Reports - MeCDC; DHHS Maine

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Division of the Maine Department of Health and Human Services Contact EPI | News | Online services | Publications | Subject index Search EPI Search Maine CDC Home Health Topics A-Z Data/Reports For Health Care Curricula Train the Trainer School Health Videos Information for Laboratories 211 logo Social Services Help

CPC - Monitoring & Data: Pacific Island Climate Data

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Weather Service NWS logo - Click to go to the NWS home page Climate Prediction Center Home Site Map News Web resources and services. HOME > Monitoring and Data > Pacific Islands Climate Data & Maps island stations. NOAA/ National Weather Service NOAA Center for Weather and Climate Prediction Climate

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.

Orion Service Module Umbilical (OSMU) Lift & Preparation for Ins

NASA Image and Video Library

2017-03-13

Crane specialists monitor the progress as the bracket for the Orion Service Module Umbilical (OSMU) is lifted up for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals, that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. EM-1 is scheduled to launch in 2018. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Orion Service Module Umbilical (OSMU) Installation

NASA Image and Video Library

2017-03-16

Construction workers assist as a crane and rigging are used to position the Orion Service Module Umbilical (OSMU) for installation high up on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals, that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. EM-1 is scheduled to launch in 2018. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Orion Service Module Umbilical (OSMU) Lift & Preparation for Ins

NASA Image and Video Library

2017-03-13

A view from below the mobile launcher shows a crane positioning the bracket for the Orion Service Module Umbilical (OSMU) high up for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals, that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. EM-1 is scheduled to launch in 2018. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Orion Service Module Umbilical (OSMU) Lift & Preparation for Ins

NASA Image and Video Library

2017-03-13

Crane specialists monitor the progress as the bracket for the Orion Service Module Umbilical (OSMU) is lifted high up for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals, that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. EM-1 is scheduled to launch in 2018. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Orion Service Module Umbilical (OSMU) Lift & Preparation for Ins

NASA Image and Video Library

2017-03-13

In this view looking down from high up on the mobile launcher, a crane positions the bracket for the Orion Service Module Umbilical (OSMU) for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals, that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. EM-1 is scheduled to launch in 2018. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

[Management of chemical burns and inhalation poisonings in acute medical care procedures of the State Fire Service].

PubMed

Chomoncik, Mariusz; Nitecki, Jacek; Ogonowska, Dorota; Cisoń-Apanasewicz, Urszula; Potok, Halina

2013-01-01

Emergency Medical Services (EMS) were founded by the government to perform tasks aimed at providing people with help in life-threatening conditions. The system comprises two constituent parts. The first one is public administrative bodies which are to organise, plan, coordinate and supervise the completion of the tasks. The other constituent is EMS units which keep people, resources and units in readiness. Supportive services, which include: the State Fire Service (SFS) and the National Firefighting and Rescue System (NFRS), are of great importance for EMS because they are eligible for providing acute medical care (professional first aid). Acute medical care covers actions performed by rescue workers to help people in life-threatening conditions. Rescue workers provide acute medical care in situations when EMS are not present on the spot and the injured party can be accessed only with the use of professional equipment by trained workers of NFRS. Whenever necessary, workers of supportive services can assist paramedics' actions. Cooperation of all units of EMS and NFRS is very important for rescue operations in the integrated rescue system. Time is a key aspect in delivering first aid to a person in life-threatening conditions. Fast and efficient first aid given by the accident's witness, as well as acute medical care performed by a rescue worker can prevent death and minimise negative effects of an injury or intoxication. It is essential that people delivering first aid and acute medical care should act according to acknowledged and standardised procedures because only in this way can the process of decision making be sped up and consequently, the number of possible complications following accidents decreased. The present paper presents an analysis of legal regulations concerning the management of chemical burn and inhalant intoxication in acute medical care procedures of the State Fire Service. It was observed that the procedures for rescue workers entitled to provide acute medical care should be correlated with the procedures for emergency medical teams.

Batavia Boy Scouts | News

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Financial Officer Finance Section Office of the Chief Operating Officer Facilities Engineering Services Accelerator Division Accelerator Physics Center Office of the Chief Safety Officer Environment, Safety, Health and Quality Section Office of the Chief Project Officer Office of Project Support Services Office of

Availability and use of emergency obstetric care services in public hospitals in Laos PDR: a systems analysis.

PubMed

Douangphachanh, Xaysomphou; Ali, Moazzam; Outavong, Phathammavong; Alongkon, Phengsavanh; Sing, Menorath; Chushi, Kuroiwa

2010-12-01

The maternal mortality ratio in Laos in 2005 was 660 per 100,000 lives birth which was the third highest in Asia-Pacific Region. The objective was to determine the availability and use of emergency obstetric care (EmOC) in provincial and district hospitals in Borikhamxay, Khammouane, and Savannakhet provinces using UN guidelines. A hospital-based cross sectional survey was conducted from January to March 2008. All district (30) and provincial hospitals (3) from three provinces were included. Analysis was based on hospital records reflecting 12 months of facility data. Data indicates that only 14 hospitals (42.4%) were providing EmOC services, i.e., 9 basic, 5 comprehensive services. The proportion of births in EmOC facilities was only 11.2%, the met need was a very low 14.5%, and the cesarean section rate was only 0.9%. The case fatality rate in Borikhanxay province was 2.8%; in Khammouane and in Savannakhet provinces it was less than 1%. Record keeping at hospitals was poor. Signal functions provided in the last three months showed only 48.5% of the facilities performed assisted vaginal delivery. This is the first study in Lao PDR to assess EmOC services. Almost all the indicators were below the UN recommendations. Health planners must take evidence-based decisions to rectify and improve the situation in the hospitals regarding EmOC services. These data can therefore help government to assign and allocate budgets appropriately, and help policymakers and planners to identify systemic bottlenecks and prioritize solutions and will help in improving maternal health.

Division of Public Health

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Alaska Mental Health Board

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State Employees Alaska Mental Health Board DHSS State of Alaska Home Divisions and Agencies Alaska Pioneer Homes Behavioral Health Office of Children's Services Office of the Commissioner Office of Substance Misuse and Addiction Prevention Finance & Management Services Health Care Services Juvenile

OPC Mobile Website

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NOAA logo NWS logo National Weather Service Ocean Prediction Center View full site Atlantic Data This information is provided as a public service from: Ocean Prediction Center National Centers for Environmental Prediction National Weather Service National Oceanic and Atmospheric Administration Department of

Sandia National Laboratories, California Environmental Management System program manual.

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

Larsen, Barbara L.

2012-03-01

The Sandia National Laboratories, California (SNL/CA) Environmental Management System (EMS) Program Manual documents the elements of the site EMS Program. The SNL/CA EMS Program conforms to the International Standard on Environmental Management Systems, ISO 14001:2004and Department of Energy (DOE) Order 436.1. Sandia National Laboratories, California (SNL/CA) has maintained functional environmental programs to assist with regulatory compliance for more than 30 years. During 2005, these existing programs were rolled into a formal environmental management system (EMS) that expands beyond the traditional compliance focus to managing and improving environmental performance and stewardship practices for all site activities. An EMS is a setmore » of inter-related elements that represent a continuing cycle of planning, implementing, evaluating, and improving processes and actions undertaken to achieve environmental policy and goals. The SNL/CA EMS Program conforms to the International Standard for Environmental Management Systems, ISO 14001:2004 (ISO 2004). The site first received ISO 14001 certification in September 2006 and recertification in 2009. SNL/CA's EMS Program is applicable to the Sandia, Livermore site only. Although SNL/CA operates as one organizational division of the overall Sandia National Laboratories, the EMS Program is site-specific, with site-specific objectives and targets. SNL/CA (Division 8000) benefits from the organizational structure as it provides corporate level policies, procedures, and standards, and established processes that connect to and support elements of the SNL/CA EMS Program. Additionally, SNL/CA's EMS Program benefits from two corporate functional programs (Facilities Energy and Water Resource Management and Fleet Services programs) that maintain responsibility for energy management and fleet services for all Sandia locations. Each EMS element is further enhanced with site-specific processes and standards. Division 8000 has several groups operating at Sandia National Laboratories, New Mexico (SNL/NM). Although these groups, from an organizational perspective, are part of Division 8000, they are managed locally and fall under the environmental requirements specific to their New Mexico location. The New Mexico groups in Division 8000 follow the corporate EMS Program for New Mexico operations.« less

Health Analytics and Vital Records

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Division of Behavioral Health: FAQ

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CIDR

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

PubMed

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

2017-12-01

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

ACHP | News

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Search skip specific nav links Home arrow News Internal Revenue Service Wins Chairman's Award for Federal Redstone Castle WASHINGTON, DC-The Internal Revenue Service (IRS) received the Advisory Council on Historic

Buy or sell used musical instruments | News

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David Toback re-elected CDF co-spokesperson | News

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Financial Officer Finance Section Office of the Chief Operating Officer Facilities Engineering Services Accelerator Division Accelerator Physics Center Office of the Chief Safety Officer Environment, Safety, Health and Quality Section Office of the Chief Project Officer Office of Project Support Services Office of

Incidence, source, and nature of complaints received in a large, urban emergency medical services system.

PubMed

Curka, P A; Pepe, P E; Zachariah, B S; Gray, G D; Matsumoto, C

1995-06-01

To document the incidence, source, and reasons for all complaints received by a large municipal emergency medical services (EMS) program. A retrospective review of all complaints received during three consecutive years (1990-1992) in a centralized EMS system serving a large municipality (population 2 million). All cases were categorized by year, source, and nature of the complaint. In the three study years, EMS responded to 416,892 incidents with nearly a half-million patient contacts. Concurrently, 371 complaints were received (incidence of 1.12 per thousand); 132 in 1990, 129 in 1991, and 110 in 1992. Most complaints involved either: 1) allegations of "rude or unprofessional conduct" (34%), 2) "didn't take patient to the hospital" (19%), or 3) "problems with medical treatment" (13%). Only 1.6% (n = 6) were response-time complaints. Other complaints included "lost/damaged property," "taken to the wrong hospital," "inappropriate billing," and "poor driving habits." The most common sources were patient's families (39%) and the patients themselves (30%). Only 7.8% were from health care providers. Reviews of complaints provide information regarding EMS system performance and reveal targets for quality improvement. For the EMS system examined, this study suggests a future training focus on interpersonal skills and heightened sensitivities, not only toward patients, but also toward bystanders and family members.

Media Contacts - Public Affairs - NOAA's National Weather Service

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Service Headquarters - Silver Spring, Md. Eastern Region - Bohemia N.Y. Main phone number, (301) 713-0622 National Weather Service 1325 East-West Highway Silver Spring, MD 20910 Page Author: NWS Internet Services

NOAA releases final report of Sandy service assessment

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released a report on the National Weather Service's performance during hurricane/post tropical cyclone Sandy. The report, Hurricane/Post Tropical Cyclone Sandy Service Assessment, reaffirms that the National warnings for dangerous storms like Sandy, even when they are expected to become post-tropical cyclones by

Demonstration of Essential Reliability Services by Utility-Scale Solar

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Essential Reliability Services by Utility-Scale Solar Photovoltaic Power Plant: Q&A Demonstration of Essential Reliability Services by Utility-Scale Solar Photovoltaic Power Plant: Q&A Webinar Questions & Answers April 27, 2017 Is photovoltaic (PV) generation required to provide grid supportive

HSD products

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OAS - Organization of American States: Democracy for peace, security, and

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Information Offices in the Member States Our History Logo Authorities Services Legal Protocol Topics A Access Knowledge-based Society L Labor Legal Services M MACCIH MAPP Migration Multidimensional Security O Estate Strategy Financial Reports Annual Operating Plan Legal Services Ombudsperson Strategic Plan

Command Home Page

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Home Naval Special Warfare Home Subscribe to Navy News Service Search Navy.mil Advanced Search Home coordinator, explains details of the Montgomery G.I. Bill for active-duty service members to Naval Special fees, yearly books and supplies, and a monthly housing allowance to qualified service members. U.S

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From Nigel Lockyer: Five things you should know | News

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MicroBooNE project team recognized by Department of Energy | News

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Washington VAAC Redirect Page

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Project #8, Task 2 - Travel Information Services (TIS), Definition Of Goals For The I-95 Corridor

DOT National Transportation Integrated Search

1995-01-23

CONTINUED FROM DOCUMENT NUMBER 6303 : RESEARCH AND DEVELOPMENT OR R&D, ELECTRONIC PAYMENT SYSTEMS, AUTOMATED FARE COLLECTION, EMERGENCY MANAGEMENT SERVICES OR EMS, FREEWAY MANAGEMENT SYSTEMS, INCIDENT MANAGEMENT/INCIDENT DETECTION : THE L-95 CORRI...

PRIVATE WEATHER SERVICES PROVIDERS

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Office Marine, Tropical, and Tsunami Services Branch Items of Interest Marine Forecasts Text, Graphic , Marine, Tropical, and Tsunami Services Branch, Items of Interest, Forecasts, Observations, Portals

Defense.gov Special Report: National Disability Employment Awareness Month

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service at the U.S. Army Corps of Engineers, DeLisa L. Kviz currently works as chief ... Profile photo of of service with the Department of the Navy, including over 11 years ... Profile photo of Ivan E is a technical information specialist in the Analysis and ... Profile photo of Chad A. Molenhour

Senior Enlisted Advisor to the CNGB - The National Guard

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, Army Good Conduct Medal, Army Service Ribbon, National Defense Service Ribbon, Armed Forces Reserve ARNG Command Sergeant Major of the ARNG State Mission Sustainability Training ARNG Distributed Learning Program Training & Technology Battle Lab (T3BL) Civil Support Simulation Exercises Regional Training

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

PubMed

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

2016-01-01

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

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

PubMed Central

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

2016-01-01

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

Home | UMass Amherst

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Current Students International Faculty and Staff Continuing Education Alumni Popular Now Photos and Amherst Rising Researchers 2018 Stepping Up to the Challenge UMass Amherst undergraduate students tackle American play UMass students train service dogs UMass students train service dogs Diggity Dogs UMass

National Weather Service

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Forecast and Warning Services of the National Weather Service Introduction Quantitative precipitation future which is an active area of research currently. 2) Evaluate HPN performance for forecast periods

Orion Service Module Umbilical (OSMU) Lift & Preparation for Ins

NASA Image and Video Library

2017-03-13

Construction workers and crane specialists high up on the mobile launcher tower monitor the progress as a crane positions the bracket for the Orion Service Module Umbilical (OSMU) for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The tower will be equipped with a number of lines, called umbilicals, that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. EM-1 is scheduled to launch in 2018. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

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 decontamination units should be available in all hospital districts. Jama TJ , Kuisma MJ . Preparedness of Finnish Emergency Medical Services for chemical emergencies. Prehosp Disaster Med. 2016;31(4):392-396.

Alternative Fuels Data Center

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-4730 U.S. Internal Revenue Service Phone: (800) 829-1040 Federal Trade Commission Phone: (202) 326-2222 Excise Tax Branch U.S. Internal Revenue Service Office of Chief Counsel Phone: (202) 317-6855 U.S

Challenges to effective crisis management: using information and communication technologies to coordinate emergency medical services and emergency department teams.

PubMed

Reddy, Madhu C; Paul, Sharoda A; Abraham, Joanna; McNeese, Michael; DeFlitch, Christopher; Yen, John

2009-04-01

The purpose of this study is to identify the major challenges to coordination between emergency department (ED) teams and emergency medical services (EMS) teams. We conducted a series of focus groups involving both ED and EMS team members using a crisis scenario as the basis of the focus group discussion. We also collected organizational workflow data. We identified three major challenges to coordination between ED and EMS teams including ineffectiveness of current information and communication technologies, lack of common ground, and breakdowns in information flow. The three challenges highlight the importance of designing systems from socio-technical perspective. In particular, these inter-team coordination systems must support socio-technical issues such as awareness, context, and workflow between the two teams.

Washington Headquarters Services

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Status OPM Status: Open Open Main Navigation Home Our Services Our Customers Our People Our Leaders Our Organization Contact Us CAC Site Navigation Customers Employees Our Services Our Customers Our People Our facilities in the Washington, DC area. Read more about Our Customers Our People A picture with the left edge

After 10 years of service, NOAA retires GOES-12 satellite

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Destinations After 10 years of service, NOAA retires GOES-12 satellite Progress continuing toward launch of next-generation GOES-R satellite August 19, 2013 GOES-12 captured this visible image of Hurricane 10 years of stellar service, NOAA's Geostationary Operational Environmental Satellite (GOES)-12

Alternative Fuels Data Center: Republic Services Reduces Waste with 87 CNG

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operating on CNG within the next five years. " Rachele Klein, Republic Services Business Development maintenance facilities. Baird and Republic Services teamed up to research and select vehicle manufacturers and operating on CNG within the next five years," Klein said. "The model that stemmed from this

ERDDAP - RESTful Web Services

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, graphs, or information about datasets). A RESTful web service (external link) - a URL that computer to get the same information in a more computer-program-friendly format like JSON (external link .jsonlKVP, where column names are on every row): Each column has a column name and one type of information

A priority dispatch system for emergency medical services.

PubMed

Slovis, C M; Carruth, T B; Seitz, W J; Thomas, C M; Elsea, W R

1985-11-01

A decision tree priority dispatch system for emergency medical services (EMS) was developed and implemented in Atlanta and Fulton County, Georgia. The dispatch system shortened the average response time from 14.2 minutes to 10.4 minutes for the 30% of patients deemed most urgent (P less than or equal to .05); resulted in a significant increase in the use of advanced life support units for this group (P less than or equal to .02); decreased the number of calls that required a backup ambulance service; and significantly increased conformity to national EMS response time standards for critically ill and injured patients (P less than or equal to .0009). Due to dispatch error, 0.3% of calls were dispatched as least severe but subsequently were found to be most urgent.

Alternative Fuels Data Center

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an individual, locality, public institution of higher education, or the Virginia Department of Conservation and Recreation, who is not a public utility, public service corporation, or public service company public utility. The Virginia State Corporation Commission may not set the rates, charges, or fees for

National Centers for Environmental Prediction

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. Government's official Web portal to all Federal, state and local government Web resources and services. MISSION Web Page [scroll down to "Verification" Section] HRRR Verification at NOAA ESRL HRRR Web Verification Web Page NOAA / National Weather Service National Centers for Environmental Prediction

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interoperability emerging infrastructure for data management on computational grids Software Packages Services : ATLAS: Management and Steering: Computing Management Board Software Project Management Board Database Model Group Computing TDR: 4.5 Event Data 4.8 Database and Data Management Services 6.3.4 Production and

Defense.gov Special Report: National Native American Heritage Month -

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non-combat situation), Bronze Star - Operation DESERT STORM Campaign, Defense Meritorious Service Medal - Operation IRAQI FREEDOM, Defense Meritorious Service Medal - Operation ENDURING FREEDOM, and Campaign Medals - Operation IRAQI FREEDOM / Operation ENDURING FREEDOM. Maj. Maureen A. Trujillo U.S. Air

Small Community Training & Education

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training and adult education professionals. • National Technical Information Service (NTIS) This U.S residents of New Jersey and beyond through education and public service. • Operator Training Committee of Water Wastewater Training Security Conservation & Water Efficiency Water for All Americans Water We

NWS Water Resource Services Branch Division

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and Service Reports Waterloo, Iowa Stakeholder Report August 10, 2017 Greenville, North Carolina Stakeholder Report June 21, 2017 Maricopa County, Arizona Stakeholder Report April 19, 2017 Austin, Texas Stakeholder Report February 8, 2017 Final Russian River Basin Partner Report, January 2016 Flash Flood

Climate Prediction Center - Outlooks

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Weather Service NWS logo - Click to go to the NWS home page Climate Prediction Center Home Site Map News Web resources and services. Climate Diagnostics Bulletin Climate Diagnostics Bulletin - Home Climate Diagnostics Bulletin - Tropics Climate Diagnostics Bulletin - Extratropics About the Forecast Forum ENSO

Operation Protective Edge - A Unique Challenge for a Civilian EMS Agency.

PubMed

Jaffe, Eli; Strugo, Refael; Wacht, Oren

2015-10-01

During July through August 2014, Operation Protective Edge, a military conflict between Israel and the Hamas regime in Gaza, dramatically affected both populations. Magen David Adom (MDA), the Israeli national Emergency Medical Service (EMS) and a member of the Red Cross, faced a unique challenge during the conflict: to continue providing crucial service to the entire civilian population of Israel, which was under constant missile threat. This challenge included not only providing immediate care for routine EMS calls under missile threat, but also preparing and delivering immediate care to civilians injured in attacks on major cities, as well as small communities, in Israel. This task is a challenge for a civilian EMS agency that normally operates in a non-military environment, yet, in an instant, must enhance its capability to respond to a considerable threat to its population. During Operation Protective Edge, MDA provided care for 842 wounded civilians and utilized a significant amount of its resources. Providing EMS services for a civilian population in a mixed civilian/military scenario is a challenging task on a national level for an EMS system, especially when the threat lasts for weeks. This report describes MDA's preparedness and operations during Operation Protective Edge, and the unique EMS challenges and dilemmas the agency faced.

Defense.gov Special Report: Civilian Expeditionary Workforce

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TRAINING CENTER, Ind., March 10, 2011 - Civilian Expeditionary Workforce members provide a vital service to Training Center, Ind., and nearby Camp Atterbury, strive for realism to prepare civilians for service in undergo rigorous training on Muscatatuck Urban Training Center and Camp Atterbury, Ind., where they learn

Purchasing, Division of General Services, Department of Administration,

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State of Alaska Skip to main content State of Alaska alaska.gov myAlaska My Government Resident Business in Alaska Visiting Alaska State Employees State of Alaska, Department of Administration, Division Search General Services State of Alaska State of Alaska > Departments > Administration > General

European Service Module Structural Test Article Load onto Guppy for Transport to Denver Colorado

NASA Image and Video Library

2017-06-23

At Kennedy Space Center's Shuttle Landing Facility in Florida, workers move the Orion service module structural test article for Exploration Mission-1 (EM-1), built by the European Space Agency, inside NASA's Super Guppy aircraft. The module is secured inside the aircraft and shipped to Lockheed Martin's Denver facility to undergo testing. The Orion spacecraft will launch atop the agency's Space Launch System rocket on EM-1 in 2019

United States Southern Command * Home

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know how we are doing through Interactive Customer Evaluation (ICE) Passports & Visas Mission ] Customer Service Hours Monday - Friday 08:00 a.m. to 11:00 a.m and 2:30 p.m. to 4:00 pm. Passport and Visa endorsement or warranty of their respective services. We are committed to quality customer service. Let us

NREL to Receive Public Service Award for 40 Years of Energy Innovation |

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NREL | News | NREL to Receive Public Service Award for 40 Years of Energy Innovation News Release: NREL to Receive Public Service Award for 40 Years of Energy Innovation July 24, 2017 The U.S . Department of Energy's National Renewable Energy Laboratory (NREL) is again receiving national recognition

Home, Division of General Services, Department of Administration, State of

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Statistical Models... MOS Prod GFS-LAMP Prod Climate Past Weather Predictions Weather Safety Weather Radio National Weather Service on FaceBook NWS on Facebook NWS Director Home > Climate > Predictions Climate Prediction Long range forecasts across the U.S. Climate Prediction Web Sites Climate Prediction

Alcohol as a Factor in 911 Calls in Denver.

PubMed

Joseph, Daniel; Vogel, Jody A; Smith, C Sam; Barrett, Whitney; Bryskiewicz, Gary; Eberhardt, Aaron; Edwards, David; Rappaport, Lara; Colwell, Christopher B; McVaney, Kevin E

2018-02-08

Excessive alcohol consumption is associated with a substantial number of emergency department visits annually and is responsible for a significant number of lives lost each year in the United States. However, a minimal amount is known about the impact of alcohol on the EMS system. The primary objective was to determine the proportion of 9-1-1 calls in Denver, Colorado in which (1) alcohol was a contributing factor or (2) the individual receiving EMS services had recently ingested alcohol. The secondary objectives were to compare the characteristics of EMS calls and to estimate the associated costs. This was a prospective observational cohort study of EMS calls for adults from July 1, 2012, to June 30, 2014. Primary outcomes for the study were alcohol as a contributing factor to the EMS call and recent alcohol consumption by the patient receiving EMS services. Logistic regression was utilized to determine the associations between EMS call characteristics and the outcomes. Cost was estimated using historic data. During the study period, 169,642 EMS calls were completed by the Denver Health Paramedic Division. Of these 71% were medical and 29% were trauma-related. The median age was 45 (interquartile range [IQR] 29-59) years, and 55% were male. 50,383 calls (30%) had alcohol consumption, and 49,165 (29%) had alcohol as a contributing factor. Alcohol related calls were associated with male sex, traumatic injuries including head trauma, emergent response, use of airway adjuncts, cardiac monitoring, glucose measurement, use of restraints, use of spinal precautions, and administration of medications for sedation. Estimated costs to the EMS system due to alcohol intoxication exceeded $14 million dollars over the study period and required in excess of 37 thousand hours of paramedic time. Compared to 9-1-1 calls that do not involve alcohol, alcohol-related calls are more likely to involve male patients, emergent response, traumatic injuries, advanced monitoring, airway adjuncts, and medications for sedation. This represents a significant burden on the emergency system and society. Further studies are needed to evaluate whether additional interventions such as social services could be used to lessen this burden.

The Emergency Medical System in Greece: Opening Aeolus’ Bag of Winds

PubMed Central

Kotsiou, Ourania S.; Srivastava, David S.; Kotsios, Panagiotis; Exadaktylos, Aristomenis K.; Gourgoulianis, Konstantinos I.

2018-01-01

An Emergency Medical Service (EMS) system must encompass a spectrum of care, with dedicated pre-hospital and in-hospital medical facilities. It has to be organised in such a way as to include all necessary services—such as triage accurate initial assessment, prompt resuscitation, efficient management of emergency cases, and transport to definitive care. The global economic downturn has had a direct effect on the health sector and poses additional threats to the healthcare system. Greece is one of the hardest-hit countries. This manuscript aims to present the structure of the Greek EMS system and the impact of the current economic recession on it. Nowadays, primary care suffers major shortages in crucial equipment, unmet health needs, and ineffective central coordination. Patients are also facing economic limitations that lead to difficulties in using healthcare services. The multi-factorial problem of in-hospital EMS overcrowding is also evident and has been linked with potentially poorer clinical outcomes. Furthermore, the ongoing refugee crisis challenges the national EMS. Adoption of a triage scale, expansion of the primary care network, and an effective primary–hospital continuum of care are urgently needed in Greece to provide comprehensive, culturally competent, and high-quality health care. PMID:29652816

Rabies

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Coastal Warning Display Program

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! Boating Safety Beach Hazards Rip Currents Hypothermia Hurricanes Thunderstorms Lightning Coastal Flooding Tsunamis 406 EPIRB's National Weather Service Marine Forecasts COASTAL WARNING DISPLAY PROGRAM Marine COASTAL WARNING DISPLAY PROGRAM As of February 15, 1989, the National Weather Service retired its Coastal

The EmX Franklin Corridor BRT project evaluation : final report, April 2009.

DOT National Transportation Integrated Search

2009-04-01

Lane Transit District began BRT service on its Franklin Corridor EmX in January 14, 2007. The four mile long route connects downtown Eugene and downtown Springfield, the two main hubs for LTDs system. The corridor, which has the greatest ridership...

Defense.gov Special Report: Gates Bids Farewell to Troops

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service members and their families for their service. Gates will retire as secretary of defense on June 30 - Defense Secretary Robert M. Gates has served for four-and-a-half years -- longer than all but four of his of the Defense Department. He was focused almost exclusively on the war in Iraq. Story Gates' Bio

Beach Monitoring

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Public Swimming Pools

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State Agencies | Online Services Forms Rules Ohio Public Health Advisory Board (OPHAB) Draft Pending Final Referenced Material Local Health Depts Find My Local Health Department What Do LHDs Do ? About Us About ODH ODH Locations News Reports Online Services What is Public Health? Employment

NOAA honors New York farmer for 84 years of service as volunteer weather

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Print Facebook Google StumbleUpon Digg More Destinations NOAA honors New York farmer for 84 years of Weather Service, Herbert Hoover occupied the White House. Since then the Bridgehampton, New York, farmer decades, the new 80-year service award will be named in his honor. Richard G. Hendrickson looks out over

Alaska Office of Veterans Affairs - About Veterans Affairs

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Service Officers Healthcare Benefits Employment Benefits Education Benefits Real Estate Permits, Passes families improve their lives. From helping veterans to file claims for education, medical or other benefits find the benefits you are entitled to and assist you in claiming them. Our services, as well as the

Orion EM-1 Crew Module Adapter Move to Clean Room

NASA Image and Video Library

2016-11-29

Inside the Neil Armstrong Operations and Checkout Building high bay at NASA’s Kennedy Space Center in Florida, the Orion crew module adapter (CMA) for Exploration Mission 1 (EM-1) is being moved to a clean room. The CMA will undergo propellant and environmental control and life support system tube installation and welding. The adapter will connect the Orion crew module to the European Space Agency-provided service module. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission, in late 2018.

Orion EM-1 Crew Module Adapter Move to Clean Room

NASA Image and Video Library

2016-11-29

Inside the Neil Armstrong Operations and Checkout Building high bay at NASA’s Kennedy Space Center in Florida, Lockheed Martin technicians move the Orion crew module adapter (CMA) for Exploration Mission 1 (EM-1) into a clean room. The CMA will undergo propellant and environmental control and life support system tube installation and welding. The adapter will connect the Orion crew module to the European Space Agency-provided service module. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission, in late 2018.

Orion EM-1 Crew Module Adapter Move to Clean Room

NASA Image and Video Library

2016-11-29

Inside the Neil Armstrong Operations and Checkout Building high bay at NASA’s Kennedy Space Center in Florida, Lockheed Martin technicians move the Orion crew module adapter (CMA) for Exploration Mission 1 (EM-1) toward a clean room. The CMA will undergo propellant and environmental control and life support system tube installation and welding. The adapter will connect the Orion crew module to the European Space Agency-provided service module. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission, in late 2018.

Emerging organizational structures in the ambulance industry in the United States.

PubMed

Narad, R A

2000-01-01

This analysis seeks to identify emerging forms of organizations in emergency medical services (EMS) in the United States, to provide examples of them, to relate them to changes in healthcare generally, and to apply a classification scheme. Public policy issues related to these new forms of organizations and lessons from other areas of the healthcare system are identified. Recent changes in the healthcare system in the United States have been marked by modifications in the structure of organizations that provide and pay for health services. New forms of organizations and alliances among existing organizations have emerged in an effort to improve the efficiency of the services provided and to improve organizations' market positions. Reflecting increased competition within EMS and the demands of the changing health-care delivery system, several types of organizations have begun to emerge in EMS that resemble those occurring in health care generally. These include forms of horizontal integration, such as consolidated ambulance services and various models of ambulance service networks; and forms of vertical integration, such as demand management programs and public-private joint ventures. The ultimate end might be complete integration with a carve-out of all non-scheduled care. Although changes in EMS organizations result largely from marketplace decisions by sellers and purchasers, this does not mean that there is no public policy role. While new organizational forms may increase the ambulance industry's efficiency, public policy makers must be concerned about quality and access as well. Some policy responses will promote marketplace changes, others will accept them generally, but will seek to correct problems, and a third group will attempt to restrain the market.

Home - Pest Tracker - CAPS Services

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sponsored by the Plant Protection and Quarantine division of USDA Animal and Plant Inspection Services STOP EXOTIC PESTS outreach collection image Plant Native Species Stopping exotic invaders is a working with APHIS Plant Safety and Research staff members removed onionweed from their landscapes. In

Ohio Department of Health Home

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Immunization Program | Department of Public Health and Social Services

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Skip to main content logo Department of Public Health & Social Services Dipattamenton Salut of Public Health Division of Public Welfare Division of Environmental Health Division of Senior Recordings Health Inspection Database Healthy Vending Machine Calculator Photo Galleries Videos Medical

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Operation Atlantic Resolve

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Ukraine, Defense Secretary Ash Carter told service members aboard the USS San Antonio in Estonia. Story . Story U.S. Soldiers, Airmen Train With Latvian Service Members U.S. and Latvian troops conducted airborne training in Latvia while supporting Operation Atlantic Resolve, which focuses on joint training

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FISHERIES CHARTING SATELLITES CLIMATE RESEARCH CAREERS Satellite and Data Policy Developing Partnerships Satellite and Information Service International and Interagency Affairs Office NOAA Satellite and , NESDIS IIAD facilitates the access, provision, and use of in situ and satellite data and products, and

Orion Service Module Umbilical (OSMU) Testing Complete

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2016-10-19

Testing of the Orion Service Module Umbilical (OSMU) was completed at the Launch Equipment Test Facility at NASA’s Kennedy Space Center in Florida. The OSMU was attached to Vehicle Motion Simulator 1 for a series of simulated launch tests to validate it for installation on the mobile launcher. The mobile launcher tower will be equipped with a number of lines, called umbilicals that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. Kennedy's Engineering Directorate is providing support to the Ground Systems Development and Operations Program for testing of the OSMU. EM-1 is scheduled to launch in 2018.

CIDR

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Initiation Application Schedule Service Information and Pricing Services Sample Requirements Pricing SNP Genotyping General Information Genome Wide Association Custom FFPE Sample Options Methylation Linkage Consortium Developed Mouse Whole Genome Sequencing General Information Whole Genome Whole Exome Custom

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/TAMRF Human Resources For updated policies and forms, see the IODP-USIO Human Resources web site. For additional information contact: Kim Johnson Supervisor of Human Resources and Insurance Services Ocean

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Saving tourists: the status of emergency medical services in California's National Parks.

PubMed

Heggie, Travis W; Heggie, Tracey M

2009-01-01

Providing emergency medical services (EMS) in popular tourist destinations such as National Parks requires an understanding of the availability and demand for EMS. This study examines the EMS workload, EMS transportation methods, EMS funding, and EMS provider status in California's National Park Service units. A retrospective review of data from the 2005 Annual Emergency Medical Services Report for National Park Service (NPS) units in California. Sixteen NPS units in California reported EMS activity. EMS program funding and training costs totaled USD $1,071,022. During 2005 there were 84 reported fatalities, 910 trauma incidents, 663 non-cardiac medicals, 129 cardiac incidents, and 447 first aid incidents. Sequoia and Kings Canyon National Parks, Yosemite National Park, Golden Gate National Recreation Area, and Death Valley National Park accounted for 83% of the total EMS case workload. Ground transports accounted for 85% of all EMS transports and Emergency Medical Technicians with EMT-basic (EMT-B) training made up 76% of the total 373 EMS providers. Providing EMS for tourists can be a challenging task. As tourist endeavors increase globally and move into more remote environments, the level of EMS operations in California's NPS units can serve as a model for developing EMS operations serving tourist populations.

DefenseLink.mil - Special Report - Military Integration

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Order Sets Family Tradition The Brunson family of Fayetteville, N.C., have made a family tradition of military service. WASHINGTON, July 29, 2008 – For the Brunson family of Fayetteville, N.C., President Harry S. Truman's 1948 order paved the way for Army service to become a family tradition. Story Former

Privacy & Security Notice | Argonne National Laboratory

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server logs: The Internet Protocol (IP) address of the domain from which you access the Internet (i.e service to authorized users, to access, obtain, alter, damage, or destroy information, or otherwise to . 123.456.789.012) whether yours individually or provided as a proxy by your Internet Service Provider (ISP), The

Prehospital system delay in ST-segment elevation myocardial infarction care: a novel linkage of emergency medicine services and in hospital registry data.

PubMed

Fosbøl, Emil L; Granger, Christopher B; Peterson, Eric D; Lin, Li; Lytle, Barbara L; Shofer, Frances S; Lohmeier, Chad; Mears, Greg D; Garvey, J Lee; Corbett, Claire C; Jollis, James G; Glickman, Seth W

2013-03-01

Emergency medical services (EMS) are critical in the treatment of ST-segment elevation myocardial infarction (STEMI). Prehospital system delays are an important target for improving timely STEMI care, yet few limited data are available. Using a deterministic approach, we merged EMS data from the North Carolina Pre-hospital Medical Information System (PreMIS) with data from the Reperfusion of Acute Myocardial Infarction in Carolina Emergency Departments-Emergency Response (RACE-ER) Project. Our sample included all patients with STEMI from June 2008 to October 2010 who arrived by EMS and who had primary percutaneous coronary intervention (PCI). Prehospital system delays were compared using both RACE-ER and PreMIS to examine agreement between the 2 data sources. Overall, 8,680 patients with STEMI in RACE-ER arrived at a PCI hospital by EMS; 21 RACE-ER hospitals and 178 corresponding EMS agencies across the state were represented. Of these, 6,010 (69%) patients were successfully linked with PreMIS. Linked and notlinked patients were similar. Overall, 2,696 patients were treated with PCI only and were taken directly to a PCI-capable hospital by EMS; 1,750 were transferred from a non-PCI facility. For those being transported directly to a PCI center, 53% reached the 90-minute target guideline goal. For those transferred from a non-PCI facility, 24% reached the 120-minute target goal for primary PCI. We successfully linked prehospital EMS data with in hospital clinical data. With this linked STEMI cohort, less than half of patients reach goals set by guidelines. Such a data source could be used for future research and quality improvement interventions. Copyright © 2013 Mosby, Inc. All rights reserved.

NOAA Freedom of Information Act (FOIA) Corporate Services, Staff and Line

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Items of Interest for the Public FOIA Contacts Frequently requested records Reading Room For NOAA Staff -628-5755 Andre Sivels Records Officer NOAA Corporate Services 301-628-5658 Staff Office, Service

Areas of Potential Impact of the Patient Protection and Affordable Care Act on EMS: A Synthesis of the Literature.

PubMed

Ostermayer, Daniel G; Brown, Charles A; Fernandez, William G; Couvillon, Emily

2017-04-01

This comprehensive review synthesizes the existing literature on the Patient Protection and Affordable Care Act (ACA) as it relates to emergency medical services (EMS) in order to provide guidance for navigating current and future healthcare changes. We conducted a comprehensive review to identify all existing literature related to the ACA and EMS and all sections within the federal law pertaining to EMS. Many changes enacted by the ACA directly affect emergency care with potential indirect effects on EMS systems. New Medicaid enrollees and changes to existing coverage plans may alter EMS transport volumes. Reimbursement changes such as adjustments to the ambulance inflation factor (AIF) alter the yearly increases in EMS reimbursement by incorporating the multifactor productivity value into yearly reimbursement adjustments. New initiatives, funded by the Center for Medicare & Medicaid Innovation are exploring novel and cost-effective prehospital care delivery opportunities while EMS agencies individually explore partnerships with healthcare systems. EMS systems should be aware of the direct and indirect impact of ACA on prehospital care due to the potential for changes in financial reimbursement, acuity and volume changes, and ongoing new care delivery initiatives.

Areas of Potential Impact of the Patient Protection and Affordable Care Act on EMS: A Synthesis of the Literature

PubMed Central

Ostermayer, Daniel G.; Brown, Charles A.; Fernandez, William G.; Couvillon, Emily

2017-01-01

Introduction This comprehensive review synthesizes the existing literature on the Patient Protection and Affordable Care Act (ACA) as it relates to emergency medical services (EMS) in order to provide guidance for navigating current and future healthcare changes. Methods We conducted a comprehensive review to identify all existing literature related to the ACA and EMS and all sections within the federal law pertaining to EMS. Results Many changes enacted by the ACA directly affect emergency care with potential indirect effects on EMS systems. New Medicaid enrollees and changes to existing coverage plans may alter EMS transport volumes. Reimbursement changes such as adjustments to the ambulance inflation factor (AIF) alter the yearly increases in EMS reimbursement by incorporating the multifactor productivity value into yearly reimbursement adjustments. New initiatives, funded by the Center for Medicare & Medicaid Innovation are exploring novel and cost-effective prehospital care delivery opportunities while EMS agencies individually explore partnerships with healthcare systems. Conclusion EMS systems should be aware of the direct and indirect impact of ACA on prehospital care due to the potential for changes in financial reimbursement, acuity and volume changes, and ongoing new care delivery initiatives. PMID:28435495

Ventilator use by emergency medical services during 911 calls in the United States.

PubMed

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

2018-05-01

Emergency and transport ventilators use in the prehospital field is not well described. This study examines trends of ventilator use by EMS agencies during 911 calls in the United States and identifies factors associated with this use. This retrospective study used four consecutive releases of the US National Emergency Medical Services Information System (NEMSIS) public research dataset (2011-2014) to describe scene EMS activations (911 calls) with and without reported ventilator use. Ventilator use was reported in 260,663 out of 28,221,321 EMS 911 scene activations (0.9%). Patients with ventilator use were older (mean age 67±18years), nearly half were males (49.2%), mostly in urban areas (80.2%) and cared for by advanced life support (ALS) EMS services (89.5%). CPAP mode of ventilation was most common (71.6%). "Breathing problem" was the most common dispatch complaint for EMS activations with ventilator use (63.9%). Common provider impression categories included "respiratory distress" (72.5%), "cardiac rhythm disturbance" (4.6%), "altered level of consciousness" (4.3%) and "cardiac arrest"(4.0%). Ventilator use was consistently higher at the Specialty Care Transport (SCT) and Air Medical Transport (AMT) service levels and increased over the study period for both suburban and rural EMS activations. Significant factors for ventilator use included demographic characteristics, EMS agency type, specific complaints, provider's primary impressions and condition codes. Providers at different EMS levels use ventilators during 911 scene calls in the US. Training of prehospital providers on ventilation technology is needed. The benefit and effectiveness of this intervention remain to be assessed. Copyright © 2017 Elsevier Inc. All rights reserved.

About NOAA's National Weather Service

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official web portal to all federal, state and local government web resources and services. Follow the Field Offices are located across the country. Links to web sites of these components of the National that affect small businesses have established Web sites, e-mail addresses, and toll free phone numbers

Remembering Sept. 11, 2001

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ever during a 9/11 remembrance service at the Pentagon Memorial. Story Panetta, at Pentagon Memorial audience during a 9/11 remembrance ceremony at the Pentagon Memorial. Story Dempsey Memorializes a Hero during a remembrance service at the National 9/11 Pentagon Memorial. Story Winnefeld: Events of 9/11

DGIC Interconnection Insights | Distributed Generation Interconnection

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ripe for cost reductions. Utilities, public service commissions, legislators, and even developers can timelines, strand assets, stress debt service, and ultimately drive up the cost of solar energy. NREL ). The financier also indicated that solar's cost of capital, on the whole, is still 100-200 basis points

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The Department of Legal Services ("DLS") is a dependency of the Secretariat for Legal Affairs of the OAS General Secretariat. www.oas.org/en/sla DLS provides legal advice on: interpretation of Secretariat for Legal Affairs Inter-American Commission on Human Rights Inter-American Court of Human Rights

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National Characteristics of Emergency Medical Services Responses for Older Adults in the United States.

PubMed

Duong, Hieu V; Herrera, Lauren Nicholas; Moore, Justin Xavier; Donnelly, John; Jacobson, Karen E; Carlson, Jestin N; Mann, N Clay; Wang, Henry E

2018-01-01

Older adults, those aged 65 and older, frequently require emergency care. However, only limited national data describe the Emergency Medical Services (EMS) care provided to older adults. We sought to determine the characteristics of EMS care provided to older adults in the United States. We used data from the 2014 National Emergency Medical Services Information System (NEMSIS), encompassing EMS response data from 46 States and territories. We excluded EMS responses for children <18 years, interfacility transports, intercepts, non-emergency medical transports, and standby responses. We defined older adults as age ≥65 years. We compared patient demographics (age, sex, race, primary payer), response characteristics (dispatch time, location type, time intervals), and clinical course (clinical impression, injury, procedures, medications) between older and younger adult EMS emergency 9-1-1 responses. During the study period there were 20,212,245 EMS emergency responses. Among the 16,116,219 adult EMS responses, there were 6,569,064 (40.76%) older and 9,547,155 (59.24%) younger adults. Older EMS patients were more likely to be white and the EMS incident to be located in healthcare facilities (clinic, hospital, nursing home). Compared with younger patients, older EMS patients were more likely to present with syncope (5.68% vs. 3.40%; OR 1.71; CI: 1.71-1.72), cardiac arrest/rhythm disturbance (3.27% vs. 1.69%; OR 1.97; CI: 1.96-1.98), stroke (2.18% vs. 0.74%; OR 2.99; CI: 2.96-3.02) and shock (0.77% vs. 0.38%; OR 2.02; CI: 2.00-2.04). Common EMS interventions performed on older persons included intravenous access (32.02%), 12-lead ECG (14.37%), CPR (0.87%), and intubation (2.00%). The most common EMS drugs administered to older persons included epinephrine, atropine, furosemide, amiodarone, and albuterol or ipratropium. One of every three U.S. EMS emergency responses involves older adults. EMS personnel must be prepared to care for the older patient.

DMAWDS

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Office Marine, Tropical, and Tsunami Services Branch Items of Interest Marine Forecasts Text, Graphic Services Branch, Items of Interest, Forecasts, Observations, Portals, Dissemination, Publications, Links

The day that the START triage system came to a STOP: observations from the World Trade Center disaster.

PubMed

Asaeda, Glenn

2002-03-01

The Fire Department of the City of New York--Emergency Medical Services (EMS) Operations is one of the largest EMS systems in the country. On a daily basis, this system responds to approximately 3,000 to 3,500 calls for ambulance requests. This equates to 1.2 to 1.5 million calls annually. As part of its response, EMS deals on a daily basis with multiple casualty and disaster-type situations. The magnitude of the attacks on the World Trade Center, however, was on a scale not previously seen by any system. This article is a case report of the September 11, 2001, incident.

CIDR

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quality, cutting-edge genomic services and technologies in order to expand our understanding of disease high quality next generation sequencing and genotyping services to investigators working to discover issues as they relate to study design, data production and quality control. Completed studies encompass

Poison Prevention Program

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State Employees Chronic Disease Prevention and Health Promotion DHSS State of Alaska Home Divisions and Agencies Alaska Pioneer Homes Behavioral Health Office of Children's Services Office of the Commissioner Office of Substance Misuse and Addiction Prevention Finance & Management Services Health Care

PEER - National Information Service for Earthquake Engineering - NISEE

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Information Service for Earthquake Engineering - NISEE The NISEE/PEER Library is an affiliated library of the Field Station, five miles from the main Berkeley campus. Address NISEE/PEER Library, University of Regents Hours Monday - Friday, 9:00 am - 1:00 pm Open to the public NISEE/PEER Library home page. 325

ACHP | New and Improved Course: The Section 106 Essentials

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Interior's Standards for the Treatment of Historic Properties: 36 CFR Part 68 http://www.nps.gov/history Park Service History and Culture Publications http://www.nps.gov/history/index.htm National Park ://www.nps.gov/history/nagpra/ Technical Preservation Services for Historic Buildings http://www.nps.gov/tps

Forecasts - NOAA's National Weather Service

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National Maps - Pacific - NOAA's National Weather Service

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Weather Education/Outreach - NOAA's National Weather Service

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Careers in Weather - NOAA's National Weather Service

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International Partnership) thumbnail For Italian physics & engineering grads PST - Pre-Service Teacher Internship (No longer active) thumbnail For STEM pre-service teachers Fermi National Accelerator Laboratory

Use of facility assessment data to improve reproductive health service delivery in the Democratic Republic of the Congo

PubMed Central

2009-01-01

Background Prolonged exposure to war has severely impacted the provision of health services in the Democratic Republic of the Congo (DRC). Health infrastructure has been destroyed, health workers have fled and government support to health care services has been made difficult by ongoing conflict. Poor reproductive health (RH) indicators illustrate the effect that the prolonged crisis in DRC has had on the on the reproductive health (RH) of Congolese women. In 2007, with support from the RAISE Initiative, the International Rescue Committee (IRC) and CARE conducted baseline assessments of public hospitals to evaluate their capacities to meet the RH needs of the local populations and to determine availability, utilization and quality of RH services including emergency obstetric care (EmOC) and family planning (FP). Methods Data were collected from facility assessments at nine general referral hospitals in five provinces in the DRC during March, April and November 2007. Interviews, observation and clinical record review were used to assess the general infrastructure, EmOC and FP services provided, and the infection prevention environment in each of the facilities. Results None of the nine hospitals met the criteria for classification as an EmOC facility (either basic or comprehensive). Most facilities lacked any FP services. Shortage of trained staff, essential supplies and medicines and poor infection prevention practices were consistently documented. All facilities had poor systems for routine monitoring of RH services, especially with regard to EmOC. Conclusions Women's lives can be saved and their well-being improved with functioning RH services. As the DRC stabilizes, IRC and CARE in partnership with the local Ministry of Health and other service provision partners are improving RH services by: 1) providing necessary equipment and renovations to health facilities; 2) improving supply management systems; 3) providing comprehensive competency-based training for health providers in RH and infection prevention; 4) improving referral systems to the hospitals; 5) advocating for changes in national RH policies and protocols; and 6) providing technical assistance for monitoring and evaluation of key RH indicators. Together, these initiatives will improve the quality and accessibility of RH services in the DRC - services which are urgently needed and to which Congolese women are entitled by international human rights law. PMID:20025757

Home | www.charlescountymd.gov

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Customer Survey Mobile Services Contact Search form Search Search Main menu Home Businesses Tourism Animal Shelter Water and Sewer Billing Mobile Friendly Services Opioid Abuse & Overdose Prevention OFFICIAL WEBSITE OF THE CHARLES COUNTY GOVERNMENT 200 Baltimore Street | La Plata, Maryland 20646 Mobile

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Office Marine, Tropical, and Tsunami Services Branch Items of Interest Marine Forecasts Text, Graphic interest to the mariner on 2670 kHz following an initial announcement on 2182 kHz. Typical transmission Office, Marine, Tropical, and Tsunami Services Branch, Items of Interest, Forecasts, Observations

A validation of ground ambulance pre-hospital times modeled using geographic information systems.

PubMed

Patel, Alka B; Waters, Nigel M; Blanchard, Ian E; Doig, Christopher J; Ghali, William A

2012-10-03

Evaluating geographic access to health services often requires determining the patient travel time to a specified service. For urgent care, many research studies have modeled patient pre-hospital time by ground emergency medical services (EMS) using geographic information systems (GIS). The purpose of this study was to determine if the modeling assumptions proposed through prior United States (US) studies are valid in a non-US context, and to use the resulting information to provide revised recommendations for modeling travel time using GIS in the absence of actual EMS trip data. The study sample contained all emergency adult patient trips within the Calgary area for 2006. Each record included four components of pre-hospital time (activation, response, on-scene and transport interval). The actual activation and on-scene intervals were compared with those used in published models. The transport interval was calculated within GIS using the Network Analyst extension of Esri ArcGIS 10.0 and the response interval was derived using previously established methods. These GIS derived transport and response intervals were compared with the actual times using descriptive methods. We used the information acquired through the analysis of the EMS trip data to create an updated model that could be used to estimate travel time in the absence of actual EMS trip records. There were 29,765 complete EMS records for scene locations inside the city and 529 outside. The actual median on-scene intervals were longer than the average previously reported by 7-8 minutes. Actual EMS pre-hospital times across our study area were significantly higher than the estimated times modeled using GIS and the original travel time assumptions. Our updated model, although still underestimating the total pre-hospital time, more accurately represents the true pre-hospital time in our study area. The widespread use of generalized EMS pre-hospital time assumptions based on US data may not be appropriate in a non-US context. The preference for researchers should be to use actual EMS trip records from the proposed research study area. In the absence of EMS trip data researchers should determine which modeling assumptions more accurately reflect the EMS protocols across their study area.

Prevalence of emergency medical service utilisation in patients with out-of-hospital cardiac arrest in Thailand.

PubMed

Monsomboon, Apichaya; Chantawatsharakorn, Prasit; Suksuriyayothin, Saovanee; Keorochana, Kris; Mukda, Achara; Prapruetkit, Nattakarn; Surabenjawong, Usapan; Nakornchai, Tanyaporn; Chakorn, Tipa

2016-03-01

Most patients with out-of-hospital cardiac arrest (OHCA) have grave outcomes. The efficacy of emergency medical services (EMS) may affect outcomes. However, no data exists in Thailand. To ascertain the prevalence of EMS utilisation in patients with OHCA transferred to Siriraj Hospital and also to elucidate the rates of return of spontaneous circulation (ROSC), hospital admission and survival to hospital discharge. This prospective cohort study was conducted in patients with OHCA at a university hospital in Bangkok, Thailand from May 2011 to February 2013. The data was gathered by interviewing bystanders. Data about the mode of transportation, reasons for EMS usage, response time, ROSC and 30-day mortality were collected. Patients with rigour mortis or livor mortis were excluded. The factors affecting ROSC and survival rate were determined by univariate analysis. One hundred and fifty-two patients were included. The prevalence of EMS usage was 14.5% (95% CI 9.3 to 21.0). The most common cause of non-usage of EMS was not knowing or forgetting an EMS number (49.2%). The proportion of bystanders having known an EMS number and using EMS was 34%. The ROSC and 30-day survival rates were 53.3% and 10.5%, respectively. Non-cardiac causes and witnessed arrests were associated with ROSC (p<0.05). The prevalence of EMS utilisation in OHCA at Siriraj Hospital was very low. This may affect the outcomes of patients with OHCA. Improving the EMS system by publicity to increase public awareness and providing life-support education nationwide may improve outcomes of patients with OHCA in Thailand. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

NOAA WEATHER WIRE SERVICE

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Open Archives Initiative (OAI) Services | OSTI, US Dept of Energy Office of

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Climate Prediction Center - The ENSO Cycle

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Weather Service NWS logo - Click to go to the NWS home page Climate Prediction Center Home Site Map News Web resources and services. HOME > El Niño/La Niña > The ENSO Cycle ENSO Cycle Banner Climate for Weather and Climate Prediction Climate Prediction Center 5830 University Research Court College

EMS helicopter incidents reported to the NASA Aviation Safety Reporting System

NASA Technical Reports Server (NTRS)

Connell, Linda J.; Reynard, William D.

1993-01-01

The objectives of this evaluation were to: Identify the types of safety-related incidents reported to the Aviation Safety Reporting System (ASRS) in Emergency Medical Service (EMS) helicopter operations; Describe the operational conditions surrounding these incidents, such as weather, airspace, flight phase, time of day; and Assess the contribution to these incidents of selected human factors considerations, such as communication, distraction, time pressure, workload, and flight/duty impact.

Application Processing | Distributed Generation Interconnection

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delivering swift customer service. The rapid rise of distributed generation (DG) PV interconnection speed processing, reduce paperwork, and improve customer service. Webinars and publications are

The NSET Subcommittee | Nano

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Charles Ying Nuclear Regulatory Commission (NRC) Brian Thomas* U.S. Department of Agriculture (USDA ) Agriculture Research Service (ARS) James Lindsay Forest Service (FS) World L.S. Nieh National Institute of Food and Agriculture (NIFA) Hongda Chen U.S. International Trade Commission (USITC) Elizabeth R

National Weather Service - Strategic Planning and Policy

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National Research Council Committee" NWS FOCUS Article - "Recent Study Identifies Digital products and services. For example, every experimental product should go through a public comment period . For example, providing a marine forecast product tailored to the needs of a particular shipping

Training and Development, Division of Personnel and Labor Relations,

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ALASKA MARINE VHF VOICE

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Orion EM-1 Crew Module Adapter Move to Clean Room

NASA Image and Video Library

2016-11-29

Inside the Neil Armstrong Operations and Checkout Building high bay at NASA’s Kennedy Space Center in Florida, Lockheed Martin technicians begin to move the Orion crew module adapter (CMA) for Exploration Mission 1 (EM-1) to a clean room. The CMA will undergo propellant and environmental control and life support system tube installation and welding. The adapter will connect the Orion crew module to the European Space Agency-provided service module. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission, in late 2018.

Orion EM-1 Crew Module Adapter Move to Clean Room

NASA Image and Video Library

2016-11-29

Inside the Neil Armstrong Operations and Checkout Building high bay at NASA's Kennedy Space Center in Florida, Lockheed Martin technicians secure a protective cover around the Orion crew module adapter (CMA) for Exploration Mission 1 (EM-1) for its move to a clean room. The CMA will undergo propellant and environmental control and life support system tube installation and welding. The adapter will connect the Orion crew module to the European Space Agency-provided service module. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission, in late 2018.

Orion EM-1 Crew Module Adapter Move to Clean Room

NASA Image and Video Library

2016-11-29

Inside the Neil Armstrong Operations and Checkout Building high bay at NASA’s Kennedy Space Center in Florida, a Lockheed Martin technician secures a protective cover around the Orion crew module adapter (CMA) for Exploration Mission 1 (EM-1) for its move to a clean room The CMA will undergo propellant and environmental control and life support system tube installation and welding. The adapter will connect the Orion crew module to the European Space Agency-provided service module. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission, in late 2018.

Orion EM-1 Crew Module Adapter Move to Clean Room

NASA Image and Video Library

2016-11-29

Inside the Neil Armstrong Operations and Checkout Building high bay at NASA’s Kennedy Space Center in Florida, Lockheed Martin technicians secure a protective cover around the Orion crew module adapter (CMA) for Exploration Mission 1 (EM-1) for its move to a clean room. The CMA will undergo propellant and environmental control and life support system tube installation and welding. The adapter will connect the Orion crew module to the European Space Agency-provided service module. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission, in late 2018.

Orion EM-1 Crew Module Adapter Move to Clean Room

NASA Image and Video Library

2016-11-29

Inside the Neil Armstrong Operations and Checkout Building high bay at NASA’s Kennedy Space Center in Florida, a protective cover is installed around the Orion crew module adapter (CMA) for Exploration Mission 1 (EM-1) for its move to a clean room. The CMA will undergo propellant and environmental control and life support system tube installation and welding. The adapter will connect the Orion crew module to the European Space Agency-provided service module. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission, in late 2018.

Orion EM-1 Crew Module Adapter Move to Clean Room

NASA Image and Video Library

2016-11-29

Inside the Neil Armstrong Operations and Checkout Building high bay at NASA’s Kennedy Space Center in Florida, Lockheed Martin technicians are preparing the Orion crew module adapter (CMA) for Exploration Mission 1 (EM-1) for the move into a clean room. The CMA will undergo propellant and environmental control and life support system tube installation and welding. The adapter will connect the Orion crew module to the European Space Agency-provided service module. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission, in late 2018.

Orion EM-1 Crew Module Adapter Move to Clean Room

NASA Image and Video Library

2016-11-29

Inside the Neil Armstrong Operations and Checkout Building high bay at NASA's Kennedy Space Center in Florida, Lockheed Martin technicians secure a protective cover around the Orion crew module adapter (CMA) for Exploration Mission 1 (EM-1) for its move to a clean. The CMA will undergo propellant and environmental control and life support system tube installation and welding. The adapter will connect the Orion crew module to the European Space Agency-provided service module. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission, in late 2018.

Orion EM-1 Crew Module Adapter Move to Clean Room

NASA Image and Video Library

2016-11-29

Inside the Neil Armstrong Operations and Checkout Building high bay at NASA’s Kennedy Space Center in Florida, the Orion crew module adapter (CMA) for Exploration Mission 1 (EM-1) is in a clean room with protective walls secured around it. The adapter will undergo propellant and environmental control and life support system tube installation and welding. The adapter will connect the Orion crew module to the European Space Agency-provided service module. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission, in late 2018.

Review of emergency obstetric care interventions in health facilities in the Upper East Region of Ghana: a questionnaire survey.

PubMed

Kyei-Onanjiri, Minerva; Carolan-Olah, Mary; Awoonor-Williams, John Koku; McCann, Terence V

2018-03-15

Maternal morbidity and mortality is most prevalent in resource-poor settings such as sub-Saharan Africa and southern Asia. In sub-Saharan Africa, Ghana is one of the countries still facing particular challenges in reducing its maternal morbidity and mortality. Access to emergency obstetric care (EmOC) interventions has been identified as a means of improving maternal health outcomes. Assessing the range of interventions provided in health facilities is, therefore, important in determining capacity to treat obstetric emergencies. The aim of this study was to examine the availability of emergency obstetric care interventions in the Upper East Region of Ghana. A cross-sectional survey of 120 health facilities was undertaken. Status of emergency obstetric care was assessed through an interviewer administered questionnaire to directors/in-charge officers of maternity care units in selected facilities. Data were analysed using descriptive statistics. Eighty per cent of health facilities did not meet the criteria for provision of emergency obstetric care. Comparatively, private health facilities generally provided EmOC interventions less frequently than public health facilities. Other challenges identified include inadequate skill mix of maternity health personnel, poor referral processes, a lack of reliable communication systems and poor emergency transport systems. Multiple factors combine to limit women's access to a range of essential maternal health services. The availability of EmOC interventions was found to be low across the region; however, EmOC facilities could be increased by nearly one-third through modest investments in some existing facilities. Also, the key challenges identified in this study can be improved by enhancing pre-existing health system structures such as Community-based Health Planning and Services (CHPS), training more midwifery personnel, strengthening in-service training and implementation of referral audits as part of health service monitoring. Gaps in availability of EmOC interventions, skilled personnel and referral processes must be tackled in order to improve obstetric outcomes.

Physician medical direction and clinical performance at an established emergency medical services system.

PubMed

Munk, Marc-David; White, Shaun D; Perry, Malcolm L; Platt, Thomas E; Hardan, Mohammed S; Stoy, Walt A

2009-01-01

Few developed emergency medical services (EMS) systems operate without dedicated medical direction. We describe the experience of Hamad Medical Corporation (HMC) EMS, which in 2007 first engaged an EMS medical director to develop and implement medical direction and quality assurance programs. We report subsequent changes to system performance over time. Over one year, changes to the service's clinical infrastructure were made: Policies were revised, paramedic scopes of practice were adjusted, evidence-based clinical protocols were developed, and skills maintenance and education programs were implemented. Credentialing, physician chart auditing, clinical remediation, and online medical command/hospital notification systems were introduced. Following these interventions, we report associated improvements to key indicators: Chart reviews revealed significant improvements in clinical quality. A comparison of pre- and post-intervention audited charts reveals a decrease in cases requiring remediation (11% to 5%, odds ratio [OR] 0.43 [95% confidence interval (CI) 0.20-0.85], p = 0.01). The proportion of charts rated as clinically acceptable rose from 48% to 84% (OR 6 [95% CI 3.9-9.1], p < 0.001). The proportion of misplaced endotracheal tubes fell (3.8% baseline to 0.6%, OR 0.16 [95% CI 0.004-1.06], (exact) p = 0.05), corresponding to improved adherence to an airway placement policy mandating use of airway confirmation devices and securing devices (0.7% compliance to 98%, OR 714 [95% CI 64-29,334], (exact) p < 0.001). Intravenous catheter insertion in unstable cases increased from 67% of cases to 92% (OR 1.31 [95% CI 1.09-1.71], p = 0.004). EMS administration of aspirin to patients with suspected ischemic chest pain improved from 2% to 77% (OR 178 [95% CI 35-1,604], p < 0.001). We suggest that implementation of a physician medical direction is associated with improved clinical indicators and overall quality of care at an established EMS system.

Energy Services Company | Climate Neutral Research Campuses | NREL

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different corporate and ownership structures. While many are large engineering or equipment manufacturers Services Company Options Performance-based contracts can take different forms including guaranteed energy different financing options for energy performance contracting, please refer to page 13 of the April 2009

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Home Energy Saver

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Energy Saver (HES) Licensing Information The Home Energy Saver is a web-based residential energy calculator and web service that provides customized estimates of residential energy use, energy bills, and potential energy-saving strategies and ranks them in order of cost-effectiveness. Use of the web-services

Recreational Water Illness (RWI) - Infectious Disease Epidemiology Program

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Search the Division of Finance site DOF State of Alaska Finance Home Content Area Accounting Charge Cards IRIS HRM Login LearnAlaska SFOA SharePoint Site Vendor Self Service (VSS) Content Area Accounting Dunayski, Accounting Services Lead Danielle Meier, State E-Travel Manager Stephanie Church, IRIS Financial

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local climate science or impacts, please contact the National Weather Service office in your area. link impacts everyone. How warm is a typical June across the Midwest? What is the average snowfall in January local climate science or impacts, contact the National Weather Service Office in your area. State

Extension Service :: Calendar

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Month view List view Extension Service details submit new event to this calendar basic view Export as 9:00am Linn & Benton Master Food Preserver Training 9:00am Master Food Preserver Volunteer Training Program - Linn and Benton Counties 1:00pm Linn County Master Gardener Association Board Meeting 2

Attention: Page has moved

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Weather Service NWS logo - Click to go to the NWS home page Climate Prediction Center Site Map News bookmarks with the new address. NOAA/ National Weather Service National Centers for Environmental Prediction Climate Prediction Center 5830 University Research Court College Park, Maryland 20740 Page Author: Climate

Oceans & Coasts | National Oceanic and Atmospheric Administration

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NOAA's National Ocean Service is positioning America's coastal communities for the future Focus_Area_oceanscoasts1.jpg NOAA NOAA's National Ocean Service is positioning America's coastal communities for the future them. Almost 40 percent of the country's population lives in coastal shoreline counties. These counties

Sanctuaries | National Oceanic and Atmospheric Administration

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coastal and marine places that NOAA's National Ocean Service works to protect. Focus_Area_sanctuaries.jpg NOAA Discover the coastal and marine places that NOAA's National Ocean Service works to protect. LATEST national marine sanctuaries, about $8 billion annually is generated in local coastal and ocean dependent

LINKS to NATIONAL WEATHER SERVICE MARINE FORECAST OFFICES

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Coastal Flooding Tsunamis 406 EPIRB's National Weather Service Marine Forecasts LINKS to NATIONAL WEATHER Marine Forecasts in text form ) Coastal NWS Forecast Offices have regionally focused marine webpages which are overflowing with information such as coastal forecasts, predicted tides, and buoy observations

National Weather Service Marine Forecasts - FAQ

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! Boating Safety Beach Hazards Rip Currents Hypothermia Hurricanes Thunderstorms Lightning Coastal Flooding marine coastal areas may be found in Appendix B of the National Ocean Service's Coast Pilot's, volumes 1 Advisory (SCA): An advisory issued by coastal and Great Lakes Weather Forecast Offices (WFO) for areas

NATIONAL WEATHER SERVICE MARINE PRODUCTS VIA NOAA WEATHER RADIO

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! Boating Safety Beach Hazards Rip Currents Hypothermia Hurricanes Thunderstorms Lightning Coastal Flooding Radio network provides voice broadcasts of local and coastal marine forecasts on a continuous cycle. The forecasts are produced by local National Weather Service Forecast Offices. Coastal stations also broadcast

CIDR

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variety of arrays appropriate for a wide breadth of study design needs. Genomic coverage of many of the chromosomal anomalies are services offered at NO ADDITIONAL COST to study investigators with GWAS projects be submitted for both the initial GWAS study as well as replication using our custom SNP service

Department of Navy FY17 Budget: Delivering Options, Assuring Allies,

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Services program and Surface Electronic Warfare Improvement Program. Hard Choices This fiscal environment requires each Service to make hard choices in prioritizing their budget, examining every account to sustain advantage, accelerate learning and strengthen our team. In making hard choices and allocating risk

Climate Prediction Center - monthly Outlook

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Weather Service NWS logo - Click to go to the NWS home page Climate Prediction Center Site Map News Outlooks monthly Climate Outlooks Banner OFFICIAL Forecasts June 2018 [UPDATED MONTHLY FORECASTS SERVICE CHANGE NOTICE] [EXPERIMENTAL TWO-CLASS SEASONAL FORECASTS] Text-Format Discussions Monthly Long Lead 30

Long Exposure Photos of Mobile Launcher

NASA Image and Video Library

2017-03-14

A long-exposure view of the mobile launcher at NASA's Kennedy Space Center in Florida. Cranes and rigging are being used to lift the bracket for the Orion Service Module Umbilical (OSMU) up for installation on the mobile launcher tower. The tower will be equipped with a number of lines, called umbilicals, that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. EM-1 is scheduled to launch in 2018. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Acknowledgments & Citation | USDA Plant Hardiness Zone Map

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USDA Logo Agricultural Research Service United States Department of Agriculture Mapping by PRISM , 2012. Agricultural Research Service, U.S. Department of Agriculture. Accessed from http

Division of Behavioral Health

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that the most acute and chronic conditions require a corresponding increased level of services intervention to acute psychiatric care. Included are services for the general population (prevention &

Oslo government district bombing and Utøya island shooting July 22, 2011: The immediate prehospital emergency medical service response

PubMed Central

2012-01-01

Background On July 22, 2011, a single perpetrator killed 77 people in a car bomb attack and a shooting spree incident in Norway. This article describes the emergency medical service (EMS) response elicited by the two incidents. Methods A retrospective and observational study was conducted based on data from the EMS systems involved and the public domain. The study was approved by the Data Protection Official and was defined as a quality improvement project. Results We describe the timeline and logistics of the EMS response, focusing on alarm, dispatch, initial response, triage and evacuation. The scenes in the Oslo government district and at Utøya island are described separately. Conclusions Many EMS units were activated and effectively used despite the occurrence of two geographically separate incidents within a short time frame. Important lessons were learned regarding triage and evacuation, patient flow and communication, the use of and need for emergency equipment and the coordination of helicopter EMS. PMID:22280935

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

PubMed

Dalby, Miles; Whitbread, Mark

2013-08-22

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

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

PubMed

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

2018-01-01

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

Emergency medical service (EMS): A unique flight environment

NASA Technical Reports Server (NTRS)

Shively, R. Jay

1993-01-01

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

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Tax Exemption Alternative fuels used in a manner that the Internal Revenue Service (IRS) deems as of Columbia. This exemption is not available to tax exempt entities that are not liable for excise 4041) Point of Contact Excise Tax Branch U.S. Internal Revenue Service Office of Chief Counsel Phone

Public Affairs - NOAA's National Weather Service

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Publications Contact Us USA.gov is the U.S. government's official web portal to all federal, state and local government web resources and services. Top Story NOAA predicts active 2013 Atlantic hurricane season In its ... Weather Favorites Finding Past Weather Alphabetical listing of NOAA's most sought after weather Web sites

Ocean Drilling Program: Publication Services: Online Manuscript Submission

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products Drilling services and tools Online Janus database Search the ODP/TAMU web site ODP/TAMU Science Operator Home ODP's main web site Publications Policy Author Instructions Scientific Results Manuscript use the submission and review forms available on the IODP-USIO publications web site. ODP | Search

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Service provides a gateway to the online Astronomy and Physics literature. You can navigate this content filtering options as well as visualizations. Astronomy and Astrophysics Classic Search, an legacy interface which searches the 2,311,600 records currently in the Astronomy database, including 198,834 abstracts

Managed Utility Services Contracts | Climate Neutral Research Campuses |

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the energy cost savings generated by the project. Managed Utility Services Contracts In a Managed . The owner, in this case the research campus, bears no upfront cost through this agreement, pays the revenue to capital cost repayment and maintenance costs. In addition to removing the burden of an upfront

Alternative Fuels Data Center: Workplace Charging Success: MetLife

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people to use PEVs. " MetLife's Senior Vice President, Global Corporate Services, Joseph Sprouls vehicle (PEV) charging stations at 14 of its U.S. corporate offices as a partner in the Department of benefits of using alternative energy sources. MetLife's Senior Vice President, Global Corporate Services

Defense.gov Special Coverage: Sexual Assault

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exclusively against women. Story Sexual Assault Rates Decrease at Military Service Academies Rates of unwanted sexual contact at the military service academies declined in 2014, according to a report released today by the Defense Department. Story Soldiers Engage in SHARP Training in Afghanistan Members of 5-5 Air

WWV, WWVH HF VOICE (TIME TICK)

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Tsunamis 406 EPIRB's National Weather Service Marine Forecasts WWV, WWVH HF VOICE (TIME TICK) Marine of Standards, broadcasts a time and frequency service from stations WWV in Fort Collins, CO and WWVH in Kauai, Hawaii., commonly known to mariners as the "Time Tick", used as an aid in

Contact USDA-ARS | USDA Plant Hardiness Zone Map

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service color guard performs as U.S. Joint Forces Command hosted the Tenth Annual Salute to Veterans service color guard performs as U.S. Joint Forces Command hosted the Tenth Annual Salute to Veterans * Job Fair Highlights Veterans' Unique Skills Click to view 'The Great War' Flash special Veterans Day

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Noxious Weeds in the US and Canada

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projects • Comments Agricultural Research Service United States Department of Agriculture Noxious weeds in supported by the USDA Agricultural Research Service. Principal investigators: Dr. Kerri Skinner, University

Ocean Drilling Program: Mirror Sites

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Charting | National Oceanic and Atmospheric Administration

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Ocean Service provides products, tools, and services to ensure safe passage along our coastal waters ensure safe passage along our coastal waters. LATEST FEATURES // Instrument used for reestablishment of

Emergency medical service attitudes toward geriatric prehospital care and continuing medical education in geriatrics.

PubMed

Peterson, Lars-Kristofer N; Fairbanks, Rollin J; Hettinger, Aaron Z; Shah, Manish N

2009-03-01

To understand the opinions of emergency medical service (EMS) providers regarding their ability to care for older adults, the domains of geriatric medicine in which they need more training, and the modality through which continuing education could be best delivered. Qualitative study using key informant interviews. Prehospital EMS system in Rochester, New York. EMS providers, EMS instructors and administrators, emergency physicians, and geriatricians. Semistructured interviews were conducted using an interview guide that addressed knowledge and skill deficiencies, recommendations for improvement of geriatrics continuing education, and delivery methods of education. Participant responses were generally congruous despite the diverse backgrounds, and redundancy was achieved rapidly. All participants perceived a deficit in EMS education on the care of older adults, particularly related to communications with patients and skilled nursing facility staff. All desired more geriatric continuing education for EMS providers, especially in communications and psychosocial issues. Education was desired in various modalities. Further geriatric continuing education for EMS providers is needed. Some specific topics relate to medical issues, but a large proportion involve communications and psychosocial issues. Education should be delivered in a variety of modalities to meet the needs of the EMS community. Emerging on-line video technologies may bridge the gap between learners preferring classroom-based modailities and those preferring self-study modules.

NOAA Photo Library - Historic Weather Service/Meteorological

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Navy Personnel Command

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Weather Info Other Links Customer Service MPTE Portal (Intranet) Career Navigator Career Waypoints CMS/ID ? Suggestions? Call NPC Customer Service: 866-U-ASK-NPC (DSN 882-5672), Live Chat or Email the Webmaster Last

Deferred Compensation Plan | Alaska Division of Retirement and Benefits

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Publications - GMC 367 | Alaska Division of Geological & Geophysical

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. Minerals Management Service, and Core Laboratories Publication Date: Aug 2009 Publisher: Alaska Division of Bibliographic Reference U.S. Minerals Management Service, and Core Laboratories, 2009, Sidewall core analyses

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Orion Service Module Umbilical (OSMU) Testing Complete

NASA Image and Video Library

2016-10-19

Testing of the Orion Service Module Umbilical (OSMU) was completed at the Launch Equipment Test Facility at NASA’s Kennedy Space Center in Florida. The OSMU was attached to Vehicle Motion Simulator 1 for a series of simulated launch tests to validate it for installation on the mobile launcher. The test team gathered for an event to mark the end of testing. The mobile launcher tower will be equipped with a number of lines, called umbilicals that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. Kennedy's Engineering Directorate is providing support to the Ground Systems Development and Operations Program for testing of the OSMU. EM-1 is scheduled to launch in 2018.

Orion Service Module Umbilical (OSMU) Testing Complete

NASA Image and Video Library

2016-10-19

Testing of the Orion Service Module Umbilical (OSMU) was completed at the Launch Equipment Test Facility at NASA’s Kennedy Space Center in Florida. The OSMU was attached to Vehicle Motion Simulator 1 for a series of simulated launch tests to validate it for installation on the mobile launcher. Patrick Simpkins, director of Engineering, speaks to the test team during an event to mark the end of testing. The mobile launcher tower will be equipped with a number of lines, called umbilicals that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. Kennedy's Engineering Directorate is providing support to the Ground Systems Development and Operations Program for testing of the OSMU. EM-1 is scheduled to launch in 2018.

Orion Service Module Umbilical (OSMU) Testing Complete

NASA Image and Video Library

2016-10-19

Testing of the Orion Service Module Umbilical (OSMU) was completed at the Launch Equipment Test Facility at NASA’s Kennedy Space Center in Florida. The OSMU was attached to Vehicle Motion Simulator 1 for a series of simulated launch tests to validate it for installation on the mobile launcher. The test team gathered with a special banner during an event to mark the end of testing. The mobile launcher tower will be equipped with a number of lines, called umbilicals that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. Kennedy's Engineering Directorate is providing support to the Ground Systems Development and Operations Program for testing of the OSMU. EM-1 is scheduled to launch in 2018.

Orion Service Module Umbilical (OSMU) Testing Complete

NASA Image and Video Library

2016-10-19

Testing of the Orion Service Module Umbilical (OSMU) was completed at the Launch Equipment Test Facility at NASA’s Kennedy Space Center in Florida. The OSMU was attached to Vehicle Motion Simulator 1 for a series of simulated launch tests to validate it for installation on the mobile launcher. One of the test team members signs a banner during an event to mark the end of testing. The mobile launcher tower will be equipped with a number of lines, called umbilicals that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. Kennedy's Engineering Directorate is providing support to the Ground Systems Development and Operations Program for testing of the OSMU. EM-1 is scheduled to launch in 2018.

Orion Service Module Umbilical (OSMU) Testing Complete

NASA Image and Video Library

2016-10-19

Testing of the Orion Service Module Umbilical (OSMU) was completed at the Launch Equipment Test Facility at NASA’s Kennedy Space Center in Florida. The OSMU was attached to Vehicle Motion Simulator 1 for a series of simulated launch tests to validate it for installation on the mobile launcher. The test team signed a special banner during an event to mark the end of testing. The mobile launcher tower will be equipped with a number of lines, called umbilicals that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. Kennedy's Engineering Directorate is providing support to the Ground Systems Development and Operations Program for testing of the OSMU. EM-1 is scheduled to launch in 2018.

Impact of emergency medical services stroke routing protocols on Primary Stroke Center certification in California.

PubMed

Schuberg, Sam; Song, Sarah; Saver, Jeffrey L; Mack, William J; Cen, Steven Y; Sanossian, Nerses

2013-12-01

Organized stroke systems of care include Primary Stroke Center (PSC) certification and preferential emergency medical services (EMS) routing of suspected patients with stroke to designated PSCs. Stroke EMS routing is not nationally governed; in California, routing is determined by county. EMS routing policies might provide an incentive for PSC accreditation. We evaluated the relationship between independent adoption of EMS routing protocols and PSC designation acquisition in California. Dates of PSC certification were obtained through The Joint Commissions Website and confirmatory calls to stroke coordinators. Starting date of county EMS PSC routing policies was obtained from county EMS agencies. We provide descriptive analysis of number of hospitals achieving PSC designation relative to implementation of EMS routing policies for all counties with PSCs. By June 2012, there were 131 California PSCs in 27 counties, and 22 of 58 counties had implemented EMS routing policies. The greatest number of PSCs was in Los Angeles (30) followed by San Diego (11), Orange (9), and Santa Clara (9) counties. Achievement of PSC designation occurred more frequently immediately before and after EMS routing: 51 PSCs (39%) within 1 year; 85 PSCs (65%) within 2 years. The yearly rate of eligible hospital conversion to PSC designation accelerated concurrent with EMS diversion policy adoption from 3.8% before to 16.2% during and decelerated afterward to 7.6%. Implementation of EMS routing policies may be an important factor driving PSC certification. National adoption of stroke routing policies may lead to more PSCs, positively impacting patient care.

European Service Module Structural Test Article Load onto Transport Truck

NASA Image and Video Library

2017-06-21

The Orion service module structural test article for Exploration Mission-1 (EM-1), built by the European Space Agency, is prepared for shipment to Lockheed Martin's Denver facility to undergo testing. Inside the Neil Armstrong Operations and Checkout Building high bay at NASA's Kennedy Space Center in Florida, a crane lifts the module onto a transport truck, where it is secured to be moved to the Shuttle Landing Facility for shipment. The Orion spacecraft will launch atop the agency's Space Launch System rocket on EM-1 in 2019.

European Service Module-Structural Test Article Load onto Transp

NASA Image and Video Library

2017-06-21

The Orion service module structural test article for Exploration Mission-1 (EM-1), built by the European Space Agency, is prepared for shipment to Lockheed Martin's Denver facility to undergo testing. Inside the Neil Armstrong Operations and Checkout Building high bay at NASA's Kennedy Space Center in Florida, workers secure the protective covering around the module and a crane lifts the module, secured on stand, for the move to the transport truck. The Orion spacecraft will launch atop the agency's Space Launch System rocket on EM-1 in 2019.

Doppler Radar National Mosaic - NOAA's National Weather Service

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Skip Navigation Links weather.gov NOAA logo-Select to go to the NOAA homepage National Oceanic and Atmospheric Administration's Select to go to the NWS homepage National Weather Service Site Map News select the go button to submit request City, St Go Sign-up for Email Alerts RSS Feeds RSS Feeds Warnings

2010 ESGR Employer Support Freedom Awards

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business consistently offers seamless customer service even when office manager, U.S. Navy Petty Officer continues to provide full differential pay and health benefits to its only Guard and Reserve member when he respect for me and the duties required of Reservists. He likes to tell people about my service. This is

Ocean Drilling Program: Information Services: Database Services

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Available Examples of Data Core Photos Logging Database (LDEO-BRG) RIDGE Petrological Database (LDEO from postcruise research All ODP and DSDP core photos All ODP data are available online through Janus proprietary for a period of one year after the end of a cruise and are available only to the participating

Two-way Satellite Time Transfer - Naval Oceanography Portal

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section Advanced Search... Sections Home Time Earth Orientation Astronomy Meteorology Oceanography Ice You are here: Home › USNO › Precise Time › TWSTT USNO Logo USNO Navigation Master Clock GPS Display Clocks TWSTT What is TWSTT? Operational Services Calibration Services Precision Telephone Time NTP Info

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E-print Network Alert Service

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Website Policies and Important Links E-print Web Log alert image About Search Browse by Discipline search profile you submit to us. You can even receive new postings from a number of sites by submitting a profiles as you wish. Simply register for the Service and create your search strategies for your profiles

Defense.gov - Congressional Gold Medal Presentation: Women Airforce Service

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, received the Congressional Gold Medal at a ceremony in the Capitol. Story Female World War II Pilots World War II Women Airforce Service Pilot corps remembered their sisters-in-arms during a wreath-laying homage to the achievements of the first women to fly military aircraft during World War II. Story Women

GOES Composite - El Niño Support Imagery - Satellite Products and Services

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Division/Office of Satellite and Product Operations Skip Navigation Link NESDIS banner image Information Service Home Page Default Office of Satellite and Product Operations banner image and link to OSPO MIRS MSPPS Ocean -- Coral Bleaching -- Ocean Color -- Sea/Lake Ice -- Sea Surface Height -- Sea Surface

Disaster Relief and Emergency Medical Services Project (DREAMS TM): Digital EMS

DTIC Science & Technology

2000-10-01

exchanges between the hospital and the EMS vehicle. By creating the virtual presence of a physician at or near the emergency scene, more lives will be saved ...address, cross street, zip code etc. The map can be saved to the clipboard or to an EMF graphics file for use by other applications in the system. 29...section can be found in Appendix B. The EMS personnel on board the ambulance can benefit greatly from technology integration. Several time- saving

National Weather Service - Strategic Planning and Policy

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Policy ATTN: W/SP 1325 East-West Highway Silver Spring, MD 20910-3283 Phone: (301) 713-0258; Fax: (301 Administration National Weather Service Strategic Planning and Policy Office 1325 East West Highway Silver Spring

Pediatric Intubation by Paramedics in a Large Emergency Medical Services System: Process, Challenges, and Outcomes.

PubMed

Prekker, Matthew E; Delgado, Fernanda; Shin, Jenny; Kwok, Heemun; Johnson, Nicholas J; Carlbom, David; Grabinsky, Andreas; Brogan, Thomas V; King, Mary A; Rea, Thomas D

2016-01-01

Pediatric intubation is a core paramedic skill in some emergency medical services (EMS) systems. The literature lacks a detailed examination of the challenges and subsequent adjustments made by paramedics when intubating children in the out-of-hospital setting. We undertake a descriptive evaluation of the process of out-of-hospital pediatric intubation, focusing on challenges, adjustments, and outcomes. We performed a retrospective analysis of EMS responses between 2006 and 2012 that involved attempted intubation of children younger than 13 years by paramedics in a large, metropolitan EMS system. We calculated the incidence rate of attempted pediatric intubation with EMS and county census data. To summarize the intubation process, we linked a detailed out-of-hospital airway registry with clinical records from EMS, hospital, or autopsy encounters for each child. The main outcome measures were procedural challenges, procedural success, complications, and patient disposition. Paramedics attempted intubation in 299 cases during 6.3 years, with an incidence of 1 pediatric intubation per 2,198 EMS responses. Less than half of intubations (44%) were for patients in cardiac arrest. Two thirds of patients were intubated on the first attempt (66%), and overall success was 97%. The most prevalent challenge was body fluids obscuring the laryngeal view (33%). After a failed first intubation attempt, corrective actions taken by paramedics included changing equipment (33%), suctioning (32%), and repositioning the patient (27%). Six patients (2%) experienced peri-intubation cardiac arrest and 1 patient had an iatrogenic tracheal injury. No esophageal intubations were observed. Of patients transported to the hospital, 86% were admitted to intensive care and hospital mortality was 27%. Pediatric intubation by paramedics was performed infrequently in this EMS system. Although overall intubation success was high, a detailed evaluation of the process of intubation revealed specific challenges and adjustments that can be anticipated by paramedics to improve first-pass success, potentially reduce complications, and ultimately improve clinical outcomes. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

National Weather Service will stop using all caps in its forecasts |

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lines. Teleprinters only allowed the use of upper case letters, and while the hardware and software used not for lack of trying. The National Weather Service has proposed to use mixed-case letters several times since the 1990s, when widespread use of the Internet and email made teletype obsolete. In fact, in

Comparing Methodologies for Evaluating Emergency Medical Services Ground Transport Access to Time-critical Emergency Services: A Case Study Using Trauma Center Care.

PubMed

Doumouras, Aristithes G; Gomez, David; Haas, Barbara; Boyes, Donald M; Nathens, Avery B

2012-09-01

The regionalization of medical services has resulted in improved outcomes and greater compliance with existing guidelines. For certain "time-critical" conditions intimately associated with emergency medicine, early intervention has demonstrated mortality benefits. For these conditions, then, appropriate triage within a regionalized system at first diagnosis is paramount, ideally occurring in the field by emergency medical services (EMS) personnel. Therefore, EMS ground transport access is an important metric in the ongoing evaluation of a regionalized care system for time-critical emergency services. To our knowledge, no studies have demonstrated how methodologies for calculating EMS ground transport access differ in their estimates of access over the same study area for the same resource. This study uses two methodologies to calculate EMS ground transport access to trauma center care in a single study area to explore their manifestations and critically evaluate the differences between the methodologies. Two methodologies were compared in their estimations of EMS ground transport access to trauma center care: a routing methodology (RM) and an as-the-crow-flies methodology (ACFM). These methodologies were adaptations of the only two methodologies that had been previously used in the literature to calculate EMS ground transport access to time-critical emergency services across the United States. The RM and ACFM were applied to the nine Level I and Level II trauma centers within the province of Ontario by creating trauma center catchment areas at 30, 45, 60, and 120 minutes and calculating the population and area encompassed by the catchments. Because the methodologies were identical for measuring air access, this study looks specifically at EMS ground transport access. Catchments for the province were created for each methodology at each time interval, and their populations and areas were significantly different at all time periods. Specifically, the RM calculated significantly larger populations at every time interval while the ACFM calculated larger catchment area sizes. This trend is counterintuitive (i.e., larger catchment should mean higher populations), and it was found to be most disparate at the shortest time intervals (under 60 minutes). Through critical evaluation of the differences, the authors elucidated that the ACFM could calculate road access in areas with no roads and overestimates access in low-density areas compared to the RM, potentially affecting delivery of care decisions. Based on these results, the authors believe that future methodologies for calculating EMS ground transport access must incorporate a continuous and valid route through the road network as well as use travel speeds appropriate to the road segments traveled; alternatively, we feel that variation in methods for calculating road distances would have little effect on realized access. Overall, as more complex models for calculating EMS ground transport access become used, there needs to be a standard methodology to improve and to compare it to. Based on these findings, the authors believe that this should be the RM. © 2012 by the Society for Academic Emergency Medicine.

On Real-Time Operating Systems.

DTIC Science & Technology

1987-04-01

1Ri2 193 ONREAL-TIME OPERATING SYS EMS(U MAYLAN UN V COLLG PARK DEPT OF COMPUTER SCIENCE S LEVI ET AL APR 87 CS-TR-1838 NOSO14-87-K-9124 UNCLASSIFIED...and processes. In each instance the abstraction takes the form of some non- physical resource and benefits both the system and the user. ...The...service, which is important as an inter-process service (for physical synchronization) as well as an internal service for a process. A time service in a

Epidemiology of Pediatric Prehospital Basic Life Support Care in the United States.

PubMed

Diggs, Leigh Ann; Sheth-Chandra, Manasi; De Leo, Gianluca

2016-01-01

Children have unique medical needs compared to adults. Emergency medical services personnel need proper equipment and training to care for children. The purpose of this study is to characterize emergency medical services pediatric basic life support to help better understand the needs of children transported by ambulance. Pediatric basic life support patients were identified in this retrospective descriptive study. Descriptive statistics were used to examine incident location, possible injury, cardiac arrest, resuscitation attempted, chief complaint, primary symptom, provider's primary impression, cause of injury, and procedures performed during pediatric basic life support calls using the largest aggregate of emergency medical services data available, the 2013 National Emergency Medical Services Information System (NEMSIS) Public Release Research Data Set. Pediatric calls represented 7.4% of emergency medical services activations. Most pediatric patients were male (49.8%), White (40.0%), and of non-Hispanic origin (56.5%). Most incidents occurred in the home. Injury, cardiac arrest, and resuscitation attempts were highest in the 15 to 19 year old age group. Global complaints (37.1%) predominated by anatomic location and musculoskeletal complaints (26.9%) by organ system. The most common primary symptom was pain (30.3%) followed by mental/psychiatric (13.4%). Provider's top primary impression was traumatic injury (35.7%). The most common cause of injury was motor vehicle accident (32.3%). The most common procedure performed was patient assessment (27.4%). Median EMS system response time was 7 minutes (IQR: 5-12). Median EMS scene time was 12 minutes (IQR: 8-19). Median transport time was 14 minutes (IQR: 8-24). Median EMS total call time was 51 minutes (IQR: 33-77). The epidemiology of pediatric basic life support can help to guide efforts in both emergency medical services operations and training.

Emergency medical services as a strategy for improving ST-elevation myocardial infarction system treatment times.

PubMed

Langabeer, James R; Dellifraine, Jami; Fowler, Raymond; Jollis, James G; Stuart, Leilani; Segrest, Wendy; Griffin, Russell; Koenig, William; Moyer, Peter; Henry, Timothy D

2014-03-01

Reducing delays in time to treatment is a key goal of ST-elevation myocardial infarction (STEMI) emergency care. Emergency medical services (EMS) are a critical component of the STEMI chain of survival. We sought to assess the impact of the careful integration of EMS as a strategy for improving systemic treatment times for STEMI. We conducted a study of all 747 nontransfer STEMI patients who underwent primary percutaneous coronary intervention (PCI) in Dallas County, Texas from October 1, 2010 through December 31, 2011. EMS leaders from 24 agencies and 15 major PCI receiving hospitals collected and shared common, de-identified patient data. We used 15 months of data to develop a generalized linear regression to assess the impact of EMS on two treatment metrics-hospital door to balloon (D2B) time, and symptom onset to arterial reperfusion (SOAR) time, a new metric we developed to assess total treatment times. We found statistically significant reductions in median D2B (11.1-min reduction) and SOAR (63.5-min reduction) treatment times when EMS transported patients to the receiving facility, compared to self-transport. In addition, when trained EMS paramedics field-activated the cardiac catheterization laboratory using predefined specified protocols, D2B times were reduced by 38% (43 min) after controlling for confounding variables, and field activation was associated with a 21.9% reduction (73 min) in the mean SOAR time (both with p < 0.001). Active EMS engagement in STEMI treatment was associated with significantly lower D2B and total coronary reperfusion times. Copyright © 2014 Elsevier Inc. All rights reserved.

A validation of ground ambulance pre-hospital times modeled using geographic information systems

PubMed Central

2012-01-01

Background Evaluating geographic access to health services often requires determining the patient travel time to a specified service. For urgent care, many research studies have modeled patient pre-hospital time by ground emergency medical services (EMS) using geographic information systems (GIS). The purpose of this study was to determine if the modeling assumptions proposed through prior United States (US) studies are valid in a non-US context, and to use the resulting information to provide revised recommendations for modeling travel time using GIS in the absence of actual EMS trip data. Methods The study sample contained all emergency adult patient trips within the Calgary area for 2006. Each record included four components of pre-hospital time (activation, response, on-scene and transport interval). The actual activation and on-scene intervals were compared with those used in published models. The transport interval was calculated within GIS using the Network Analyst extension of Esri ArcGIS 10.0 and the response interval was derived using previously established methods. These GIS derived transport and response intervals were compared with the actual times using descriptive methods. We used the information acquired through the analysis of the EMS trip data to create an updated model that could be used to estimate travel time in the absence of actual EMS trip records. Results There were 29,765 complete EMS records for scene locations inside the city and 529 outside. The actual median on-scene intervals were longer than the average previously reported by 7–8 minutes. Actual EMS pre-hospital times across our study area were significantly higher than the estimated times modeled using GIS and the original travel time assumptions. Our updated model, although still underestimating the total pre-hospital time, more accurately represents the true pre-hospital time in our study area. Conclusions The widespread use of generalized EMS pre-hospital time assumptions based on US data may not be appropriate in a non-US context. The preference for researchers should be to use actual EMS trip records from the proposed research study area. In the absence of EMS trip data researchers should determine which modeling assumptions more accurately reflect the EMS protocols across their study area. PMID:23033894

hi_dni_10km

Science.gov Websites

Microsoft Windows XP Version 5.1 (Build 2600) Service Pack 3; ESRI ArcCatalog 9.3.0.1770 en Monthly and @NREL.gov 10km Direct Normal Microsoft Windows XP Version 5.1 (Build 2600) Service Pack 3; ESRI ArcCatalog

--No Title--

Science.gov Websites

} ItemDescription Microsoft Windows XP Version 5.1 (Build 2600) Service Pack 3; ESRI ArcCatalog 9.3.1.3000 en Annual Student RPP 303-384-7278 nick.grue@nrel.gov Microsoft Windows XP Version 5.1 (Build 2600) Service Pack 3

Linking household and health facility surveys to assess obstetric service availability, readiness and coverage: evidence from 17 low- and middle-income countries.

PubMed

Kanyangarara, Mufaro; Chou, Victoria B; Creanga, Andreea A; Walker, Neff

2018-06-01

Improving access and quality of obstetric service has the potential to avert preventable maternal, neonatal and stillborn deaths, yet little is known about the quality of care received. This study sought to assess obstetric service availability, readiness and coverage within and between 17 low- and middle-income countries. We linked health facility data from the Service Provision Assessments and Service Availability and Readiness Assessments, with corresponding household survey data obtained from the Demographic and Health Surveys and Multiple Indicator Cluster Surveys. Based on performance of obstetric signal functions, we defined four levels of facility emergency obstetric care (EmOC) functionality: comprehensive (CEmOC), basic (BEmOC), BEmOC-2, and low/substandard. Facility readiness was evaluated based on the direct observation of 23 essential items; facilities "ready to provide obstetric services" had ≥20 of 23 items available. Across countries, we used medians to characterize service availability and readiness, overall and by urban-rural location; analyses also adjusted for care-seeking patterns to estimate population-level coverage of obstetric services. Of the 111 500 health facilities surveyed, 7545 offered obstetric services and were included in the analysis. The median percentages of facilities offering EmOC and "ready to provide obstetric services" were 19% and 10%, respectively. There were considerable urban-rural differences, with absolute differences of 19% and 29% in the availability of facilities offering EmOC and "ready to provide obstetric services", respectively. Adjusting for care-seeking patterns, results from the linking approach indicated that among women delivering in a facility, a median of 40% delivered in facilities offering EmOC, and 28% delivered in facilities "ready to provide obstetric services". Relatively higher coverage of facility deliveries (≥65%) and coverage of deliveries in facilities "ready to provide obstetric services" (≥30% of facility deliveries) were only found in three countries. The low levels of availability, readiness and coverage of obstetric services documented represent substantial missed opportunities within health systems. Global and national efforts need to prioritize upgrading EmOC functionality and improving readiness to deliver obstetric service, particularly in rural areas. The approach of linking health facility and household surveys described here could facilitate the tracking of progress towards quality obstetric care.

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Police transport versus ground EMS: A trauma system-level evaluation of prehospital care policies and their effect on clinical outcomes.

PubMed

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

2016-11-01

Rapid transport to definitive care ("scoop and run") versus field stabilization in trauma remains a topic of debate and has resulted in variability in prehospital policy. We aimed to identify trauma systems frequently using a true "scoop and run" police transport approach and to compare mortality rates between police and ground emergency medical services (EMS) transport. Using the National Trauma Databank (NTDB), we identified adult gunshot and stab wound patients presenting to Level 1 or 2 trauma centers from 2010 to 2012. Hospitals were grouped into their respective cities and regional trauma systems. Patients directly transported by police or ground EMS to trauma centers in the 100 most populous US trauma systems were included. Frequency of police transport was evaluated, identifying trauma systems with high utilization. Mortality rates and risk-adjusted odds ratio for mortality for police versus EMS transport were derived. Of 88,564 total patients, 86,097 (97.2%) were transported by EMS and 2,467 (2.8%) by police. Unadjusted mortality was 17.7% for police transport and 11.6% for ground EMS. After risk adjustment, patients transported by police were no more likely to die than those transported by EMS (OR = 1.00, 95% CI: 0.69-1.45). Among all police transports, 87.8% occurred in three locations (Philadelphia, Sacramento, and Detroit). Within these trauma systems, unadjusted mortality was 19.9% for police transport and 13.5% for ground EMS. Risk-adjusted mortality was no different (OR = 1.01, 95% CI: 0.68-1.50). Using trauma system-level analyses, patients with penetrating injuries in urban trauma systems were found to have similar mortality for police and EMS transport. The majority of prehospital police transport in penetrating trauma occurs in three trauma systems. These cities represent ideal sites for additional system-level evaluation of prehospital transport policies. Prognostic/epidemiologic study, level III.

An Overview of the Concept of Operations for Assembly, Integration, Testing and Ground Servicing Develoed for the MPCV-ESM Propulsion System

NASA Technical Reports Server (NTRS)

Bielozer, M.; VanLear, Benjamin S.; Kindred, N.; Monien, G.; Schulte, U.

2014-01-01

A concept of operations for the Assembly, Integration and Testing (AIT) and the Ground Systems Development Operations (GSDO) of the European Service Module (ESM) propulsion system has been developed. The AIT concept of operations covers all fabrication, integration and testing activities in both Europe and in the United States. The GSDO Program develops the facilities, equipment, and procedures for the loading of hypergolic propellants, the filling of high-pressure gases, and contingency de-servicing operations for the ESM. NASA and ESA along with the Lockheed Martin and Airbus Space and Defense are currently working together for the EM-1 and EM-2 missions in which the ESM will be flown as part of the Orion Multi-Purpose Crew Vehicle (MPCV). The NASA/ESA SM propulsion team is collaborating with the AIT personnel from ESA/Airbus and NASA/Lockheed Martin to ensure successful integration of the European designed Service Module propulsion system, the Lockheed Martin designed Crew Module Adapter and the heritage Space Shuttle Orbital Maneuvering System Engines (OMS-E) being provided as Government Furnished Equipment (GFE). This paper will provide an overview of the current AIT and GSDO concept of operations for the ESM propulsion system.

An Overview of the Concept of Operations for Assembly, Integration, Testing and Ground Servicing Developed for the MPCV-ESM Propulsion System

NASA Technical Reports Server (NTRS)

Bielozer, Matthew C.

2014-01-01

A concept of operations for the Assembly, Integration and Testing (AIT) and the Ground Systems Development Operations (GSDO) of the European Service Module (ESM) propulsion system has been developed. The AIT concept of operations covers all fabrication, integration and testing activities in both Europe and in the United States. The GSDO Program develops the facilities, equipment, and procedures for the loading of hypergolic propellants, the filling of high-pressure gases, and contingency de-servicing operations for the ESM. NASA and ESA along with the Lockheed Martin and Airbus Space and Defense are currently working together for the EM-1 and EM-2 missions in which the ESM will be flown as part of the Orion Multi-Purpose Crew Vehicle (MPCV). The NASA/ESA SM propulsion team is collaborating with the AIT personnel from ESA/Airbus and NASA/Lockheed Martin to ensure successful integration of the European designed Service Module propulsion system, the Lockheed Martin designed Crew Module Adapter and the heritage Space Shuttle Orbital Maneuvering System Engines (OMS-E) being provided as Government Furnished Equipment (GFE). This paper will provide an overview of the current AIT and GSDO concept of operations for the ESM propulsion system.

Ensuring the effectiveness of community-wide emergency cardiac care.

PubMed

Becker, L B; Pepe, P E

1993-02-01

To improve emergency cardiac care (ECC) on the national or international level, we must translate to the rest of our communities the successes found in cities with high survival rates. In recent years, important developments have evolved in our understanding of the treatment and evaluation of cardiac arrest. Some of the most important of these developments include 1) recognition of the chain of survival, which is necessary to achieve high survival rates; 2) widespread acceptance that survival rates must be assessed routinely to ensure continuous quality improvements in the emergency medical services (EMS) system; and 3) development of improved methods for performing survival rate studies that will maximize the effectiveness of information gathering and analysis. While each community should determine how to optimize their own ECC services, some general guidelines are useful. Successful treatment of cardiac arrest starts in the community with prevention and education, including early recognition of the signs and symptoms of cardiovascular ischemia. Obtaining 911 service (and preferably enhanced 911) should be a top priority for all communities. EMS dispatchers should dispatch the unit to the scene in less than one minute, provide critical information to the responders regarding the type of emergency, and offer the caller telephone-assisted CPR instructions. The EMS first-responders should strive to arrive at the patient's side in less than four minutes, be able to immediately defibrillate if necessary, and begin basic CPR. An excellent strategy to accomplish this is to equip and train all fire-fighting units in the operation of automatic external defibrillators and dispatch them as a first-responder team. To manage the cardiac arrest patient, a minimum of two rescuers trained in advanced cardiac life support plus two or more rescuers trained in basic life support are needed. Furthermore, an EMS system is not complete without on-going evaluation. Therefore, the 1992 National Conference on CPR and ECC strongly endorses the position that all ECC systems assess their survival rates through an ongoing quality improvement process and that all members of the chain of providers should be represented in the outcome assessment team. We still have much to discover regarding optimal techniques of CPR, methods for data collection, and optimal structure of an EMS system. Research in these areas will provide the foundation for future changes in EMS systems development.

NDBC - National Weather Service Marine Forecast FZUS51 KGYX

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Coastal Waters Forecast National Weather Service Gray ME 1218 PM EDT Sun May 27 2018 COASTAL WATERS FROM STONINGTON ME TO MERRIMACK RIVER MA OUT TO 25 NM ANZ100-280630- 1218 PM EDT Sun May 27 2018 Synopsis for - 1218 PM EDT Sun May 27 2018 SMALL CRAFT ADVISORY IN EFFECT UNTIL 6 PM EDT THIS EVENING REST OF TODAY E

ESTRACK Support for CCSDS Space Communication Cross Support Service Management

NASA Astrophysics Data System (ADS)

Dreihahn, H.; Unal, M.; Hoffmann, A.

2011-08-01

The CCSDS Recommended Standard for Space Communication Cross Support Service Management (SCCS SM) published as Blue Book in August 2009 is intended to provide standardised interfaces to negotiate, schedule, and manage the support of space missions by ground station network operators. ESA as a member of CCSDS has actively supported the development of the SCCS SM standard and is obviously interested in adopting it. Support of SCCS SM conforming interfaces and procedures includes:• Provision of SCCS SM conforming interfaces to non ESA missions;• Use of SCCS SM interfaces provided by other ground station operators to manage cross support of ESA missions;• In longer terms potentially use of SCCS SM interfaces and procedures also internally for support of ESA missions by ESTRACK.In the recent years ESOC has automated management and scheduling of ESA Tracking Network (ESTRACK) services by the specification, development, and deployment of the ESTRACK Management System (EMS), more specifically its planning and scheduling components ESTRACK Planning System and ESTRACK Scheduling System. While full support of the SCCS SM standard will involve also other elements of the ground segment operated by ESOC such as the Flight Dynamic System, EMS is at the core of service management and it is therefore appropriate to initially focus on the question to what extent EMS can support SCCS SM. This paper presents results of the initial analysis phase. After briefly presenting the SCCS SM standard and the relevant components of the ESTRACK management system, we will discuss the initial deployment options, open issues and a tentative roadmap for the way to proceed. Obviously the adoption of a cross support standard requires and discussion and coordination of the involved parties and agencies, especially in the light of the fact that the SCCS SM standard has many optional parts.

Response interval comparison between urban fire departments and ambulance services.

PubMed

Jermyn, B D

1999-01-01

To measure the response intervals of fire departments compared with ambulance services in three urban centers to determine whether defibrillators should be added to fire vehicles. A prospective sample of 1,882 code 4 (life-threatening) tiered calls were collected over a six-month period from March 1, 1994, to August 31, 1994. A matched pairs experimental design compared the response interval of the fire department with that of the ambulance service for each call. This emergency medical services (EMS) system encompasses three urban centers with populations of 80,000, 95,000, and 170,000. In two of three of the urban centers, the fire department arrived on scene more than a minute sooner than the ambulance service: Cambridge (n = 571, mean = 2.22 min, p < 0.0001); Kitchener (n = 1,011, mean = 1.24 min, p < 0.003); and Waterloo (n = 300, mean = 0.69 min, p < 0.98). The shorter response interval of fire departments suggests placing defibrillators on fire response vehicles in an effort to decrease the time to defibrillation for cardiac arrest victims in this EMS system.

Determinants of ambulance response time: A study in Sabah, Malaysia

NASA Astrophysics Data System (ADS)

Chin, Su Na; Cheah, Phee Kheng; Arifin, Muhamad Yaakub; Wong, Boh Leng; Omar, Zaturrawiah; Yassin, Fouziah Md; Gabda, Darmesah

2017-04-01

Ambulance response time (ART) is one of the standard key performance indicators (KPI) in measuring the emergency medical services (EMS) delivery performances. When the mean time of ART of EMS system reaches the KPI target, it shows that the EMS system performs well. This paper considers the determinants of ART, using data sampled from 967 ambulance runs in a government hospital in Sabah. Multiple regression analysis with backward elimination was proposed for the identification of significant factors. Amongst the underlying factors, travel distance, age of patients, type of treatment and peak hours were identified to be significantly affecting ART. Identifying factors that influence ART helps the development of strategic improvement planning for reducing the ART.

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Prehospital Indicators for Disaster Preparedness and Response: New York City Emergency Medical Services in Hurricane Sandy.

PubMed

Smith, Silas W; Braun, James; Portelli, Ian; Malik, Sidrah; Asaeda, Glenn; Lancet, Elizabeth; Wang, Binhuan; Hu, Ming; Lee, David C; Prezant, David J; Goldfrank, Lewis R

2016-06-01

We aimed to evaluate emergency medical services (EMS) data as disaster metrics and to assess stress in surrounding hospitals and a municipal network after the closure of Bellevue Hospital during Hurricane Sandy in 2012. We retrospectively reviewed EMS activity and call types within New York City's 911 computer-assisted dispatch database from January 1, 2011, to December 31, 2013. We evaluated EMS ambulance transports to individual hospitals during Bellevue's closure and incremental recovery from urgent care capacity, to freestanding emergency department (ED) capability, freestanding ED with 911-receiving designation, and return of inpatient services. A total of 2,877,087 patient transports were available for analysis; a total of 707,593 involved Manhattan hospitals. The 911 ambulance transports disproportionately increased at the 3 closest hospitals by 63.6%, 60.7%, and 37.2%. When Bellevue closed, transports to specific hospitals increased by 45% or more for the following call types: blunt traumatic injury, drugs and alcohol, cardiac conditions, difficulty breathing, "pedestrian struck," unconsciousness, altered mental status, and emotionally disturbed persons. EMS data identified hospitals with disproportionately increased patient loads after Hurricane Sandy. Loss of Bellevue, a public, safety net medical center, produced statistically significant increases in specific types of medical and trauma transports at surrounding hospitals. Focused redeployment of human, economic, and social capital across hospital systems may be required to expedite regional health care systems recovery. (Disaster Med Public Health Preparedness. 2016;10:333-343).

Medicare payments to the neurology workforce in 2012

PubMed Central

Skolarus, Lesli E.; Burke, James F.; Callaghan, Brian C.; Becker, Amanda

2015-01-01

Objective: Little is known about how neurology payments vary by service type (i.e., evaluation and management [E/M] vs tests/treatments) and compare to other specialties, yet this information is necessary to help neurology define its position on proposed payment reform. Methods: Medicare Provider Utilization and Payment Data from 2012 were used. These data included all direct payments to providers who care for fee-for-service Medicare recipients. Total payment was determined by medical specialty and for various services (e.g., E/M, EEG, electromyography/nerve conduction studies, polysomnography) within neurology. Payment and proportion of services were then calculated across neurologists' payment categories. Results: Neurologists comprised 1.5% (12,317) of individual providers who received Medicare payments and were paid $1.15 billion by Medicare in 2012. Sixty percent ($686 million) of the Medicare payment to neurologists was for E/M, which was a lower proportion than primary providers (approximately 85%) and higher than surgical subspecialties (range 9%–51%). The median neurologist received nearly 75% of their payments from E/M. Two-thirds of neurologists received 60% or more of their payment from E/M services and over 20% received all of their payment from E/M services. Neurologists in the highest payment category performed more services, of which a lower proportion were E/M, and performed at a facility, compared to neurologists in lower payment categories. Conclusion: E/M is the dominant source of payment to the majority of neurologists and should be prioritized by neurology in payment restructuring efforts. PMID:25832665

Medicare payments to the neurology workforce in 2012.

PubMed

Skolarus, Lesli E; Burke, James F; Callaghan, Brian C; Becker, Amanda; Kerber, Kevin A

2015-04-28

Little is known about how neurology payments vary by service type (i.e., evaluation and management [E/M] vs tests/treatments) and compare to other specialties, yet this information is necessary to help neurology define its position on proposed payment reform. Medicare Provider Utilization and Payment Data from 2012 were used. These data included all direct payments to providers who care for fee-for-service Medicare recipients. Total payment was determined by medical specialty and for various services (e.g., E/M, EEG, electromyography/nerve conduction studies, polysomnography) within neurology. Payment and proportion of services were then calculated across neurologists' payment categories. Neurologists comprised 1.5% (12,317) of individual providers who received Medicare payments and were paid $1.15 billion by Medicare in 2012. Sixty percent ($686 million) of the Medicare payment to neurologists was for E/M, which was a lower proportion than primary providers (approximately 85%) and higher than surgical subspecialties (range 9%-51%). The median neurologist received nearly 75% of their payments from E/M. Two-thirds of neurologists received 60% or more of their payment from E/M services and over 20% received all of their payment from E/M services. Neurologists in the highest payment category performed more services, of which a lower proportion were E/M, and performed at a facility, compared to neurologists in lower payment categories. E/M is the dominant source of payment to the majority of neurologists and should be prioritized by neurology in payment restructuring efforts. © 2015 American Academy of Neurology.

Treasury > Home

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Establishment Criteria for Integrated Wind Shear Detection Systems: Low-Level Wind Shear Alert System (LLWAS), Terminal Doppler Weather Radar (TDWR), and Modified Airport Surveillance Radar

DTIC Science & Technology

1990-12-01

Overviev . ......................................... 9 2. Programs , Syr!ems, and Services ........................ 11 a. National Weather Service...Equipment Appropriation. ADA, a computer system developed and maintained by the Office of Aviation Policy and rlans, facilitates APS-I processing... Program Plan. The primary benefit of LLWAS, TDWR, and modified airport surveillance radar is reduced risk and expected incidence of wind shear-related

Sustainability Goals

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EMS-physicians' self reported airway management training and expertise; a descriptive study from the Central Region of Denmark

PubMed Central

2011-01-01

Background Prehospital advanced airway management, including prehospital endotracheal intubation is challenging and recent papers have addressed the need for proper training, skill maintenance and quality control for emergency medical service personnel. The aim of this study was to provide data regarding airway management-training and expertise from the regional physician-staffed emergency medical service (EMS). Methods The EMS in this part of The Central Region of Denmark is a two tiered system. The second tier comprises physician staffed Mobile Emergency Care Units. The medical directors of the programs supplied system data. A questionnaire addressing airway management experience, training and knowledge was sent to the EMS-physicians. Results There are no specific guidelines, standard operating procedures or standardised program for obtaining and maintaining skills regarding prehospital advanced airway management in the schemes covered by this study. 53/67 physicians responded; 98,1% were specialists in anesthesiology, with an average of 17,6 years of experience in anesthesiology, and 7,2 years experience as EMS-physicians. 84,9% reported having attended life support course(s), 64,2% an advanced airway management course. 24,5% fulfilled the curriculum suggested for Danish EMS physicians. 47,2% had encountered a difficult or impossible PHETI, most commonly in a patient in cardiac arrest or a trauma patient. Only 20,8% of the physicians were completely familiar with what back-up devices were available for airway management. Conclusions In this, the first Danish study of prehospital advanced airway management, we found a high degree of experience, education and training among the EMS-physicians, but their equipment awareness was limited. Check-outs, guidelines, standard operating procedures and other quality control measures may be needed. PMID:21303510

Increasing off-service resident productivity while on their emergency department rotation using shift cards.

PubMed

Chakravarthy, Bharath; Posadas, Emerson; Ibrahim, Deena; McArthur, Kurt; Osborn, Megan; Hoonpongsimanont, Wirachin; Wong, Andrew; Lotfipour, Shahram

2015-04-01

Differences in productivity between off-service residents rotating in the emergency department (ED) and their emergency medicine (EM) resident counterparts have never been directly quantified. We sought to quantify the difference between off-service residents rotating in the ED and their EM resident counterparts. We also sought to find whether shift cards could be used to increase the productivity of off-service residents rotating in the ED. This is a prospective cohort study conducted at an urban, tertiary, Level I trauma center. We implemented the use of shift cards for off-service residents during their EM rotation. Completion of the shift card involved recording patients seen and their dispositions, procedures done, and documenting a learned bedside teaching point from their shift that day. Productivity was measured in terms of patients seen per hour (PPH) and relative value units per hour (RVU/h). Off-service residents showed a productivity of 0.529 PPH (95% confidence interval [CI] 0.493-0.566) and 1.40 RVU/h (95% CI 1.28-1.53) prior to implementation of shift cards. With the introduction of shift cards, productivity increased to 0.623 PPH (95% CI 0.584-0.663, p = 0.001) and 1.77 RVU/h (95% CI 1.64-1.91, p = 0.001). In comparison, first year EM resident productivity was 0.970 PPH (95% CI 0.918-1.02) and 3.01 RVU/h (95% CI 2.83-3.19). Shift cards can be used to foster motivation for off-service residents rotating in the ED, and is a simple and cost-effective method to improve system-based practices and utilization of resources. Copyright © 2015 Elsevier Inc. All rights reserved.

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Developing an analytical tool for evaluating EMS system design changes and their impact on cardiac arrest outcomes: combining geographic information systems with register data on survival rates

PubMed Central

2013-01-01

Background Out-of-hospital cardiac arrest (OHCA) is a frequent and acute medical condition that requires immediate care. We estimate survival rates from OHCA in the area of Stockholm, through developing an analytical tool for evaluating Emergency Medical Services (EMS) system design changes. The study also is an attempt to validate the proposed model used to generate the outcome measures for the study. Methods and results This was done by combining a geographic information systems (GIS) simulation of driving times with register data on survival rates. The emergency resources comprised ambulance alone and ambulance plus fire services. The simulation model predicted a baseline survival rate of 3.9 per cent, and reducing the ambulance response time by one minute increased survival to 4.6 per cent. Adding the fire services as first responders (dual dispatch) increased survival to 6.2 per cent from the baseline level. The model predictions were validated using empirical data. Conclusion We have presented an analytical tool that easily can be generalized to other regions or countries. The model can be used to predict outcomes of cardiac arrest prior to investment in EMS design changes that affect the alarm process, e.g. (1) static changes such as trimming the emergency call handling time or (2) dynamic changes such as location of emergency resources or which resources should carry a defibrillator. PMID:23415045

A Descriptive Analysis of US Prehospital Care Response to Law Enforcement Tactical Incidents.

PubMed

Aberle, Sara J; Lohse, Christine M; Sztajnkrycer, Matthew D

2015-01-01

Law enforcement tactical incidents involve high-risk operations that exceed the capabilities of regular, uniformed police. Despite the existence of tactical teams for 50 years, little is known about the frequency or nature of emergency medical services (EMS) response to tactical events in the United States. The purpose of this study was to perform a descriptive analysis of tactical events reported to a national EMS database. Descriptive analysis of the 2012 National Emergency Medical Services Information System (NEMSIS) Public Release research data set, containing EMS emergency response data from 41 states. A total of 17,479,328 EMS events were reported, of which 3,953 events were coded as "Activation-Tactical or SWAT Specialty Service/Response Team." The most common level of prehospital care present on scene was basic life support (55.2%). The majority (72.3%) of tactical incident activations involved a single patient; mass casualty incidents occurred in 0.5% of events. The most common EMS response locations were homes (48.4%), streets or highways (37.0%), and public buildings (6.3%). The mean age of treated patients was 44.1 years ± 22.0 years; 3.5% of tactical incident activation patients were aged 8 years or less. Injuries were coded as firearm assault in 14.8% and as chemical exposure in 8.9% of events. Cardiac arrest occurred in 5.1% of patients, with the majority (92.2%) occurring prior to EMS arrival. The primary symptoms reported by EMS personnel were pain (37.4%), change in responsiveness (13.1%), and bleeding (8.1%). Advanced airway procedures occurred in 30 patients. No patients were documented as receiving tourniquets or needle thoracostomy. Approximately 11 EMS responses in support of law enforcement tactical operations occur daily in the United States. The majority occur in homes and involve a single patient. Advanced airway procedures are required in a minority of patients. Cardiac arrest is rare and occurs prior to EMS response in the majority of cases. Better understanding of the nature and location of EMS responses to tactical incidents is required to develop consistent EMS policies in support of law enforcement tactical operations. 2015.

Use of emergency medical service transport among patients with ST-segment-elevation myocardial infarction: findings from the National Cardiovascular Data Registry Acute Coronary Treatment Intervention Outcomes Network Registry-Get With The Guidelines.

PubMed

Mathews, Robin; Peterson, Eric D; Li, Shuang; Roe, Matthew T; Glickman, Seth W; Wiviott, Stephen D; Saucedo, Jorge F; Antman, Elliott M; Jacobs, Alice K; Wang, Tracy Y

2011-07-12

Activation of emergency medical services (EMS) is critical for the early triage and treatment of patients experiencing ST-segment-elevation myocardial infarction, yet data regarding EMS use and its association with subsequent clinical care are limited. We performed an observational analysis of 37 634 ST-segment-elevation myocardial infarction patients treated at 372 US hospitals participating in the National Cardiovascular Data Registry Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With the Guidelines between January 2007 and September 2009, and examined independent patient factors associated with EMS transportation versus patient self-transportation. We found that EMS transport was used in only 60% of ST-segment-elevation myocardial infarction patients. Older patients, those living farther from the hospital, and those with hemodynamic compromise were more likely to use EMS transport. In contrast, race, income, and education level did not appear to be associated with the mode of transport. Compared with self-transported patients, EMS-transported patients had significantly shorter delays in both symptom-onset-to-arrival time (median, 89 versus 120 minutes; P<0.0001) and door-to-reperfusion time (median door-to-balloon time, 63 versus 76 minutes; P<0.0001; median door-to-needle time, 23 versus 29 minutes; P<0.0001). Emergency medical services transportation to the hospital is underused among contemporary ST-segment-elevation myocardial infarction patients. Nevertheless, use of EMS transportation is associated with substantial reductions in ischemic time and treatment delays. Community education efforts are needed to improve the use of emergency transport as part of system-wide strategies to improve ST-segment-elevation myocardial infarction reperfusion care.

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The State of Leadership Education in Emergency Medical Services: A Multi-national Qualitative Study.

PubMed

Leggio, William Joseph

2014-10-01

This study investigated how leadership is learned in Emergency Medical Services (EMS) from a multi-national perspective by interviewing EMS providers from multiple nations working in Riyadh, Kingdom of Saudi Arabia. A phenomenological, qualitative methodology was developed and 19 EMS providers from multiple nations were interviewed in June 2013. Interview questions focused on how participants learned EMS leadership as an EMS student and throughout their careers as providers. Data were analyzed to identify themes, patterns, and codes to be used for final analysis to describe findings. Emergency Medical Services leadership is primarily learned from informal mentoring and on-the-job training in less than supportive environments. Participants described learning EMS leadership during their EMS education. A triangulation of EMS educational resources yielded limited results beyond being a leader of patient care. The only course that yielded results from triangulation was EMS Management. The need to develop EMS leadership courses was supported by the findings. Findings also supported the need to include leadership education as part of continuing medical education and training. Emergency Medical Services leadership education that prepares students for the complexities of the profession is needed. Likewise, the need for EMS leadership education and training to be part of continuing education is supported. Both are viewed as a way to advance the EMS profession. A need for further research on the topic of EMS leadership is recognized, and supported, with a call for action on suggested topics identified within the study.

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services. Marine Modeling and Analysis Branch Logo Click here to go to the EMC/MMAB homepage MMAB Mission Statement The Marine Modeling and Analysis Branch is part of the Environmental Modeling Center, which is Environmental Prediction Environmental Modeling Center Marine Modeling and Analysis Branch 5830 University

Meeting national response time targets for priority 1 incidents in an urban emergency medical services system in South Africa: More ambulances won't help.

PubMed

Stein, Christopher; Wallis, Lee; Adetunji, Olufemi

2015-09-19

Response time is viewed as a key performance indicator in most emergency medical services (EMS) systems. To determine the effect of increased emergency vehicle numbers on response time performance for priority 1 incidents in an urban EMS system in Cape Town, South Africa, using discrete-event computer simulation. A simulation model was created, based on input data from part of the EMS operations. Two different versions of the model were used, one with primary response vehicles and ambulances and one with only ambulances. In both cases the models were run in seven different scenarios. The first scenario used the actual number of emergency vehicles in the real system, and in each subsequent scenario vehicle numbers were increased by adding the baseline number to the cumulative total. The model using only ambulances had shorter response times and a greater number of responses meeting national response time targets than models using primary response vehicles and ambulances. In both cases an improvement in response times and the number of responses meeting national response time targets was observed with the first incremental addition of vehicles. After this the improvements rapidly diminished and eventually became negligible with each successive increase in vehicle numbers. The national response time target for urban areas was never met, even with a seven-fold increase in vehicle numbers. The addition of emergency vehicles to an urban EMS system improves response times in priority 1 incidents, but alone is not capable of the magnitude of response time improvement needed to meet the national response time targets.

Policy, Practice, and Research Agenda for Emergency Medical Services Oversight: A Systematic Review and Environmental Scan.

PubMed

Taymour, Rekar K; Abir, Mahshid; Chamberlin, Margaret; Dunne, Robert B; Lowell, Mark; Wahl, Kathy; Scott, Jacqueline

2018-02-01

Introduction In a 2015 report, the Institute of Medicine (IOM; Washington, DC USA), now the National Academy of Medicine (NAM; Washington, DC USA), stated that the field of Emergency Medical Services (EMS) exhibits signs of fragmentation; an absence of system-wide coordination and planning; and a lack of federal, state, and local accountability. The NAM recommended clarifying what roles the federal government, state governments, and local communities play in the oversight and evaluation of EMS system performance, and how they may better work together to improve care. This systematic literature review and environmental scan addresses NAM's recommendations by answering two research questions: (1) what aspects of EMS systems are most measured in the peer-reviewed and grey literatures, and (2) what do these measures and studies suggest for high-quality EMS oversight? To answer these questions, a systematic literature review was conducted in the PubMed (National Center for Biotechnology Information, National Institutes of Health; Bethesda, Maryland USA), Web of Science (Thomson Reuters; New York, New York USA), SCOPUS (Elsevier; Amsterdam, Netherlands), and EMBASE (Elsevier; Amsterdam, Netherlands) databases for peer-reviewed literature and for grey literature; targeted web searches of 10 EMS-related government agencies and professional organizations were performed. Inclusion criteria required peer-reviewed literature to be published between 1966-2016 and grey literature to be published between 1996-2016. A total of 1,476 peer-reviewed titles were reviewed, 76 were retrieved for full-text review, and 58 were retained and coded in the qualitative software Dedoose (Manhattan Beach, California USA) using a codebook of themes. Categorizations of measure type and level of application were assigned to the extracted data. Targeted websites were systematically reviewed and 115 relevant grey literature documents were retrieved. A total of 58 peer-reviewed articles met inclusion criteria; 46 included process, 36 outcomes, and 18 structural measures. Most studies applied quality measures at the personnel level (40), followed by the agency (28) and system of care (28), and few at the oversight level (5). Numerous grey literature articles provided principles for high-quality EMS oversight. Limited quality measurement at the oversight level is an important gap in the peer-reviewed literature. The grey literature is ahead in this realm and can guide the policy and research agenda for EMS oversight quality measurement. Taymour RK , Abir M , Chamberlin M , Dunne RB , Lowell M , Wahl K , Scott J . Policy, practice, and research agenda for Emergency Medical Services oversight: a systematic review and environmental scan. Prehosp Disaster Med. 2018;33(1):89-97.

MCST Research Operations | NREL

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Readiness. Laboratory Utilization. Custom Research Equipment Design-Build Capabilities. Add short description Concept and Design Design Requirements Assessment Controls and Automation Design-Build Services International (SEMI) S2 standard assessment Computer-Aided Design (CAD)/Piping and Instrumentation Diagram (P

Retiree Benefits

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Science Programs Applied Energy Programs Civilian Nuclear Energy Programs Laboratory Directed Research Service Academies Research Associates (SARA) Postdocs, Students Employee, Retiree Resources Benefits New » Retiree Benefits Retiree Benefits Employees and retirees are the building blocks of the Lab's success. Our

Arielle Cardinal | NREL

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, Arielle worked in the hospitality sector, developing her customer service and business management skills . Arielle is responsible for overseeing and coordinating the planning, management, execution, and reporting

Demonstration of Essential Reliability Services by Utility-Scale Solar

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control (AGC) * Primary frequency control * Active power ramp rate control * Voltage regulation and reactive power control. See a list of Questions and Answers from the webinar. Read the NREL technical

Emergency Medical Services Perspectives on Identifying and Reporting Victims of Elder Abuse, Neglect, and Self-Neglect.

PubMed

Rosen, Tony; Lien, Cynthia; Stern, Michael E; Bloemen, Elizabeth M; Mysliwiec, Regina; McCarthy, Thomas J; Clark, Sunday; Mulcare, Mary R; Ribaudo, Daniel S; Lachs, Mark S; Pillemer, Karl; Flomenbaum, Neal E

2017-10-01

Emergency Medical Services (EMS) providers, who perform initial assessments of ill and injured patients, often in a patient's home, are uniquely positioned to identify potential victims of elder abuse, neglect, or self-neglect. Despite this, few organized programs exist to ensure that EMS concerns are communicated to or further investigated by other health care providers, social workers, or the authorities. To explore attitudes and self-reported practices of EMS providers surrounding identification and reporting of elder mistreatment. Five semi-structured focus groups with 27 EMS providers. Participants reported believing they frequently encountered and were able to identify potential elder mistreatment victims. Many reported infrequently discussing their concerns with other health care providers or social workers and not reporting them to the authorities due to barriers: 1) lack of EMS protocols or training specific to vulnerable elders; 2) challenges in communication with emergency department providers, including social workers, who are often unavailable or not receptive; 3) time limitations; and 4) lack of follow-up when EMS providers do report concerns. Many participants reported interest in adopting protocols to assist in elder protection. Additional strategies included photographically documenting the home environment, additional training, improved direct communication with social workers, a dedicated location on existing forms or new form to document concerns, a reporting hotline, a system to provide feedback to EMS, and community paramedicine. EMS providers frequently identify potential victims of elder abuse, neglect, and self-neglect, but significant barriers to reporting exist. Strategies to empower EMS providers and improve reporting were identified. Copyright © 2017 Elsevier Inc. All rights reserved.

OHD/SRC - Collaborative Research Projects

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Office of Water Prediction

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Toggle navigation National Water Center Home (current) Visualize Map Image Viewer What's New About National Water Center National Water Model National Weather Service National Oceanic and Atmospheric Administration Welcome to the Office of Water Prediction Scientific excellence and innovation driving water

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and Infra-Red Observation Satellite. Data from this first meteorological satellite was processed at the Weather Bureau's Meteorological Satellite Laboratory. This laboratory ultimately evolved into the satellite operations of NOAA's National Environmental Satellite, Data, and Information Service (NESDIS

Booster Engine Service Platforms Delivered to VAB

NASA Image and Video Library

2018-04-17

A new service platform for NASA's Space Launch System booster engines, secured on a flatbed truck, has arrived at the Vehicle Assembly Building (VAB) at the agency's Kennedy Space Center in Florida. It was transported from fabricator Met-Con Inc. in Cocoa, Florida. The platform will be stored in the VAB and used for processing and checkout of the engines for the rocket's twin five-segment solid rocket boosters for Exploration Mission-1 (EM-1). During EM-1, an uncrewed Orion spacecraft will launch on the SLS to a stable orbit beyond the Moon and return to Earth for a splashdown in the Pacific Ocean.

Booster Engine Service Platforms Delivered to VAB

NASA Image and Video Library

2018-04-17

A new service platform for NASA's Space Launch System booster engines, secured on a flatbed truck, is on its way to the agency's Kennedy Space Center in Florida. It was transported from fabricator Met-Con Inc. in Cocoa, Florida. The platform will be delivered to the Vehicle Assembly Building, where it will be stored and used for processing and checkout of the engines for the rocket's twin five-segment solid rocket boosters for Exploration Mission-1 (EM-1). During EM-1, an uncrewed Orion spacecraft will launch on the SLS to a stable orbit beyond the Moon and return to Earth for a splashdown in the Pacific Ocean.

Legislative Affairs Media Contact - Public Affairs - NOAA's National

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Media Contacts -NWS Media Contacts -NOAA Media Contacts -Legislative Affairs Media Tools -Archived News Media Contact Matthew R. Borgia Congressional Affairs Specialist - All National Weather Service issues (202)482-1939 Back Top Home | Mission | Strategic Plan | NWS Media Contacts | NOAA Media Contacts US

Evaluating the Potential Benefits of Advanced Automatic Crash Notification.

PubMed

Plevin, Rebecca E; Kaufman, Robert; Fraade-Blanar, Laura; Bulger, Eileen M

2017-04-01

Advanced Automatic Collision Notification (AACN) services in passenger vehicles capture crash data during collisions that could be transferred to Emergency Medical Services (EMS) providers. This study explored how EMS response times and other crash factors impacted the odds of fatality. The goal was to determine if information transmitted by AACN could help decrease mortality by allowing EMS providers to be better prepared upon arrival at the scene of a collision. The Crash Injury Research and Engineering Network (CIREN) database of the US Department of Transportation/National Highway Traffic Safety Administration (USDOT/NHTSA; Washington DC, USA) was searched for all fatal crashes between 1996 and 2012. The CIREN database also was searched for illustrative cases. The NHTSA's Fatal Analysis Reporting System (FARS) and National Automotive Sampling System Crashworthiness Data System (NASS CDS) databases were queried for all fatal crashes between 2000 and 2011 that involved a passenger vehicle. Detailed EMS time data were divided into prehospital time segments and analyzed descriptively as well as via multiple logistic regression models. The CIREN data showed that longer times from the collision to notification of EMS providers were associated with more frequent invasive interventions within the first three hours of hospital admission and more transfers from a regional hospital to a trauma center. The NASS CDS and FARS data showed that rural collisions with crash-notification times >30 minutes were more likely to be fatal than collisions with similar crash-notification times occurring in urban environments. The majority of a patient's prehospital time occurred between the arrival of EMS providers on-scene and arrival at a hospital. The need for extrication increased the on-scene time segment as well as total prehospital time. An AACN may help decrease mortality following a motor vehicle collision (MVC) by alerting EMS providers earlier and helping them discern when specialized equipment will be necessary in order to quickly extricate patients from the collision site and facilitate expeditious transfer to an appropriate hospital or trauma center. Plevin RE , Kaufman R , Fraade-Blanar L , Bulger EM . Evaluating the potential benefits of advanced automatic crash notification. Prehosp Disaster Med. 2017;32(2):156-164.

NCEP SST Analysis

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Branches Global Climate & Weather Modeling Mesoscale Modeling Marine Modeling and Analysis Contact EMC Weather Service NWS logo - Click to go to the NWS homepage Environmental Modeling Center Home News Organization Search Go Search Polar Go MMAB SST Analysis Main page About MMAB Our Mission Our Personnel EMC

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DHEC: General Agency Information

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Skip to content South Carolina Department of Health and Environmental Control Search Button RSS Services Programs/Divisions Report State Agency Fraud Health Health All Health Topics Child and Teen Health Data, Maps - SC Public Health Diseases and Conditions Flu Tuberculosis STD/HIV and Viral Hepatitis Zika

CIDR

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Institutes and provides genotyping, sequencing and statistical genetic services to investigators approved for access through competitive peer review. An application is required for projects supported by the NIH CIDR Two pathways exist to access the CIDR facility: NIH CIDR Program The CIDR contract is funded by 10 NIH

Electric School Bus Testing | Transportation Research | NREL

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Electric School Bus Evaluation Electric School Bus Evaluation Photo of children boarding school bus . NREL is evaluating the performance of electric and conventional school buses operated by two California school districts. Photo courtesy of School Bus Fleet Magazine NREL is evaluating the in-service

Nuclear and Particle Physics, Astrophysics and Cosmology : T-2 : LANL

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linked in Search T-2, Nuclear and Particle Physics, Astrophysics and Cosmology T-2 Home T Division Focus Areas Nuclear Information Service Nuclear Physics Particle Physics Astrophysics Cosmology CONTACTS Group energy security, heavy ion physics, nuclear astrophysics, physics beyond the standard model, neutrino

Coverage of emergency obstetric care and availability of services in public and private health facilities in Bangladesh.

PubMed

Alam, Badrul; Mridha, Malay K; Biswas, Taposh K; Roy, Lumbini; Rahman, Maksudur; Chowdhury, Mahbub E

2015-10-01

To assess the coverage of emergency obstetric care (EmOC) and the availability of obstetric services in Bangladesh. In a national health facility assessment performed between November 2007 and July 2008, all public EmOC facilities and private facilities providing obstetric services in the 64 districts of Bangladesh were mapped. The performance of EmOC services in these facilities during the preceding month was investigated using a semi-structured questionnaire completed through interviews of managers and service providers, and record review. In total, 8.6 (2.1 public and 6.5 private) facilities per 500000 population offered obstetric care services. Population coverage by obstetric care facilities varied by region. Among 281 public facilities designated for comprehensive EmOC, cesarean delivery was available in only 215 (76.5%) and blood transfusion services in 198 (70.5%). In the private sector (for profit and not for profit), these services were available in more than 80% of facilities. In all facility types, performance of assisted vaginal delivery (range 12.2%-48.4%) and use of parenteral anticonvulsants to treat pre-eclampsia/eclampsia (range 48.6%-80.8%) were low. The main reason for non-availability of EmOC services was a lack of specialist/trained providers. Bangladesh needs to increase the availability of EmOC services through innovative public-private partnerships. In the public sector, additional trained manpower supported by an incentivized package should be deployed. Copyright © 2015. Published by Elsevier Ireland Ltd.

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.

Standard Terms and Conditions | NREL

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and Technical Services Subcontracts, Cost-Type (1) Cost Sharing (2) Cost Reimbursement (3) Cost Plus Than Foreign) (1) Cost Sharing (2) Cost Reimbursement (2) Cost Plus Fixed Fee. Appendix B-10 (12/15/16 /15/16) Standard Terms and Conditions for Travel Requirements (1) Cost Sharing (2) Cost Reimbursement

Comparison of helicopter and ground emergency medical service: a retrospective analysis of a German rescue helicopter base.

PubMed

Mommsen, Philipp; Bradt, Nikolas; Zeckey, Christian; Andruszkow, Hagen; Petri, Max; Frink, Michael; Hildebrand, Frank; Krettek, Christian; Probst, Christian

2012-01-01

In consideration of rising cost pressure in the German health care system, the usefulness of helicopter emergency medical service (HEMS) in terms of time- and cost-effectiveness is controversially discussed. The aim of the present study was to investigate whether HEMS is associated with significantly decreased arrival and transportation times compared to ground EMS. In a retrospective study, we evaluated 1,548 primary emergency missions for time sensitive diagnoses (multiple trauma, traumatic brain and burn injury, heart-attack, stroke, and pediatric emergency) performed by a German HEMS using the medical database, NADIN, of the German Air Rescue Service. Arrival and transportation times were compared to calculated ground EMS times. HEMS showed significantly reduced arrival times at the scene in case of heart-attack, stroke and pediatric emergencies. In contrast, HEMS and ground EMS showed comparable arrival times in patients with multiple trauma, traumatic brain and burn injury due to an increased flight distance. HEMS showed a significantly decreased transportation time to the closest centre capable of specialist care in all diagnosis groups (p<0.001). The results of the present study indicate the time-effectiveness of German air ambulance services with significantly decreased transportation times.

Load shifting with the use of home energy management system implemented in FPGA

NASA Astrophysics Data System (ADS)

Bazydło, Grzegorz; Wermiński, Szymon

2017-08-01

The increases for power demand in the Electrical Power System (EPS) causes a significant increase of power in daily load curve and transmission line overload. The large variability in energy consumption in EPS combined with unpredictable weather events can lead to a situation in which to save the stability of the EPS, the power limits must be introduced or even industrial customers in a given area have to be disconnected, which causes financial losses. Nowadays, a Transmission System Operator is looking for additional solutions to reduce peak power, because existing approaches (mainly building new intervention power unit or tariff programs) are not satisfactory due to the high cost of services in combination with insufficient power reduction effect. The paper presents an approach to load shifting with the use of home Energy Management System (EMS) installed at small end-users. The home energy management algorithm, executed by EMS controller, is modeled using Unified Modeling Language (UML). Then, the UML model is translated into Verilog description, and is finally implemented in the Field Programmable Gate Arrays. The advantages of the proposed approach are the relatively low cost of reduction service, small loss of end-users' comfort, and the convenient maintenance of EMS. A practical example illustrating the proposed approach and calculation of potential gains from its implementation are also presented.

Units

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NOAA Workforce Management Office, e-Learning, Commerce Learning Center

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United States European Command

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service members from 13 nations gathered in 7th Army Training Command's Hohenfels Training Area in NATO nations. Units will conduct training alongside our NATO allies to strengthen interoperability and Eastern European NATO nations. Units will conduct training alongside our NATO allies to strengthen

Records & Information Management Services | Alaska State Archives

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Search Search in: Archives State of Alaska Home About Records Management (RIMS) For Researchers Collections Imaging (IMS) ASHRAB Libraries, Archives, & Museums Archives Records Management (RIMS) Records records and information management for the State of Alaska. Frequently Asked Questions Submit Records

Western Mountain Initiative - Research Links

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Parks programS Forest Service Climate Change Resource Center (CCRC) North American Nitrogen Center to be told." US Global Change Research Program (GlobalChange.gov) USGS Climate and Land Use Rocky Mountain Science Center Global Change Research Program -- A Focus on Mountain Ecosystems Western

Mobile satellite business networks: A part of the European mobile system

NASA Technical Reports Server (NTRS)

deMateo, M. L.; Jongejans, A.; Loisy, C.; VanHimbeeck, C.; Marchal, J. P.; Borella, A.; Sartori, M.

1995-01-01

The European Space Agency (ESA) is presently procuring an L-band payload EMS, to be embarked on the ITALSAT-2 satellite due for launch in early 1996, in order to promote a regional European mobile system. One of the Land Mobile Communication systems supported by EMS is the MSBN (Mobile Satellite Business Network) voice and data system which will offer the services of a business network on a seamless European coverage. This paper will first recall the characteristics of the MSBN system, which is based on quasi-synchronized CDMA (Code Division Multiple Access) techniques in both directions, and then describe the CDMA receivers implementation. Main validation test results will also be reported confirming predicted performances.

Physiological scoring: an aid to emergency medical services transport decisions?

PubMed

Challen, Kirsty; Walter, Darren

2010-01-01

Attendance at UK emergency departments is rising steadily despite the proliferation of alternative unscheduled care providers. Evidence is mixed on the willingness of emergency medical services (EMS) providers to decline to transport patients and the safety of incorporating such an option into EMS provision. Physiologically based Early Warning Scores are in use in many hospitals and emergency departments, but not yet have been proven to be of benefit in the prehospital arena. The use of a physiological-social scoring system could safely identify patients calling EMS who might be diverted from the emergency department to an alternative, unscheduled, care provider. This was a retrospective, cohort study of patients with a presenting complaint of "shortness of breath" or "difficulty breathing" transported to the emergency department by EMS. Retrospective calculation of a physiological social score (PMEWS) based on first recorded data from EMS records was performed. Outcome measures of hospital admission and need for physiologically stabilizing treatment in the emergency department also were performed. A total of 215 records were analyzed. One hundred thirty-nine (65%) patients were admitted from the emergency department or received physiologically stabilizing treatment in the emergency department. Area Under the Receiver Operating Characteristic Curve (AUROC) for hospital admission was 0.697 and for admission or physiologically stabilizing treatment was 0.710. No patient scoring<2 was admitted or received stabilizing treatment. Despite significant over-triage, this system could have diverted 79 patients safely from the emergency department to alternative, unscheduled, care providers.

Excited State Processes in Electronic and Bio Nanomaterials (ESP-2016)

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links at each of these sites. General Links AgriNet-Texas A&M Agricultural Program - Agricultural University Extension National Agricultural Statistics Service (NASS) 2013 NASS Census of Aquaculture National Agricultural Library National Fisheries Institute National Sea Grant Netvet North Central Regional Aquaculture

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Linking household and health facility surveys to assess obstetric service availability, readiness and coverage: evidence from 17 low- and middle-income countries

PubMed Central

Kanyangarara, Mufaro; Chou, Victoria B; Creanga, Andreea A; Walker, Neff

2018-01-01

Background Improving access and quality of obstetric service has the potential to avert preventable maternal, neonatal and stillborn deaths, yet little is known about the quality of care received. This study sought to assess obstetric service availability, readiness and coverage within and between 17 low- and middle-income countries. Methods We linked health facility data from the Service Provision Assessments and Service Availability and Readiness Assessments, with corresponding household survey data obtained from the Demographic and Health Surveys and Multiple Indicator Cluster Surveys. Based on performance of obstetric signal functions, we defined four levels of facility emergency obstetric care (EmOC) functionality: comprehensive (CEmOC), basic (BEmOC), BEmOC-2, and low/substandard. Facility readiness was evaluated based on the direct observation of 23 essential items; facilities “ready to provide obstetric services” had ≥20 of 23 items available. Across countries, we used medians to characterize service availability and readiness, overall and by urban-rural location; analyses also adjusted for care-seeking patterns to estimate population-level coverage of obstetric services. Results Of the 111 500 health facilities surveyed, 7545 offered obstetric services and were included in the analysis. The median percentages of facilities offering EmOC and “ready to provide obstetric services” were 19% and 10%, respectively. There were considerable urban-rural differences, with absolute differences of 19% and 29% in the availability of facilities offering EmOC and “ready to provide obstetric services”, respectively. Adjusting for care-seeking patterns, results from the linking approach indicated that among women delivering in a facility, a median of 40% delivered in facilities offering EmOC, and 28% delivered in facilities “ready to provide obstetric services”. Relatively higher coverage of facility deliveries (≥65%) and coverage of deliveries in facilities “ready to provide obstetric services” (≥30% of facility deliveries) were only found in three countries. Conclusions The low levels of availability, readiness and coverage of obstetric services documented represent substantial missed opportunities within health systems. Global and national efforts need to prioritize upgrading EmOC functionality and improving readiness to deliver obstetric service, particularly in rural areas. The approach of linking health facility and household surveys described here could facilitate the tracking of progress towards quality obstetric care. PMID:29862026

NOAA's National Weather Service/Environmental Protection Agency - United

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

PubMed

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

2016-03-01

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

Alternative Fuels Data Center: Natural Gas Related Links

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, AGA provides services to member natural gas pipelines, marketers, gatherers, international gas Natural Gas Printable Version Share this resource Send a link to Alternative Fuels Data Center : Natural Gas Related Links to someone by E-mail Share Alternative Fuels Data Center: Natural Gas Related

Air Education and Training Command > Home

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78 FR 65678 - Assistance to Firefighters Grant Program

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-01

... (EMS) organizations, and state fire training academies for the purpose of enhancing the abilities of... medical services (EMS) organizations, and State Fire Training Academies (SFTAs) to enhance their ability.... Emergency Medical Services Providers: Fire departments and nonaffiliated EMS organizations; not less than 3...

Evidence-Based Guidelines for Fatigue Risk Management in Emergency Medical Services

DOT National Transportation Integrated Search

2018-01-11

Background: Administrators of Emergency Medical Services (EMS) operations lack guidance on how to mitigate workplace fatigue, which affects greater than half of all EMS personnel. The primary objective of the Fatigue in EMS Project was to create an e...

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

ERIC Educational Resources Information Center

Young, Derrick P.

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

Determining minimum staffing levels during snowstorms using an integrated simulation, regression, and reliability model.

PubMed

Kunkel, Amber; McLay, Laura A

2013-03-01

Emergency medical services (EMS) provide life-saving care and hospital transport to patients with severe trauma or medical conditions. Severe weather events, such as snow events, may lead to adverse patient outcomes by increasing call volumes and service times. Adequate staffing levels during such weather events are critical for ensuring that patients receive timely care. To determine staffing levels that depend on weather, we propose a model that uses a discrete event simulation of a reliability model to identify minimum staffing levels that provide timely patient care, with regression used to provide the input parameters. The system is said to be reliable if there is a high degree of confidence that ambulances can immediately respond to a given proportion of patients (e.g., 99 %). Four weather scenarios capture varying levels of snow falling and snow on the ground. An innovative feature of our approach is that we evaluate the mitigating effects of different extrinsic response policies and intrinsic system adaptation. The models use data from Hanover County, Virginia to quantify how snow reduces EMS system reliability and necessitates increasing staffing levels. The model and its analysis can assist in EMS preparedness by providing a methodology to adjust staffing levels during weather events. A key observation is that when it is snowing, intrinsic system adaptation has similar effects on system reliability as one additional ambulance.

Nebraska DHHS: Swimming Pool Program

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Nebraska DHHS: What is Tuberculosis?

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Overseas Cost of Living Allowances (COLA)

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Socioeconomic Data and Applications Center | SEDAC

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Themes * Agriculture * Climate * Conservation * Governance * Hazards * Health * Infrastructure * Land Use satellite imagery. Agriculture and Food Security Theme - Agriculture and Food Security Find data sets, maps , map services, featured uses of data and other resources related to Agriculture and Food Security

NOAA Workforce Management Office

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Home | Oregon State University Extension Service

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GLCF: Research

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Global Land Cover Facility About GLCF Research Publications Data & Products Gallery Library Services Contact Site Map Go Research The Global Land Cover Facility is a research center focusing on the GLCF in developing forest change products. Past research efforts were directed at boreal forests in