Emergency Medical Service Cases Research Articles

Comparison of Helicopter and Ground Transportation in Pediatric Trauma Patients

INTRODUCTION: Geographic and population diversity remains an issue in appropriate triage of helicopter emergency medical services (HEMS). Longer transport times in ground emergency medical services and HEMS are well-known to be associated with increased mortality. The over-triage of minor injuries to HEMS transport raises issues of cost-effectiveness. We hypothesize that HEMS transport is associated with decreased mortality and increased likelihood of discharge home without need for medical services. METHODS: This was a retrospective study of pediatric (younger than 18 years) trauma patients transported by HEMS or ground emergency medical services that were reported to the National Trauma Data Bank from 2007 to 2015. In-hospital mortality was the primary outcome, and discharge without the need for medical services was the secondary outcomes. Logistic regression models were used with and without propensity matching for demographic and injury-specific factors. RESULTS: There were 348,107 patients identified from the National Trauma Data Bank. After propensity matching, 21.9% of ground emergency medical services cases and 96.0% of HEMS cases were analyzed (Figure). Multivariate regression analysis showed lower odds of mortality in the HEMS group (odds ratio 0.69 [95% CI 0.64 to 0.75], p < 0.01) and increased odds of discharge home without services (odds ratio 1.29 [95% CI 1.22 to 1.41], p < 0.01).Figure.: EMS, emergency medical services; GEMS, ground medical emergency services; HEMS, helicopter emergency medical services.CONCLUSION: Appropriate triage remains an important clinical issue requiring ongoing investigation. We showed that pediatric patients transported by HEMS had decreased odds of mortality and increased odds of discharge home without services. Further research is needed to identify specific factors that may influence these results such as access to home services, insurance status, transport times, and indications for HEMS transport.

Comparison of Emergency Medical Services Cases in Different Types of Mass Gathering Events Held Between 2015-2018 in Turkey

Comparison of Emergency Medical Services Cases in Different Types of Mass Gathering Events Held Between 2015-2018 in Turkey

COVID-19 PANDEMİSİNİN HASTANE ÖNCESİ ACİL SAĞLIK HİZMETLERİNDEKİ ADLİ VAKALARA ETKİSİ

Aim&#x0D; The aim of this study is to evaluate the effects of the COVID-19 pandemic on forensic cases treated by Emergency Medical Services compared to the pre-pandemic periods.&#x0D; Material and Methods&#x0D; The study was designed to evaluate the Emergency Medical Services cases retrospectively. We included forensic cases data covering pandemic period (period A - from March 11, 2020 to March 10, 2021) and pre-pandemic period (period B - from March 11 and period C - 2019 to March 10, 2020) in Ankara, Turkey.&#x0D; Results&#x0D; We included a total of 117,753 patients. The most common type of forensic case in all periods was traffic accidents (62.9%). This was followed by assaults (14.1%) and suicides (8.2%). The number of traffic accidents was found to be lower during the pandemic period (60.3%) than in other periods (p

Validity and risk factor analysis for helicopter emergency medical services in Japan: a pilot study

BackgroundSome emergency departments use triage scales, such as the Canadian Triage and Acuity Scale and Japan Urgent Stroke Triage Score, to detect life-threatening situations. However, these protocols have not been used for aeromedical services. Therefore, we investigated the factors predicting these life-threatening situations in aeromedical services as a pilot study for establishing the protocol.MethodWe retrospectively evaluated helicopter emergency medical service cases from 1 April 2015 to 31 March 2020 at Gifu University Hospital using the mission records. We only evaluated cases dealing with suggested internal medicine issues. We excluded cases influenced by external factors such as trauma or cases that included hospital-to-hospital transportation, focusing only on prehospital care. We evaluated the validity of the medical emergencies based on the needs for emergency interventions and hospital admission and of the suggested diagnoses and associated risk factors.ResultA total of 451 cases were suitable for inclusion in the study. In the analysis for all emergency calls, 235 (52.11%) cases needed emergency intervention and 300 (64.4%) required hospital admission. The suggested diagnosis was valid for 261 (57.87%) cases. After the first assessment by emergency medical technicians, 75 cases were removed. Analysis after this first assessment found that 52.31% cases required emergency intervention, 70.26% needed admission, and the suggested diagnosis was valid for 69.41% of cases. In the analysis of emergency calls, the multivariate analysis of some key variables identified age, playing sports, and gasping as risk factors for emergency intervention. Hospital admission risk factors included being age only. The suggested diagnosis was valid only for sports situations. In the analysis after the first assessment by an emergency medical technician, risk factors for emergency intervention included being age being male, playing sports, and gasping, and those for hospital admission was being age, being male, and experiencing stroke symptoms and/or disturbance of consciousness. The suggested diagnosis was valid only for sports situations.ConclusionSome ‘second’ keywords/phrases predict medical emergencies. Therefore, the dispatch commander should gather these keyword/phrases to assess.

The Development of Consensus-Based Descriptors for Low-Acuity Emergency Medical Services Cases for the South African Setting

Emergency Medical Services (EMS) are designed to respond to and manage patients experiencing life-threatening emergencies; however, not all emergency calls are necessarily emergent and of high acuity. Emergency responses to low-acuity patients affect not only EMS, but other areas of the health care system. However, definitions of low-acuity calls are vague and subjective; therefore, it was necessary to provide a clear description of the low-acuity patient in EMS. The goal of this study was to develop descriptors for "low-acuity EMS patients" through expert consensus within the EMS environment. A Modified Delphi survey was used to develop call-out categories and descriptors of low acuity through expert opinion of practitioners within EMS. Purposive, snowball sampling was used to recruit 60 participants, of which 29 completed all three rounds. An online survey tool was used and offered both binary and free-text options to participants. Consensus of 75% was accepted on the binary options while free text offered further proposals for consideration during the survey. On completion of round two, consensus was obtained on 45% (70/155) of the descriptors, and a further 30% (46/155) consensus was obtained in round three. Experts felt that respiratory distress, unconsciousness, chest pain, and severe hemorrhage cannot be considered low acuity. For other emergency response categories, specific descriptors were offered to denote a case as low acuity. Descriptors of low acuity in EMS are provided in both medical and trauma cases. These descriptors may not only assist in the reduction of unnecessary response and transport of patients, but also assist in identifying the most appropriate response of EMS resources to call-outs. Further development and validation are required of these descriptors in order to improve accuracy and effectiveness within the EMS dispatch environment.

Evaluation of trauma cases in different types of mass gathering events.

There are several factors affecting trauma cases in mass gatherings (MG). Event type, mood of the crowd, age, gender and educational background are among these factors. It is to identify the relationship between the event types of trauma cases and temperature variables observed in MG. It is a descriptive epidemiological study. The universe of the research consists of 112 emergency medical service records (ambulance) in organizations such as Çanakkale Victory and Martyrs' Memorial Day (ÇVMMD), Zeytinli Rock Fest, Deaflympics, and European Youth Olympic Winter Festival (EYOF). For the statistical evaluations of the study, frequency analysis, Chi-square test, and logistic regression were used. Within the scope of the research, 474 emergency medical service cases were examined. About 49.5% (n=235) of the cases took place at the DEAFOLIMPICS. About 57.6% (n=273) of the cases are male. The age average of the cases is 30.3±16.5 (Min: 0, Max: 92). When the pre-diagnosis range at the ÇVMMD is examined, it is seen that 27.7% (n=20) of the cases are trauma cases while 72.2% (n=52) are non-trauma cases. Among the trauma cases, the most frequently observed ones are soft-tissue trauma, multi-trauma, lower limb injury, and head trauma. When the other cases are examined, the most common ones are angina pectoris, nausea-vomiting, asthma, and ache. In the research, 38.3% (n=90) of the cases at the DEAFOLIMPICS are trauma cases, while 61.7% (n=145) are non-trauma cases. While the trauma cases mostly consist of soft-tissue injury and lower limb injury, the non-trauma cases include nausea-vomiting and upper respiratory infections. While the trauma cases were caused by multi-trauma, sharp object injury, soft-tissue injury, and head trauma, the pre-diagnosis of the non-trauma cases mainly included mental confusion and behavioral disorder due to use of alcohol; conversion; behavioral changes due to use of substance and drug use; hypotension; and allergic reaction. As a consequence of the logistic regression modeling, the trauma cases were found to be 1.6 times (p<0.05) higher in men than women and 9.5 times more in those who participated in the EYOF event than those who participated in the ÇVMMD event (p<0.05).

Perceptions of leadership, motivation, structure, and assurance for implementation of emergency medical services in Ethiopia: Perspectives of emergency medical services case teams based on focus group discussions

The research was assessed the Ethiopian Emergency Medical Services Case teams' and officers views on Emergency Medical services in Ethiopia. The aim of study was to present the point of views, prospect and priorities of Emergency medical services case teams and its coordinator along some main dimensions of emergency medical services, such as Leadership, Motivation, Structure, and Assurance for implementation. Six focus group discussion were facilitated with EMS case teams, focal persons and FMoH emergency medical services case teams from December to August, 2017 in all regions chosen of the study. The focus group techniques were used in the study as qualitative research method for examination of viewpoints of case team members towards to the emergency medical care system and overall pre-hospital and at hospital emergency care services. The discussion was addressing the topics of: general aspects of emergency Medical Services (EMS) and which occupations included in EMS; possibilities to importance review EMS issues based on Leadership, Motivation, Structure, and Assurance for implementation of EMS in the country. Finally, thematic analysis was used to evaluate data sets which collected during the focus group discussion. There were 6 focus groups in total: an Emergency medical services case teams, officers, Directorates, and integrated disease prevention and control program coordinators groups in each of the regional, city Administration Health Bureau and Federal Ministry of Health in Ethiopia. Findings of the thematic analysis were summarized along the following dimensions: Leadership, Motivation, Structure, and Assurance for implementation. The result shown that lack of resources, shortage of training, lack of professionals and community awareness on EMS, immaturity of EMS strategic plan and lack of revision, workload as a result of limited skilled manpower, lack of partnerships and collaboration on EMS and lack of research and community services evidence are among factors affecting the quality EMS and continuity of the program at various health care facilities at the regional and national levels. The study shows views of the Ethiopian Emergency Medical Services Case teams' and officers in Emergency Medical services in Ethiopia. The participants were considered determining factors of the EMS were rather similar among the participated regional, city Administration Health Bureau and Federal Ministry of health. Nonetheless, there was some degree of difference among those participated institutes. Especially, as a national level, Ethiopian Ministry of Health is exists only one emergency medical service directorate that leading the whole national activities. Therefore, EMS program need to respond to the challenges by respondents to articulate emergency medical services policies appropriate to Ethiopia, including the pre-hospital, at hospital care system and Ambulance services with more reformed professional skills and case team work at country level including all regions, Zone, Woreda (Districts) and other related sectors.

Pediatric Out-of-Hospital Critical Procedures in the United States.

Regular clinical application is important for maintenance of difficult resuscitation skills. Although emergency medical services must provide life-saving care for critically ill and injured children, the frequency with which these procedures are performed is unknown. We sought to characterize critical pediatric procedures performed by emergency medical service personnel in the United States. We performed a retrospective, descriptive study of emergency medical service responses. We included patients less than 18 years old in the 2011 National Emergency Medical Services Information Systems national data set. We identified emergency medical service cases receiving critical procedures, including intubation, cricothyroidotomy, cardiac pacing, cardioversion, defibrillation, needle decompression, pericardiocentesis, and intraosseous or central venous catheter placement. None. We analyzed the data to determine the number and prevalence of procedures, success rates, and factors associated with success. Of the 14,371,941 emergency medical service responses, 865,591 (6.8%) involved children. Emergency medical service responses to pediatric patients most often involved traumatic injuries (35.7%) or respiratory complications (13.2%). Emergency medical service performed a total of 616,913 procedures on 246,016 pediatric cases. Critical procedures were infrequently performed (n = 11,026, 10 per 1,000 pediatric cases). The most common critical procedures performed were intubation (n = 3,599, 6.7 per 1,000 pediatric cases) and intraosseous access (n = 2,618, 5 per 1,000 pediatric cases). Overall, 81% of critical procedures were successful. Increasing age and interfacility transfers were associated with greater odds of procedural success (p < 0.01). Despite the broad range of pediatric conditions seen in the prehospital setting, pediatric critical procedures are infrequently performed. These data highlight factors that are associated with successful completion of critical pediatric procedures.