Emergency Medical Services Calls Research Articles

Drones can be used to provide dispatch centres with on-site photos before arrival of EMS in time critical incidents

BackgroundDrones are able to deliver automated external defibrillators in cases of out-of-hospital cardiac arrest (OHCA) but can be deployed for other purposes. Our aim was to evaluate the feasibility of sending live photos to dispatch centres before arrival of other units during time-critical incidents. MethodsIn this retrospective observational study, the regional dispatch centre implemented a new service using five existing AED-drone systems covering an estimated 200000 inhabitants in Sweden. Drones were deployed automatically over a 4-month study period (December 2022–April 2023) in emergency calls involving suspected OHCAs, traffic accidents and fires in buildings. Upon arrival at the scene, an overhead photo was taken and transmitted to the dispatch centre. Feasibility of providing photos in real time, and time delays intervals were examined. ResultsOverall, drones were deployed in 59/440 (13%) of all emergency calls: 26/59 (44%) of suspected OHCAs, 20/59 (34%) of traffic accidents, and 13/59 (22%) of fires in buildings.The main reasons for non-deployment were closed airspace and unfavourable weather conditions (68%). Drones arrived safely at the exact location in 58/59 cases (98%). Their overall median response time was 3:49 min, (IQR 3:18–4:26) vs. emergency medical services (EMS), 05:51 (IQR: 04:29–08:04) p-value for time difference between drone and EMS = 0,05. Drones arrived first on scene in 47/52 cases (90%) and the largest median time difference was found in suspected OHCAs 4:10 min, (IQR: 02:57–05:28). The time difference in the 5/52 (10%) cases when EMS arrived first the time difference was 5:18 min (IQR 2:19–7:38), p = NA. Photos were transmitted correctly in all 59 alerts. No adverse events occurred. ConclusionIn a newly implemented drone dispatch service, drones were dispatched to 13% of relevant EMS calls. When drones were dispatched, they arrived at scene earlier than EMS services in 90% of cases. Drones were able to relay photos to the dispatch centre in all cases.Although severely affected by closed airspace and weather conditions, this novel method may facilitate additional decision-making information during time-critical incidents.

Prediction of the future number of fall-related emergency medical services calls in older individuals

BackgroundFalls among older individuals contribute significantly to the rise in ambulance transport use. To recognize the importance of future countermeasures, we estimated the projected number and percentage of fall-related emergency medical service (EMS) calls.MethodsWe examined the sex, age group, and location of falls among patients aged ≥ 65 years who contacted emergency services in Sapporo City from 2013 to 2021. Annual fall-related calls per population subgroup were calculated, and trends were analyzed. Four models were used to estimate the future number of fall-related calls from the 2025–2060 projected population: (1) based on the 2022 data, estimates from the 2013–2022 data using (2) Poisson progression, (3) neural network, (4) estimates from the 2013–2019 data using neural network. The number of all EMS calls was also determined using the same method to obtain the ratio of all EMS calls.ResultsDuring 2013–2022, 70,262 fall-related calls were made for those aged ≥ 65 years. The rate was higher indoors among females and outdoor among males in most age groups and generally increased with age. After adjusting for age, the rate increased by year. Future estimates of the number of fall calls are approximately double the number in 2022 in 2040 and three times in 2060, with falls accounting for approximately 11% and 13% of all EMS calls in 2040 and 2060, respectively.ConclusionThe number of fall-related EMS calls among older people is expected to increase in the future, and the percentage of EMS calls will also increase; therefore, countermeasures are urgently needed.

Assertive community treatment for high-utilizing alcohol misuse patients: a before-and-after cohort study protocol

BackgroundThe challenge posed by Alcohol-Related Frequent Attenders (ARFAs) in Emergency Departments (EDs) is growing in Singapore, marked by limited engagement with conventional addiction treatment pathways. Recognizing this gap, this study aims to explore the potential benefits of Assertive Community Treatment (ACT) - an innovative, community-centered, harm-reduction strategy—in mitigating the frequency of ED visits, curbing Emergency Medical Services (EMS) calls, and uplifting health outcomes across a quartet of Singaporean healthcare institutions.MethodsEmploying a prospective before-and-after cohort design, this investigation targeted ARFAs aged 21 years and above, fluent in English or Mandarin. Eligibility was determined by a history of at least five ED visits in the preceding year, with no fewer than two due to alcohol-related issues. The study contrasted health outcomes of patients integrated into the ACT care model versus their experiences under the exclusive provision of standard emergency care across Hospitals A, B, C and D. Following participants for half a year post-initial assessment, the evaluation metrics encompassed socio-demographic factors, ED, and EMS engagement frequencies, along with validated health assessment tools, namely Christo Inventory for Substance-misuse Services (CISS) scores, University of California, Los Angeles (UCLA) Loneliness scores, and Centre for Epidemiologic Studies Depression Scale Revised (CESD-R-10) scores.DiscussionConfronted with intricate socio-economic and medical challenges, the ARFA cohort often grapples with heightened vulnerabilities in relation to alcohol misuse. Pioneering the exploration of ACT’s efficacy with ARFAs in a Singaporean context, our research is anchored in a patient-centered approach, designed to comprehensively address these multifaceted clinical profiles. While challenges, like potential high attrition rates and sporadic data collection, are anticipated, the model’s prospective contribution towards enhancing patient well-being and driving healthcare efficiencies in Singapore is substantial. Our findings have the potential to reshape healthcare strategies and policy recommendations.Trial RegistrationClinicalTrials.gov, NCT 04447079. Initiated on 25 June 2020.

Prevalence of Low-Acuity Pediatric Emergency Medical Services Transports to a Pediatric Emergency Department in an Urban Area.

Many patients transported by Emergency Medical Services (EMS) do not have emergent resource needs. Estimates for the proportion of pediatric EMS calls for low-acuity complaints, and thus potential candidates for alternative dispositions, vary widely and are often based on physician judgment. A more accurate reference standard should include patient assessments, interventions, and dispositions. The objective of this study was to describe the prevalence and characteristics of low-acuity pediatric EMS calls in an urban area. This is a prospective observational study of children transported by EMS to a tertiary care pediatric emergency department. Patient acuity was defined using a novel composite measure that included physiologic assessments, resources used, and disposition. Bivariable and multivariable logistic regression were conducted to assess for factors associated with low-acuity status. A total of 996 patients were enrolled, of whom 32.9% (95% confidence interval, 30.0-36.0) were low acuity. Most of the sample was Black, non-Hispanic with a mean age of 7 years. When compared with adolescents, children younger than 1 year were more likely to be low acuity (adjusted odds ratio, 3.1 [1.9-5.1]). Patients in a motor vehicle crash were also more likely to be low acuity (adjusted odds ratio, 2.4 [1.2-4.6]). All other variables, including race, insurance status, chief complaint, and dispatch time, were not associated with low-acuity status. One third of pediatric patients transported to the pediatric emergency department by EMS in this urban area are for low-acuity complaints. Further research is needed to determine low-acuity rates in other jurisdictions and whether EMS providers can accurately identify low-acuity patients to develop alternative EMS disposition programs for children.

Impact of the Coronavirus Disease 2019 Pandemic on Utilization of Emergency Medical Services in New York City.

Background: This study evaluates trends in the utilization of emergency medical services (EMS) in New York City, the "epicenter" of the first "wave" of the coronavirus pandemic. We hypothesize that EMS call volumes decreased overall in New York City during the first year of the pandemic, specifically with respect to trauma/injury calls. Contrarily, we posit that calls for "sick" events increased given pervasive fear of virus transmission. Materials and Methods: Retrospective New York City EMS calls data (January 1, 2019 to December 31, 2020) were obtained from the NYC Open Data/EMS Incident Dispatch database. Total EMS calls, trauma/injury calls, and "sick" event calls were collected for New York City and for all five boroughs. Census data for each borough were used to weigh daily EMS calls per 100,000 individuals. Mann-Whitney U tests were used to compare pre-pandemic (2019 to March 2020) versus pandemic (April 2020 to December 2020) EMS call volumes, p = 0.05. Results: Median daily EMS calls per 100,000 individuals decreased 21.6% at the start of the pandemic across New York City (pre-pandemic, 3,262 calls; pandemic, 2,556 calls; p < 0.001) and similarly decreased when stratified by borough (all, p < 0.001). Median daily trauma/injury and sick event calls per 100,000 also decreased in New York City and the five boroughs from pre-pandemic to pandemic time periods (all, p < 0.001). Discussion and Conclusions: These data reflect an unprecedented window into EMS utilization during an infectious disease pandemic. As decreased EMS utilization for multiple conditions likely reflects delayed or impeded access to care, utilization data have important implications for provision of acute care services during possible future disruptions related to the pandemic.

Description of the Public Safety Medical Response and Patient Encounters Within and During the Indianapolis (USA) Spring 2020 Civil Unrest.

This study describes the local Emergency Medical Services (EMS) response and patient encounters corresponding to the civil unrest occurring over a four-day period in Spring 2020 in Indianapolis, Indiana (USA). This study describes the non-conventional EMS response to civil unrest. The study included patients encountered by EMS in the area of the civil unrest occurring in Indianapolis, Indiana from May 29 through June 1, 2020. The area of civil unrest defined by Indianapolis Metropolitan Police Department covered 15 blocks by 12 blocks (roughly 4.0 square miles) and included central Indianapolis. The study analyzed records and collected demographics, scene times, interventions, dispositions, EMS clinician narratives, transport destinations, and hospital course with outcomes from receiving hospitals for patients extracted from the area of civil unrest by EMS. Twenty-nine patients were included with ages ranging from two to sixty-eight years. In total, EMS transported 72.4% (21 of 29) of the patients, with the remainder declining transport. Ballistic injuries from gun violence accounted for 10.3% (3 of 29) of injuries. Two additional fatalities from penetrating trauma occurred among patients without EMS contact within and during the civil unrest. Conditions not involving trauma occurred in 37.9% (11 of 29). Among transported patients, 33.3% (7 of 21) were admitted to the hospital and there was one fatality. While most EMS transports did not result in hospitalization, it is important to note that the majority of EMS calls did result in a transport. There was a substantial amount of non-traumatic patient encounters. Trauma in many of the encounters was relatively severe, and the findings imply the need for rapid extraction methods from dangerous areas to facilitate timely in-hospital stabilization.

Calling emergency medical services for terminally ill patients: a qualitative study exploring reasons why informal caregivers make the call.

Although emergency medical service is focused on providing acute prehospital treatment, it is often used by terminally ill patients and their informal caregivers during the last days of patient's life. Little is known about why they decide to use the emergency medical services. The aim was to explore informal caregivers' motivation and decision-making process for calling emergency medical services for their terminally ill loved ones. This study used a qualitative design. Data were collected by semi-structured interviews with 31 relatives of 30 patients who used the emergency medical services. Data were analyzed with NVivo software by utilizing principles of thematic analysis. Through the analysis, four distinct themes emerged: (1) limited availability of support from health care services; (2) insufficient planning of care; (3) decline in the health of the patient and (4) being lost and desperate. For informal caregivers, emergency medical services represented an important source of support while caring for their terminally ill loved ones due to the limited availability of other sources of help, including a lack of specialist palliative care providers. Additionally, informal caregivers had limited knowledge of the dying process and used emergency medical services for professional advice.

Development of indicators for avoidable emergency medical service calls by mapping paramedic clinical impression codes to ambulatory care sensitive conditions and mental health conditions in the UK and Canada

ObjectiveParamedic assessment data have not been used for research on avoidable calls. Paramedic impression codes are designated by paramedics on responding to a 911/999 medical emergency after an assessment of...

Exploring Population Characteristics and Recruitment Challenges in Older People Experiencing Falls at Home without Hospitalization or with an Emergency Department Visit: Insights from the RISING-DOM Experience.

An increasing number of falls among community-living older adults are reported in emergency calls. Data on evidence of appropriate fall prevention interventions are limited and challenges in recruiting this population in randomized trials are acknowledged. The main aim of this study was to provide demographic data, circumstance and fall-related outcomes of the population in the RISING-DOM study [Impact d'une évaluation des facteurs de RISque de chute et d'une prise en charge personnalisée, sur la mortalité et l'institutionnalisation, après INtervention du SAMU chez la personne âGée à DOMicile], a multicenter, randomized interventional trial involving community-dwelling older adults who have experienced a fall at home and were not hospitalized. Additionally, the challenges of remote recruitment in this population were discussed. Participants were identified through the Occitania Emergency Observatory database. Participant recruitment and data collection were performed through telephone interviews (October 2019-March 2022). Additionally, a sample survey of Emergency Medical Services calls was carried out. Out of the 1151 individuals screened, a total of 951 participants were included in the trial follow-up, resulting in an acceptance rate of 82.62%. The screening delay was extended due to the COVID-19 pandemic. Recruiting difficulties were mainly related to identifying potential participants, unavailable contact information and unreachability. Participants' mean age was 84.1 years, 65.8% were women, and 44.3% lived alone. Pain was the most frequent outcome (53%). In the previous year, 73.5% of participants reported experiencing a fall, with 66.7% of those falls requiring assistance from Emergency Medical Services (EMS). Nearly, 40% did not take proactive steps to prevent future falls and walking aids (79.8%) were the most common preventive action. Indicators of a high-risk group of falls have been identified underscoring the need for appropriate fall interventions in the target population. Challenges of large sampling for randomized fall prevention trials were provided. Clinicaltrials.gov identifier: NCT04132544. Registration date: 18/10/2019. https://www.clinicaltrials.gov/ct2/show/NCT04132544?term=rising-dom&draw=2&rank=1.

Opinion of specialists of emergency medical services on the practice of distance counseling on first aid: results of the interregional survey

Introduction. Wide implementation of distance counseling of incident witnesses on first aid (DCFA) over the telephone by dispatchers of emergency medical services (EMS) can significantly increase the rate of provision of first aid (FA) by the bystanders and contribute to reduction of mortality from the life-threatening conditions. The purpose of this study was to investigate personal experience and opinions of the specialists of EMS of the Russian Federation regarding the practice of DCFA, that is important for planning and determining priority areas for the development of a unified domestic program on DCFA.Methods. In September–October 2022, an anonymous interregional survey of the EMS specialists was conducted. EMS dispatchers constituted the target group of the survey. Participation of specialists without experience of dispatching was also allowed. The survey was carried out online using a pre-tested questionnaire that included 17 questions to assess, inter alia, personal experience of DCFA, self-confidence of the specialists when giving instructions on FA over the telephone, opinion on the importance of DCFA, level of the specialists’ knowledge on FA, experience of prior training on the methods of DCFA, as well as to identify factors that prevent or hinder real practice of DCFA. To analyze the results, nonparametric statistics was used.Results. The final sample consisted of 965 EMS specialists from 58 constituent entities of the Russian Federation, of which 77.4% (n=747) were feldshers and nurses for receiving and transmitting EMS calls. 73.3% (n=707) of the respondents reported that they had experience of DCFA. The average number of cases of DCFA in the past year reported by one specialist was 97 (median=10). 87.6% (n=619) of respondents with experience of DCFA have highly rated the importance of this practice for saving human health and life. However, only 47.8% (n=338) of the specialists with experience of DCFA reported that they felt themselves completely confident when giving the instructions to bystanders. Despite the fact that the level of confidence was characterized by a positive correlation with the specialists’ assessment of their knowledge on FA (p&lt;0.001) , only 46.4% (n=328) of the respondents with experience of DCFA have rated their knowledge as very good, and 15.7% (n=111) have ever learned the principles of DCFA. From the perspective of the respondents with experience of DCFA, main barriers to this practice include unreadiness of bystanders to follow instructions on FA, fears of dispatchers regarding possible egal liability, a lack of dispatchers and/or their overburden with receiving and transmitting calls, and a lack of clear algorithms/protocols for instructing witnesses.Conclusion. EMS dispatchers generally highly rate the importance of DCFA, but feel themselves uncertain when counseling the bystanders, and have a lack of knowledge on FA. The vast majority of the specialists have never been trained in the methods of DCFA. Priority measures aimed at implementation a unified domestic practice of DCFA include the development of a universal program for training EMS specialists on the principles and skills of DCFA, creation and testing of standardized dispatch algorithms/protocols on DCFA for various health disorders, organization of effective legal regulation for the practice of DCFA, and solution of the problem of shortage of EMS specialists who operate as dispatchers.

Pain Treatment in Polish Emergency Medical Teams—Is the Pain Management Entitlement Being Used?—A Retrospective Study

Introduction: Pain has been identified as the most common reason for emergency medical service (EMS) calls. Despite many years of pain research, it is still true that oligoanalgesia is an ongoing phenomenon. This demonstrates the need for the implementation of new solutions and for further analyses on the causes of inadequate pain treatment. The study was undertaken to analyze analgesic treatment implemented in specialist “S” and basic “P” Emergency Medical Teams (EMTs). Methods: This retrospective study was based on the analysis of medical records using the emergency medical service card. A total of 1333 medical files were analyzed, of which 539 cases were qualified for the study according to the inclusion and exclusion criteria. Results: The analysis has shown that the majority of interventions were undertaken by basic emergency medical teams and that acute pain was the most common reason for contacting the EMS. However, only 62.52% of patients received analgesia. It was shown that the frequency of administering paracetamol, metamizole, and ketoprofen was proportional to the increase in pain intensity. Similar correlations were identified in the cases of morphine, fentanyl, and drotaverine, which were most often administered to patients with the most severe pain. Conclusions: The nature and location of pain, as well as its intensity, affected the choice of analgesia. Opioids were administered more frequently with more extensive injuries and at greater pain intensity. Significant differences were found in the frequency at which acetylsalicylic acid was administered more often in “S” EMTs and drotaverine more often in “P” EMTs. The intravenous route was found to be the most common route of analgesia administration in EMTs.

Hourly Associations between Heat Index and Heat-Related Emergency Medical Service (EMS) Calls in Austin-Travis County, Texas.

This paper aims to investigate the following research questions: (1) what are the hourly patterns of heat index and heat-related emergency medical service (EMS) incidents during summertime?; and (2) how do the lagged effects of heat intensity and hourly excess heat (HEH) vary by heat-related symptoms? Using the hourly weather and heat-related EMS call data in Austin-Travis County, Texas, this paper reveals the relationship between heat index patterns on an hourly basis and heat-related health issues and evaluates the immediate health effects of extreme heat events by utilizing a distributed lag non-linear model (DLNM). Delving into the heat index intensity and HEH, our findings suggest that higher heat intensity has immediate, short-term lagged effects on all causes of heat-related EMS incidents, including in cardiovascular, respiratory, neurological, and non-severe cases, while its relative risk (RR) varies by time. HEH also shows a short-term cumulative lagged effect within 5 h in all-cause, cardiovascular, and non-severe symptoms, while there are no statistically significant RRs found for respiratory and neurological cases in the short term. Our findings could be a reference for policymakers when devoting resources, developing extreme heat warning standards, and optimizing local EMS services, providing data-driven evidence for the effective deployment of ambulances.

Perceived performance of activities of daily living by stroke patients: key in decision to call EMS and outcomes.

Until recently, public education campaigns aimed at improving help-seeking behavior by acute stroke patients have achieved only limited or even no effects. Better understanding of psychological factors determining help-seeking behavior may be relevant in the design of more effective future campaigns. In this prospective, cross-sectional study, we interviewed 669 acute stroke patients within 72 h after hospital admission. The primary endpoint was the effect of psychological factors on the decision to call emergency medical services (EMS). Secondary endpoints were the effects of such factors on treatment rates and clinical improvement (difference between modified Rankin scale (MRS) scores at admission and at discharge). Only 48.7% of the study population called the EMS. Multivariate logistic and linear regression analyses revealed that perception of unimpaired performance of activities of daily living (ADL) was the only psychological factor that predicted EMS use and outcomes. Thus, patients who perceived only minor impairment in performing ADL were less likely to use EMS (odds ratio, 0.54 [95% confidence interval, 0.38-0.76]; p = 0.001), had lower treatment rates, and had less improvement in MRS scores (b = 0.40, p = 0.004). Additional serial mediation analyses involving ischemic stroke patients showed that perception of low impairment in ADL decreased the likelihood of EMS notification, thereby increasing prehospital delays, leading to reduced thrombolysis rates and, finally, to reduced clinical improvement. Perception of unimpaired performance of ADL is a crucial barrier to appropriate help-seeking behavior after acute stroke, leading to undertreatment and less improvement in clinical symptoms. Thus, beyond improving the public's knowledge of stroke symptoms, future public education campaigns should focus on the need for calling the EMS in case of stroke symptoms even if daily activities do not seem to be severely impaired.

Demand Analysis of a German Emergency Medical Service Feedback System.

The number of emergency medical service (EMS) calls in Germany is continuously increasing. The initial assessment, the pre-hospital care and the choice of hospital for further care by the EMS influences the patient's outcome and are the basis for further care in hospital. However, the EMS does not receive any official feedback on its decisions. This study evaluates the demand for a feedback system from the emergency department (ED) to the EMS, what it should contain, and how it could be integrated in the electronic clinical systems. A semi-structured interview guideline for expert interviews with members of EMS staff (n = 6) and ED staff (n = 17) was developed. A mockup to visualise a possible implementation was designed and included in the interview. There is a significant demand for feedback on pre-diagnosis, pre-hospital care and handover of patients from the EMS to the ED. The EDs are very interested in improving the collaboration with the paramedic services through feedback. A feedback system is strongly desired by various EMS stakeholders and, according to them, could improve both EMS and ED collaboration and overall patient care.

The role of emergency medical services in the management of in-hospital emergencies: Causes and outcomes of emergency calls – A descriptive retrospective register-based study

BackgroundMedical emergency teams (METs) are in place in some hospitals in Finland to respond to critical emergency events. However, in hospitals without dedicated METs, staff are instructed to call emergency medical services (EMS) to deal with emergencies. This study examined the reasons for calling EMS to hospitals and the outcomes of these calls. MethodsDescriptive retrospective register-based study of the response and management of in-hospital emergencies by EMS in the wellbeing services county of Southwest Finland. Patient care reports of the EMS and those of the hospitals were analysed. ResultsIn total, 138 medical emergencies managed by EMS were included in this study. 108 of these related to patients, and 25 related to hospital personnel. Cardiac arrest (n = 36) and a reduced level of consciousness (n = 29) were the most common in-hospital emergencies. In 68% of in-hospital emergencies managed by the EMS team, after calling 112, hospital personnel implemented various treatment measures. In 72% of cases, follow-up treatment was required. ConclusionsHospital personnel are able to initiate medical measures in emergencies, even when no MET is available. Although EMS are important in responding to in-hospital emergencies, they seem to be performing the same role as METs.

Comparison of outcomes of out-of-hospital cardiac arrest patients: Emergency calls placed from mobile phones vs. landline phones

BackgroundUntil recently, calls to the emergency medical service (EMS) from landline phones, which display the caller’s exact location at the dispatch center, had been common. Since the use of mobile phones has become widespread, many emergency calls are now made from mobile phones. Differences in outcomes of out-of-hospital cardiac arrest (OHCA) patients for whom EMS was called from mobile versus landline phones has not yet been fully elucidated. MethodsWe performed a retrospective, population-based analysis in Kobe, Japan to examine whether EMS calls from mobiles improved the prognosis of OHCA patients over EMS calls placed from landlines. The primary outcome was favorable neurological outcome, defined as Cerebral Performance Category (CPC) scores of 1 or 2 at discharge. Secondary outcomes were survival at one-month, survival at discharge, and time durations between call and EMS activities. ResultsOf 4,231 OHCA cases, 2,194 cases (706 landline cases vs. 1,488 mobile cases) were included in this study. The percentages of favorable neurological outcomes were 0.7% (5/706) in the landline group and 3.8% (56/1,488) in the mobile group. Adjusted multivariable logistic regression revealed that favorable neurological outcomes (odds ratio [OR] 3.03, 95% confidence interval [CI] 1.12–8.17, p = 0.03) were better in the mobile group, while one-month survival (OR 1.30, 95% CI 0.80–2.14, p = 0.29) was not significantly different. Bystander CPR was more frequently administered in the mobile group (landlines 61.3% vs. mobiles 68.4%, p < 0.01). Time durations between call to EMS dispatch (184.5 [IQR 157–220 s] vs. 205 [IQR 174–248 s], p < 0.01) and EMS arrival (476.5 [IQR 377–599 s] vs. 491 [IQR 407.5–611.5 s], p < 0.01) were shorter in the landline group. ConclusionsAlthough the landline caller location display system seems effective for shorter times between EMS call and EMS arrival, mobile phone use was associated with better neurological outcomes.

Gap between recognition and response to stroke scenarios among Saudi population: Cross-sectional survey study

ObjectivesRecognition of stroke symptoms and emergency medical services (EMS) calls have a significant impact on patient management and outcome after acute strokes. The objective of this study is to assess the presence of a gap in the Saudi population between the recognition of stroke symptoms and the appropriate response to call EMS. Materials and MethodsThis questionnaire-based, cross-sectional survey study was conducted among the Saudi population with 563 total participants. The data were collected using a self-administered, web-based questionnaire. It was distributed randomly via social media platforms and emails to the general population of Saudi Arabia (SA). A series of 12 vignettes of stroke scenarios and four non-stroke scenarios was adapted from validated instruments. ResultsOur study revealed that 8% (n = 533) of the responses were appropriately recognized and resulted in calls to EMS while 38% (n = 2,639) did not respond by calling EMS despite their correct recognition. However, 9% (n = 608) chose to call EMS regardless of their incorrect recognition of the stroke scenario, and the plurality, 45% (n = 3,096), did not recognize the stroke scenario or respond by calling EMS. Furthermore, we found a statistically significant association among appropriate response, recognition, and self-efficacy. ConclusionsA recognition-response gap has been found among the Saudi population. Future campaigns should focus on the identification of common stroke symptoms and reinforce the importance of calling the EMS to apply the knowledge appropriately. Consequently, such actions could decrease mortality and chronic disability among stroke patients.

EMERG-ing data: Multi-city surveillance of workplace violence against EMS responders

Problem: Between 1980 and 2021, emergency medical services (EMS) calls experienced a 421% increase, while calls for fires declined by 55%. The more exposure, the more the opportunity for workplace violence (WPV). Due to the non– existence of a reporting system that captures physical and verbal violence, it has been difficult to quantify the degree of WPV experienced by the U.S. fire and rescue service. Methods: To describe WPV in three large metropolitan fire departments, an existing data system was modified. The EMERG platform was selected because it is one of the most confidential data systems available to collect exposures. Results: In a one-year pilot of EMERG, 126 events were reported. Verbal violence was present in 81% of all reports, with physical violence only at 19%. Patients were the most frequently reported assailant (73%).The most frequently reported injury was emotional stress (70%). Six percent of all injuries reported moderate-to-major physical injury severity, and 30% reported moderate-to-major mental injury severity. Discussion: Verbal violence as a contributor to first responder stress is often underestimated. This pilot shows that it can and should be captured. That mental injury severity was consistently rated higher than physical injury severity across all injuries is not surprising given the prevalence of verbal violence reported and because physical violence has emotional sequela. Summary: Data from the EMERG reporting system give us evidence, on a larger scale than has ever existed for the fire and rescue service, that verbal and physical violence, and the resultant emotional stress and mental injury severity, is an issue that needs further attention and resources. Practical Applications: In order to ensure robust surveillance, it remains likely that triangulation of multiple data sources will still be required to approximate the true burden.

Emergency Medical Service responses as latent social capital toward Deliberate Self-Harm, Suicidality and Suicide

ABSTRACT Escalation in Deliberate Self-Harm (DSH) is indicative of a rise in poor mental health and/or a failure of social and health services. The phenomenon of DSH exacerbates mental illness sequela, while being an essential indicator of suicide risk. Globally, about 800 000 people commit suicide yearly, averaging almost one suicide every 40 s. Based on a Retrospective Cross-Sectional Study, the aim sought to establish the scope of the DSH, suicidality and suicide case-load from a Western Cape Emergency Medical Services (EMS) prehospital perspective. A census of 3 years of EMS Incident Management Records (IMR) from a large rural district with seven local municipalities was undertaken using a novel data collection instrument. The 2976 (N) mental health-related incidents that met the inclusion criteria (from 413 712 cases) suggest a presentation rate of 7 per 1000 EMS calls. Sixty percent (n = 1776) were regarded to have deliberately self-harmed, attempted suicide or committed suicide. Overdose/deliberate self-poisoning accounted for 52% (n = 1550) of all the DSH caseload of the study. Attempted suicide accounted for 2.7% (n = 83) and Suicide for 3.4% (n = 102) of the suicidality case-load from the study, respectively. Suicide averaged 2.8. suicides per month in the Garden Route District over the 3-year period. Men were five times more likely to commit suicide than women, commonly using strangulation, while women mostly ingested household detergents and poison, and overdosed on chronic medication. Understandably, the EMS needs to assess its own capability to respond, treat, and transport health-care users with DSH and suicidality. This study demonstrates the EMS ‘everyday’ exposure to DSH, suicidality and suicide case-load. It represents a critical first step in the problem-space definition upon which a determination of the need for EMS responses can be based, to interrupt suicidality by removing methods of harm and strengthening the mental health economy through social capital investment.

Brain Stroke Prediction using Machine Learning

Abstract: A brain stroke, is a saviour disease in which a blood cot or bleeding occur in the brain during a stoke, which can result in long-term harm. This can affects person’s move, think, see, or communicate. The another medical name for the Brain Stroke is cerebrovascular or CVA is when The body part that the blood-starved brain cells regulate ceases to function. Brain Stroke is very critical situation as it directly leads to death or permanent disability. The stroke is classified into two areas ischemic stroke and Haemorrhagic. When blood clots re created in the brain and goes through the patient’s streamed lodge in the brain then there is the high chances of ischemic stroke occur. Homographic stroke is second type of stoke which occurs when there is leak of blood or ruptures in the artery in brain. In early stage if the treatment get started we can treat to the ischemic stroke efficiently. If a stroke is feared, or bystanders should call emergency medical services right away. Symptoms disappear as their own in a Ischemic stroke reminded by Transient Ischemic Attack (TIA). As per the research of World Health Organization the 2 nd leading cause of the death worldwide is Brain Stroke which is also responsible for the approximately 11% deaths. but can prevent up to 80% of stokes if they can be identified or predicted early stage stroke. Our ML model uses dataset to predict whether the person has any chances of getting stroke the parameters that are considered to predict stroke are gender, age, disease, smoking status, Cystatin-c , MMP10, Tau Our dataset focuses on major factors which has causes of brain stroke.