EMS Companies Research Articles

Implementation of a Leave-behind Naloxone Program in San Francisco: A One-year Experience

In response to the ongoing opioid overdose crisis, US officials urged the expansion of access to naloxone for opioid overdose reversal. Since then, emergency medical services' (EMS) dispensing of naloxone kits has become an emerging harm reduction strategy. We created a naloxone training and low-barrier distribution program in San Francisco: Project FRIEND (First Responder Increased Education and Naloxone Distribution). The team assembled an advisory committee of stakeholders and subject-matter experts, worked with local and state EMS agencies to augment existing protocols, created training curricula, and developed a naloxone-distribution data collection system. Naloxone kits were labeled for registration and data tracking. Emergency medical technicians and paramedics were asked to distribute naloxone kits to any individuals (patient or bystander) they deemed at risk of experiencing or witnessing an opioid overdose, and to voluntarily register those kits. Training modalities included a video module (distributed to over 700 EMS personnel) and voluntary, in-person training sessions, attended by 224 EMS personnel. From September 25, 2019-September 24, 2020, 1,200 naloxone kits were distributed to EMS companies. Of these, 232 kits (19%) were registered by EMS personnel. Among registered kits, 146 (63%) were distributed during encounters for suspected overdose, and 103 (44%) were distributed to patients themselves. Most patients were male (n = 153, 66%) and of White race (n = 124, 53%); median age was 37.5 years (interquartile range 31-47). We describe a successful implementation and highlight the feasibility of a low-threshold, leave-behind naloxone program. Collaboration with multiple entities was a key component of the program's success.

Patenting and strategies of major pharmaceutical companies in Brazil

Facing the contemporaneous changes which have intensified the market competition, survival strategies are essential for the company sustainability, such as the protection of intangible assets through the patents, which confer several advantages. In the pharmaceutical industry, where the products are result from expensive processes, the patents have become an important incentive. This article has undertaken a systematic analysis of patenting in the Brazilian pharmaceutical industry, evaluating the patents indicators of the major pharmaceutical companies in Brazil in order to categorize their strategies. The results indicated the leadership of Aché in patent applications, an extremely small number of concessions, characterizing the majority of the deposits as Invention Patents, and the lack of partnerships with universities and /or foundations for research support. The EMS and Eurofarma companies have presented analytical strategic performance, the União Química, defender, and Aché and Hypermarcas, prospector performance.

Vertical dis-integration and vertical re-integration: Limits to the modern production system

This paper attempts to sketch the characteristics of mass production activities in the modern IT/electronics industry while avoiding simplification. In the second section “Revisiting the post-Fordism controversy”, we clarify that the general perception of the characteristics of American industry/corporate organization in the 1990s, particularly in the IT/electronics industry, was a series of discussions known as Wintelism. Next, the third section “The limits of Wintelism” discusses how the limits of this industry/corporate organization were revealed in the 2000s and thereafter, focusing on the characteristics particular to a model which is apt to promote accumulation of excess production capacity. It is also important to consider changing trends in product design, namely, the spread of “integrated products.” Then, in the fourth section “Addressing the limitations of Wintelism,” we examine how Apple, a leading brand from the developed world, and an EMS company from an emerging economy (Foxconn) that is a leader in today's mass production activities have tried to break through this limitation. What becomes clear is a phenomenon that could be called the rehabilitation of vertical integration or vertical reintegration. However, the mass production activities typified by Foxconn lack, at least at present, harmonization between industrial upgrading and “social upgrading,” labor-management cooperation, or a mechanism for “coordination.” This is one challenge for modern mass production activities. We touch upon this in the conclusion.

Reliable Chip & Bond Wire QA Sampling, Counting & Inspection by Implementing Multiple Magnification AOI

Reliable Chip & Bond Wire QA Sampling, Counting & Inspection by Implementing Multiple Magnification AOI

SiP Drivers and Challenges: Supply Chain Outlook and Requirements

Cost pressures are driving the semiconductor industry to look for solutions that meet the challenge of expensive next generation silicon node fabrication. Simply integrating all functions in a single die may no longer be the most economical option. In addition, the need for close proximity of die and components has driven the development of packages that provide both the price and performance needs. System-in-Package (SiP) is gaining popularity as one of the most promising integration solutions. SiP is a functional system or subsystem assembled into a single package. It may contain two or more dissimilar die, typically combined with other components such as passives, filters, antennas, and/or mechanical parts. The components are mounted together on a substrate to create a customized, highly integrated product for a given application. SiPs may utilize a combination of wire bond, flip chip, wafer level packages, pre-packaged ICs such as CSPs, stacked packages, and/or stacked die. This presentation examines the role of system-in-package (SiP) discussing the formats most likely to emerge as volume packages and the supply chain requirements to produce these packages. The roles of OSATs and EMS companies are discussed with a discussion on the advantages and challenges of each.

Abstract 243: Regional System to Optimize First Medical Contact to Balloon times for Primary PCI in STEMI Penalized by New AHA Guidelines

INTRO: The AHA Mission Lifeline recommends an EMS first medical contact (FMC) to balloon time of 90 minutes for patients STEMI when presenting directly to a percutaneous coronary intervention (PCI) hospital but 120 minutes for those requiring transfer from a non-PCI hospital. We examine the impact of direct air medical transport from the scene to a PCI center of rural patients without access to a local PCI capable hospital versus EMS transport to and subsequent transfer from a non-PCI hospital. METHODS: A regional STEMI transport system was developed in 2012 for western Pennsylvania between non-PCI capable hospitals, local EMS agencies, and UPMC Presbyterian Hospital. This system was designed to improve transfer times and one component of this was to allow local EMS companies to activate the cath lab directly. In this program, an emergency helicopter meets the EMS and allows for direct transport of the patient to PCI hospital, bypassing the local ED. We compared reperfusion times in consecutive patients brought directly to the PCI center versus patients taken by EMS to a local ED first in 2012-2013. Patients were then matched based on distance from PCI center. RESULTS: A total of 22 patients were brought directly to the PCI center and 32 patients were taken by local EMS to their local non-PCI hospital followed by helicopter transport for primary PCI. Median FMC to balloon times for patients taken directly from the scene to PCI center was 22 minutes less (113 vs 135 minutes, p=0.0006) than when first taken to a local ED. There was no difference in PCI arrival to balloon times (26 vs 20 minutes, p=0.128) and breakdown of median times listed in table 1. The average linear flight distance between groups was 37 vs 41 miles (p=0.2123). CONCLUSIONS: In this regional system, transport of rural patients with STEMI directly to a PCI center improves FMC to balloon times when compared to patients taken to a local non-PCI hospital first. Despite shortening reperfusion times with implementation of this system, some of these patients would fall out of the recommended AHA guidelines because they are considered to present directly to the PCI hospital. Further investigation on the benefits of direct transport of rural patients to a PCI center is warranted and whether the AHA recommended FMC to balloon time needs adjustment in this scenario.

Exploration and Agility in a Taiwanese EMS Company

Exploration and Agility in a Taiwanese EMS Company

A Study on the Evaluation Criteria for the Selection of the EMS Company

A Study on the Evaluation Criteria for the Selection of the EMS Company

Impact of HR factors on employee attitudes: an empirical analysis of a sample of ISO14001 EMS companies in Malaysia

Empirical research addressing employee attitudes as it relates to the implementation of an EMS/ISO14001 is currently lacking. The aim of this paper is to extend previous research by proposing and testing an integrative research model which links several HR factors to employee attitudes’. The HR factors identified include management commitment, empowerment, feedback and review, and rewards. In this study employee attitudes refer to job satisfaction and organizational commitment. Four hundred and seventy two middle and lower level employees in five multiple manufacturing companies currently certified to ISO 14001 were the focus of this exploratory empirical investigation. In addition four of these companies are winners of the Malaysian Prime Minister’s Hibiscus Award (PMHA), Malaysia’s premier private sector environmental award for business and industry. In the final data analysis two hundred and twenty three survey responses were analyzed using SPSS version 16. The research hypotheses were assessed by the multiple linear regression analysis. The results indicate that management commitment and empowerment were positively and significantly linked to employee attitudes. In addition a significant positive relationship was observed between feedback and review, and job satisfaction. Specifically management commitment was the most pivotal HR factor in fostering employee attitudes. From the survey results, some lessons are drawn for managers in effort to maximize employee motivation for successful EMS/ISO14001 implementation. The study contributes to the growing body of literature on environmental management in newly industrialized countries such as Malaysia.

The Change of the Structure of Global Production in Electronics Industry and the Growth of Asian EMS Companies

The Change of the Structure of Global Production in Electronics Industry and the Growth of Asian EMS Companies

Implementation of Six Sigma quality system in Celestica with practical examples

This paper presents the Six Sigma methodology and the way it is implemented in an EMS company. The importance of EMS industry and its role in electronic manufacturing are discussed. The competitive advantages of Six Sigma for EMS companies are presented. Qualities and responsibilities of infrastructure levels and training procedure at each level is presented. Greenbelt and Black Belt course of study at each step as used in Celestica is provided. A comparison between Six Sigma implementation in Celestica, General Electric and Motorola is provided. Two technical examples of the projects implemented successfully through DMAIC process in Celestica are provided.

IPC. Asian flu subsiding, but keeps hold on US PWB and EMS companies

IPC. Asian flu subsiding, but keeps hold on US PWB and EMS companies

Two-thirds of US PWB and EMS companies feeling crunch of Asian economic crisis

Two-thirds of US PWB and EMS companies feeling crunch of Asian economic crisis

Emergency medical care for spectators attending national football league games

Objective. To analyze medical care facilities and resources available for spectators attending football games in the current National Football League (NFL) stadiums.Methods. A prospective, structured questionnaire regarding facilities, transportation, medications and equipment, personnel configuration, compensation, and communications was mailed to all 28 NFL organizations. Those failing to respond were interviewed by telephone using the identical questionnaire. Data were compiled using Lotus 1-2-3.Results. Data were collected from all 28 NFL organizations. Because two teams use the same stadium, results were calculated for 27 facilities (n = 27). The number of stadium first aid rooms ranges from 1 to 7, with an average of 2.4 ± 1.3 rooms per stadium (± 1 SD) and these vary in size from 120 to 2,000 square feet, with a mean of 434 ± 377 square feet. Each room is equipped with an average of 3.3 ± 2.9 stretchers (or tables), with telephones being present in 91% and sinks in 88% of all rooms. To provide contractual EMS coverage, stadiums use standard EMS system designs, including private (n = 19), fire department based (n = 7), municipal (city/county) (n = 5), volunteer (n = 4), and hospital (n = 3). Nine stadiums employ more than one type of provider. All stadiums have a minimum of one ambulance dedicated on-site for spectators, with a range of 1 to 7, and a mean of 2.9 ± 1.4. Golf carts are used for intrafacility patient transportation in 17 stadiums, with a range of 1 to 6, and a mean of 2.5 ± 1.3. Advanced Cardiac Life Support (ACLS) medications and equipment are present in all NFL stadiums and are provided by the private EMS company (n = 16), stadium (n = 10), fire EMS (n = 7), hospitals (n = 4), municipal EMS (n = 2), and the local NFL organization (n = 1). Several facilities have more than one provider of ACLS medications and equipment. The majority of stadiums dispense acetaminophen (n = 25) and aspirin (n = 24). Some dispense antacids (n = 7) and antihistamines (n = 6). The average stadium staffs 8 EMT-Bs, 7 EMT-Ps, 3 registered nurses, and 2 physicians. Nine stadiums pay a predesignated fee per game to an agency to provide emergency care to spectators. Medical personnel are compensated by an hourly rate (n = 15), a fixed rate per event (n = 9), overtime wages (n = 3), or volunteerism (n = 4). Four NFL organizations pay their medical personnel by more than one type of compensation. Courtesy seats are provided to physicians and nurses in 1 stadium and to just physicians in 8 stadiums, with a range of 2 to 6 and a mean of 3.3 ± 1.3. All stadiums use two-way radios for the communication and coordination of medical care in the stadium. Additionally, 20 use fixed telephones in the first aid rooms, 3 use cellular telephones, and 2 incorporate a pager system to dispatch personnel within the stadium.Conclusion. A wide variety of system designs, facilities, and personnel configurations are used to provide emergency medical care for spectators attending NFL games. This information may be useful for assisting those individuals responsible for organizing stadium medical coverage.