Mobile Care Service Research Articles

Percepções de usuários sobre o serviço de atendimento móvel de urgência de Belo Horizonte

This study is designed to analyze the perceptions of users concerning the work of the Mobile Care Service. We did a qualitative case study in which data was collected through the interviews of 11 users and submitted to content analysis. The results were organized into the groups: Reason for call, evaluation of the service and suggestions to improve the attendance. The interviewees request the Mobile Care Service in situations of immobility, trampling, falls and risk of injury. Most report good attendance, and as positive points: speed, efficiency, patience, professionals’ education, preference in the hospitalar attendance, medication administration and the patient’s transport. Others however, were dissatisfied with the phone attendant, as well as the unreliability of the ambulance and for they receive only orientation. Users suggest increasing of the ambulances, as well as improving the quality and speed of the phone service. In summary, the perception of users is positive before the: agility, education, experience in meeting the emergency room, operating 24 hours and ease of access to hospitals. The complaints relate to telephone service and the reliability of the ambulances.

Mobile intensive care and pre-hospital surgical service for patients with severe thoracic injuries

Objective To explore the feasibility, safety and effectiveness of mobile intensive care and pre-hospital surgical service for patients with severe thoracic injuries so as to further improve success rate of treatment of severe thoracic trauma. Methods A retrospective study was done on the clinical data of 72 patients with severe thoracic injuries (AIS≥3) treated by surgeons from Chongqing Emergency Medical Center (CEMC) from April 1998 to August 2008. The patients were divided into pre-hospital group (n = 36) and in-hospital group (n = 36) according to the time that the definite surgery performed. Results (1) There was no significant statistical difference upon arrival time from scene to primary hospital between two groups (P > 0.05). For patients in pre-hospital group, the time to receive definite surgery was (3.9±4.1) hours, which was significant shorter than (9.6±8.2) hours in in-hospital group (P 0.05). (3) There was no significant statistical difference upon ISS value between two groups (P > 0.05), but the RTS value of pre-hospital group was significantly lower than that of in-hospital group (P < 0.05). The incidence rate of shock in pre-hospital group was 86.1%, which was significantly higher than 41.7% in in-hospital group (P < 0.05). (4) The percentage of patients who received thoracic close drainage in pre-hospital group was 16.7%, which was significantly higher than 5.6% in in-hospital group. There was no significant statistical difference upon thoracic close drainage plus thoracotomy, thoracic close drainage plus laparotomy and thoracic close drainage plus other operations between two groups. However, the operative rate of thoracic close drainage plus thoracotomy for penetrating injury was 4.8 times higher than that for blunt injury in pre-hospital group, and 1.9 times higher than that for blunt injury in-hospitai group. The operative rate of thoracic close drainage plus laparotomy for blunt injury was 5 times higher than that for penetrating injury in prehospital group, and 4.5 times higher than that for penetrating injury in in-hospital group. The overall survival rate was 95.8% (69/72). Five of eight moribund patients were saved in pre-hospital group, the prevented death rate accounted for 13.9% (5/36) in this group. Conclusions It is flexible, safe and effective to implement mobile intensive care and definite lifesaving surgical interventions for patients with severe thoracic injuries in primary hospitals. After the condition of the patient is stabilized, a quick transportation of the patients to a higher level trauma centers (hospitals) for further treatment may reduce the pre-hospital death rate. Key words: Multiple trauma; Thoracic injuries; Pre-hospital care

Buscando a integralidade no atendimento ao indivíduo diabético: do serviço de atendimento móvel de urgência à atenção primária à saúde

The present article is about a reflection on the care to the diabetic subject at two health care services of different complexity levels, searching at proposing actions that may promote an integral care to this population. The reason for discussing this clientele is due to the increasing life expectancy of the Brazilian people. The result of this factor is the up-spring of non-transmissible chronic diseases like Diabetes mellitus within the set of priorities of the national public health. The principle of integrality foreseen in the Sistema Unico de Saude – SUS (Public Health System) may be translated as the care where an interaction occurs among different levels of complexity of the health system whereby the subject has access to the services that he needs to solve his health needs. This article is based on the experiences of the authors in an Emergency Mobile Care Service and in Units of the Family Health Program as well as on scientific literature. The practice of the nurse(s) is shared in the team of an Ambulance of Advanced Support according to biomedical paradigms. It is found out, yet, that in both services it is possible to enlarge the perspective of the care practice with possibilities for the nurses to make their specific knowledge becoming visible by rendering an integral care to the health of the bearer of diabetes mellitus.

Reinventing Healthcare Service through M-care Business Model: The Strategy Analysis of WiMAX Adoption

To address the emerging issues of aging society, new technology creates many opportunities to solve the problem of care service and increases added-value in the digital family. Therefore, this paper analyzes the characteristics of WiMAX wireless technology and its applications in healthcare service. To investigate the local users’ demand of wireless service, this research conducted a questionnaire survey in Hualien County, Taiwan. The findings from the analysis of the 230 returned sample data demonstrate that the new applications and service provided through WiMAX wireless technology is highly appreciated by the people. Based on these findings from surveys and indepth interviews conducted in the local area, this paper proposes a strategy map for the development of the M-care (Mobile care) service through a five-force analysis of the industrial value chain and a SWOT analysis of wireless healthcare delivery in order to provide advice to WiMAX venders on how to create new business for M-service provision.

Reduction in case fatality rate from meningococcal disease associated with improved healthcare delivery

BACKGROUND AND AIMSThe case fatality rate from meningococcal disease (MD) has remained relatively unchanged in the post antibiotic era, with 20–50% of patients who develop shock still dying. In 1992...

Mobile intensive care services in rural South Australia.

In the 12 years from 1984 to 1995, Adelaide-based mobile intensive care teams transported 4443 critically ill patients from rural areas in South Australia and adjacent States to tertiary-level hospitals in Adelaide. The SA Ambulance Service undertook communications, support staffing and deployment of transport. Average radial distances in 819 road missions were 71 km, in 808 helicopter missions 122 km, and in 2777 fixed-wing aircraft missions 398 km. The largest groups of patients were neonates (23%) and those with trauma (25%). Rural hospitals made 96% of the requests for intensive care transport; 4% came from ambulance or other emergency service crews at accident locations. Emergency surgical or operative obstetrical procedures were performed on 2.7% of patients before transport. One hundred and thirteen patients (2.5%) died during resuscitation or transport, with one death deemed to be preventable.