Journal articles on the topic 'Ambulance transfer'
To see the other types of publications on this topic, follow the link: Ambulance transfer.
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Ambulance transfer.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Tennyson, Joseph C., and Mark R. Quale. "Reduction in STEMI Transfer Times Utilizing a Municipal “911” Ambulance Service." Prehospital and Disaster Medicine 29, no. 1 (January 22, 2014): 50–53. http://dx.doi.org/10.1017/s1049023x14000016.
Full textAbstract:
AbstractIntroductionThe time interval from diagnosis to reperfusion therapy for patients experiencing ST-segment elevation myocardial infarction (STEMI) has a significant impact on morbidity and mortality.HypothesisIt is hypothesized that the time required for interfacility patient transfers from a community hospital to a regional percutaneous coronary intervention (PCI) center using an Advanced Life Support (ALS) transfer ambulance service is no different than utilizing the “911” ALS ambulance.MethodsQuality assurance data collected by a tertiary care center cardiac catheterization program were reviewed retrospectively. Data were collected on all patients with STEMI requiring interfacility transfer from a local community hospital to the tertiary care center's PCI suite, approximately 16 miles away by ground, 12 miles by air. In 2009, transfers of patients with STEMI were redirected to the municipal ALS ambulance service, instead of the hospital's contracted ALS transfer service. Data were collected from January 2007 through May 2013. Temporal data were compared between transports initiated through the contracted ALS ambulance service and the municipal ALS service. Data points included time of initial transport request and time of ambulance arrival to the sending facility and the receiving PCI suite.ResultsDuring the 4-year study period, 63 patients diagnosed with STEMI and transferred to the receiving hospital's PCI suite were included in this study. Mean times from the transport request to arrival of the ambulance at the sending hospital's emergency department were six minutes (95% CI, 4-7 minutes) via municipal ALS and 13 minutes (95% CI, 9-16 minutes) for the ALS transfer service. The mean times from the ground transport request to arrival at the receiving hospital's PCI suite when utilizing the municipal ALS ambulance and hospital contracted ALS ambulance services were 48 minutes (95% CI, 33-64 minutes) and 56 minutes (95% CI 52-59 minutes), respectively. This eight-minute period represented a 14% (P = .001) reduction in the mean transfer time to the PCI suite for patients transported via the municipal ALS ambulance.ConclusionIn the appropriate setting, the use of the municipal “911” ALS ambulance service for the interfacility transport of patients with STEMI appears advantageous in reducing door-to-catheterization times.TennysonJC, QualeMR. Reduction in STEMI transfer times utilizing a municipal “911” ambulance service. Prehosp Disaster Med. 2014;29(1):1-4.
2
McCourt, Jacita A., Eli Strait, and Jeanne Lee. "583 Photos of Burn Wounds Can Help Reduce Over-Triage and Prevent Unnecessary Ambulance Transfer." Journal of Burn Care & Research 43, Supplement_1 (March 23, 2022): S128—S129. http://dx.doi.org/10.1093/jbcr/irac012.211.
Full textAbstract:
Abstract Introduction Burn wounds can be difficult to assess for providers outside the burn center and can result in over triage. The combination of photos of burn wounds with a clinical history can help burn practitioners make appropriate triage decisions, including immediate ambulance transfer vs scheduling an outpatient follow up appointment. Appropriate photo triage can help reduce healthcare costs by eliminating both unnecessary transfers to the burn center and overburdening burn resources. This performance improvement project involved the development of a secure photo sharing web portal and photo triage clinical pathway to help burn practitioners appropriately triage burn patients being evaluated at health care facilities within the catchment area of an American Burn Association verified adult and pediatric burn center. Methods Existing technology was used to develop a burn photo sharing web portal that can be easily accessed by providers outside the burn center. A new clinical pathway for burn photo triage was developed. Education was formulated for nurses and providers within the burn center and for referring facilities. Retrospective data was collected for the 4 years of ambulance transfers captured in the outpatient burn registry prior to the implementation of the photo triage clinical pathway. Comparison data was also abstracted for the first year after implementation. Patients were categorized as over triaged or appropriately triage based on the first set of photos captured in the EMR. Results In the pre-triage years there were a total of 242 ambulance transfers to the outpatient burn clinic. 150 (62%) of those patients were appropriately triaged, while 92 (38%) were over triaged. In the year following implementation there were 27 ambulance transfers to the outpatient burn clinic. 25 (92.6%) of these patients were appropriately triaged while 2 (7.4%) were over triaged. Overall ambulance transfers to the outpatient burn clinic dropped by more than 50% (average of 60.5 transfer per year down to 27 after implementation). Conclusions Patients with burn injuries at referring facilities were more appropriately triaged when using photos of wounds which ultimately reduced the number of unnecessary ambulance transfers.
3
Hagihara, Akihito, Daisuke Onozuka, Takashi Nagata, Takeru Abe, Manabu Hasegawa, and Yoshihiro Nabeshima. "Ambulance Dispatches From Unaffected Areas After the Great East Japan Earthquake: Impact on Emergency Care in the Unaffected Areas." Disaster Medicine and Public Health Preparedness 9, no. 6 (July 28, 2015): 609–13. http://dx.doi.org/10.1017/dmp.2015.92.
Full textAbstract:
AbstractObjectiveAlthough dispatching ambulance crews from unaffected areas to a disaster zone is inevitable when a major disaster occurs, the effect on emergency care in the unaffected areas has not been studied. We evaluated whether dispatching ambulance crews from unaffected prefectures to those damaged by the Great East Japan Earthquake was associated with reduced resuscitation outcomes in out-of-hospital cardiac arrest (OHCA) cases in the unaffected areas.MethodsWe used the Box-Jenkins transfer function model to assess the relationship between ambulance crew dispatches and return of spontaneous circulation (ROSC) before hospital arrival or 1-month survival after the cardiac event.ResultsIn a model whose output was the rate of ROSC before hospital arrival, dispatching 1000 ambulance crews was associated with a 0.474% decrease in the rate of ROSC after the dispatch in the prefectures (p=0.023). In a model whose output was the rate of 1-month survival, dispatching 1000 ambulance crews was associated with a 0.502% decrease in the rate of 1-month survival after the dispatch in the prefectures (p=0.011).ConclusionsThe dispatch of ambulances from unaffected prefectures to earthquake-stricken areas was associated with a subsequent decrease in the ROSC and 1-month survival rates in OHCA cases in the unaffected prefectures. (Disaster Med Public Health Preparedness. 2015;9:609–613)
4
Kincaid, Jenevieve, Charles Mize, and Mila Dorji. "Emergency Ambulance Dispatch and Drive Times: An Analysis of Prehospital Vehicular Response in the Kingdom of Bhutan." Prehospital and Disaster Medicine 34, s1 (May 2019): s125. http://dx.doi.org/10.1017/s1049023x19002693.
Full textAbstract:
Introduction:The Kingdom of Bhutan is a small, mountainous country with limited financial resources. Its population is scattered in hard-to-reach villages with poor road access. Ambulance drivers piloting Toyota Landcruisers provide the majority of the country’s emergency response and are dispatched by the national emergency response center (Health Help Service/112) to calls in the nation’s twenty districts.Aim:By collecting and analyzing prehospital response data, we aimed to describe Bhutanese emergency medical response (EMS) ambulance activities and make system-wide recommendations to improve the speed of emergency vehicle dispatch, reduce the time between ambulance activation and ambulance arrival on scene, and adequately describe emergency vehicle drive time as it relates to distance driven.Methods:The following data was compiled in Excel: Dispatch center phone records, EMS ambulance activation times, drive times, vehicle geospatial data, and written records of ambulance drivers. No identifiable data was collected.Inclusion Criteria: All prehospital calls from 2017 and 2018 where complete data was available.Exclusion Criteria: Complete data unavailable, i.e. geographic data without a matching call or report.Statistical Tools: SPSS Statistics Version 25, NVivo 12-12.2.0.3262.Results:Preliminary analysis of the data shows a significant difference between data collected and data previously reported, the speed of emergency vehicular response and dispatch, drive times, and distance traveled. Facility transfer rather than scene response was found to take more time.Discussion:Due to adverse road conditions, lengthy drive times, and an inadequate number of personnel and satellite ambulance locations, we recommend optimizing ambulance location using an optimization model that will minimize the number of ambulances needed and maximize response time. Future considerations may include adding a ground arm to the Bhutan Emergency Aeromedical Retrieval team, or a second aeromedical team in the eastern part of the country.
5
Truche, Paul, Rachel E. NeMoyer, Sara Patiño-Franco, Juan P. Herrera-Escobar, Myerlandi Torres, Luis F. Pino, and Gregory L. Peck. "Publicly funded interfacility ambulance transfers for surgical and obstetrical conditions: A cross sectional analysis in an urban middle-income country setting." PLOS ONE 15, no. 11 (November 6, 2020): e0241553. http://dx.doi.org/10.1371/journal.pone.0241553.
Full textAbstract:
Introduction Interfacility transfers may reflect a time delay of definitive surgical care, but few studies have examined the prevalence of interfacility transfers in the urban low- and middle-income (LMIC) setting. The aim of this study was to determine the number of interfacility transfers required for surgical and obstetric conditions in an urban MIC setting to better understand access to definitive surgical care among LMIC patients. Methods A retrospective analysis of public interfacility transfer records was conducted from April 2015 to April 2016 in Cali, Colombia. Data were obtained from the single municipal ambulance agency providing publicly funded ambulance transfers in the city. Interfacility transfers were defined as any patient transfer between two healthcare facilities. We identified the number of transfers for patients with surgical conditions and categorized transfers based on patient ICD-9-CM codes. We compared surgical transfers from public vs. private healthcare facilities by condition type (surgical, obstetric, nonsurgical), transferring physician specialty, and transfer acuity (code blue, emergent, urgent and nonurgent) using logistic regression. Results 31,659 patient transports occurred over the 13-month study period. 22250 (70.2%) of all transfers were interfacility transfers and 7777 (35%) of transfers were for patients with surgical conditions with an additional 2,244 (10.3%) for obstetric conditions. 49% (8660/17675) of interfacility transfers from public hospitals were for surgical and obstetric conditions vs 32% (1466/4580) for private facilities (P<0.001). The most common surgical conditions requiring interfacility transfer were fractures (1,227, 5.4%), appendicitis (913, 4.1%), wounds (871, 3.9%), abdominal pain (818, 3.6%), trauma (652, 2.9%), and acute abdomen (271, 1.2%). Conclusion Surgical and obstetric conditions account for nearly half of all urban interfacility ambulance transfers. The most common reasons for transfer are basic surgical conditions with public healthcare facilities transferring a greater proportion of patient with surgical conditions than private facilities. Timely access to an initial healthcare facility may not be a reliable surrogate of definitive surgical care given the substantial need for interfacility transfers.
6
Azadeh, Mohammad Reza, Mohammad Parvaresh Masoud, Mina Gaeeni, and Amir Hamta. "Outcomes of Traffic Accident Patients Transferred by Air and Ground Ambulance: Propensity Score Matching." Health in Emergencies & Disasters Quarterly 7, no. 1 (October 1, 2021): 21–32. http://dx.doi.org/10.32598/hdq.7.1.397.2.
Full textAbstract:
Background: The main task of the emergency medical system is to provide primary care and transfer the patients to hospital. Studies have been conducted to investigate the outcome of air and ground ambulance patients, but they show different results. These different results may be due to the type of study, statistical methods, differences in prehospital emergency systems, and insufficient control of confounding variables. Thus, it is difficult to compare and generalize the results. This study aimed to investigate the outcomes of injured people transported by air and ground ambulance in road traffic accidents in Qom Province, Iran, during 2015-2019. Materials and Methods: In this retrospective analytical descriptive study, we used the numerical method and examined all road traffic accident patients transferred through ground or air to Qom Shahid Beheshti Hospital by the prehospital emergency from 2015 to 2019. The collected information included the type of transfer, age, sex, type of trauma, distance from the accident site to the hospital, initial vital signs, duration of the mission, and day of the accident. To control the confounding factors, we used propensity score matching. Outcomes studied included length of hospital stay, length of stay in the intensive care unit, duration of mechanical ventilation, and the need for immediate surgery. Logistic regression was used to analyze the need for immediate surgery and a generalized linear model for other consequences. Results: After matching, the number of patients in each group transferred by ground ambulances and helicopter was 566. Trauma to the head (P=0.028) and back (P=0.002) were more common in helicopter-transported patients. The patients transported by helicopter had a longer time to reach the scene (7.70 ±5.18 min) (P<0.001), a shorter duration of presence on the scene (12.17±8.33 min) (P=0.041), and a shorter duration of transfer (13.12±4.75 min) (P<0.001) than the ground ambulance. There was no significant difference between the patients who transferred by ground and helicopter ambulance regarding the length of hospital stay in the intensive care unit (P=0.718), mechanical ventilation (P=0.507), and hospitalization (P=0.089). The need for immediate surgery in helicopter-transported patients was 84.8% higher than ground ambulance patients (95%CI: 0.086-0.267; P<0.001). Conclusion: The patients transported by helicopter were not significantly different from ground ambulances transported patients regarding staying in the intensive care unit, mechanical ventilation, and hospitalization, but they more needed immediate surgery. If the patients are triaged adequately according to the type of injury and the level of consciousness at the scene and transferred to the appropriate hospital by ground or air, they can enjoy the benefits of the type of transfer.
7
Melton, JTK, S. Jain, B. Kendrick, and SD Deo. "Helicopter Emergency Ambulance Service (HEAS) Transfer: An Analysis of Trauma Patient Case-Mix, Injury Severity and Outcome." Annals of The Royal College of Surgeons of England 89, no. 5 (July 2007): 513–16. http://dx.doi.org/10.1308/003588407x202074.
Full textAbstract:
INTRODUCTION A retrospective review of all patients transferred by helicopter ambulance to the Great Western Hospital over a 20-month period between January 2003 and September 2004 was undertaken to establish the case-mix of patients (trauma and non-trauma) transferred and the outcome. PATIENTS AND METHODS Details of all Helicopter Emergency Ambulance Service (HEAS) transfers to this unit in the study time period were obtained from the three HEAS providers in the area and case notes were reviewed. RESULTS There were 156 trauma patients transferred (total 193) in the study period with 111 cases identified for analysis with a mean age of 33 years (range, 1–92 years). Average Injury Severity Score on admission was 12 (range, 1–36). Forty-five patients were discharged home from the emergency department, 24 cases had operation, 10 patients required ICU care and 2 were pronounced dead in the emergency department. Average hospital stay following HEAS transfer was 2.97 days (range, 0–18 days). DISCUSSION Helicopter ambulance transfer in the acute setting is of debated value. Triage criteria are at fault if as many as 41% of patients transferred are being discharged home from casualty having incurred the financial cost of helicopter transfer. We suggest that the triage criteria for helicopter emergency transfer should be reviewed.
8
Bruijns, Stevan R., Henry R. Guly, and Lee A. Wallis. "Vital signs during and following ambulance transfer." European Journal of Emergency Medicine 21, no. 2 (April 2014): 136–38. http://dx.doi.org/10.1097/mej.0b013e32836188b4.
Full text
9
Porter, Alison, Sarah Black, Jeremy Dale, David Fitzpatrick, Robert Harris-Mayes, Robin Lawrenson, Ronan Lyons, et al. "VP205 Implementing Electronic Records In Ambulances." International Journal of Technology Assessment in Health Care 33, S1 (2017): 246. http://dx.doi.org/10.1017/s0266462317004305.
Full textAbstract:
INTRODUCTION:Increasingly, ambulance services offer alternatives to transfer to the emergency department (ED), when this is better for patients. The introduction of electronic health records (EHR) in ambulance services is encouraged by national policy across the United Kingdom (UK) but roll-out has been variable and complex.Electronic Records in Ambulances (ERA) is a two-year study which aims to investigate and describe the opportunities and challenges of implementing EHR and associated technology in ambulances to support a safe and effective shift to out of hospital care, including the implications for workforce in terms of training, role and clinical decision-making skills.METHODS:Our study includes a scoping review of relevant issues and a baseline assessment of progress in all UK ambulance services in implementing EHR. These will inform four in-depth case studies of services at different stages of implementation, assessing current usage, and examining context.RESULTS:The scoping review identified themes including: there are many perceived potential benefits of EHR, such as improved safety and remote diagnostics, but as yet little evidence of them; technical challenges to implementation may inhibit uptake and lead to increased workload in the short term; staff implementing EHR may do so selectively or devise workarounds; and EHR may be perceived as a tool of staff surveillance.CONCLUSIONS:Our scoping review identified some complex issues around the implementation of EHR and the relevant challenges, opportunities and workforce implications. These will help to inform our fieldwork and subsequent data analysis in the case study sites, to begin early in 2017. Lessons learned from the experience of implementing EHR so far should inform future development of information technology in ambulance services, and help service providers to understand how best to maximize the opportunities offered by EHR to redesign care.
10
Dent, Tom, Inderia Tipping, Racquel Anderson, and Charles Daniels. "Hospice advice and rapid response service for ambulance clinicians." BMJ Supportive & Palliative Care 10, no. 3 (March 27, 2020): 296–99. http://dx.doi.org/10.1136/bmjspcare-2019-001911.
Full textAbstract:
ObjectivePatients in the last year of life experience medical emergencies which may lead to an emergency attendance by ambulance clinicians and some patients having a transfer to hospital even when this is unwanted by patients, carers or professionals. Here we report the patient characteristics and outcomes of a 24-hour hospice nursing telephone advice service to support an ambulance service.MethodAn evaluation of the outcomes of ambulance calls to a nursing telephone advice service for people living in northwest London, UK, attended at home during a 6-month period by the London Ambulance Service, whose clinicians then sought advice from the hospice’s 24 hours’ telephone line.ResultsForty-five attendances of 44 acutely ill people with palliative care needs resulted in a telephone call. Thirteen patients (30%) were male and the median age was over 80 years. Thirty-two attendances (71%) were managed without a transfer to hospital, with telephone advice from the hospice and in some cases arrangements for another clinician to visit. Seven attendances (16%) resulted in a transfer to hospital, of which at least five led to an admission. Six attendances (13%) resulted in a notification of the patient’s death.ConclusionsThis preliminary study shows the feasibility, outcomes and acceptability of telephone advice to support ambulance clinicians attending patients with palliative care needs. The service was associated with low rates of subsequent transfer to hospital. Further controlled research is needed to assess the clinical and cost-effectiveness of the service.
11
Massad, Rafat, Christiane Gambin, and Lisette Duval. "The Contribution of Ergonomics to the Prevention of Musculo-Skeletal Lesions among Ambulance Technicians." Proceedings of the Human Factors and Ergonomics Society Annual Meeting 44, no. 26 (July 2000): 201–4. http://dx.doi.org/10.1177/154193120004402617.
Full textAbstract:
The Association pour la santé et la sécurité, secteur affaires sociales duQuébec (ASSTSAS) has worked with three ambulance companies to develop and implement a training program for Québec's ambulance technicians on patient handling strategies that are respectful of both the needs of the patients and the biomechanical limitations of the technicians. The lifting strategies used by the ambulance technicians to transfer patients from one surface to another were questioned and new strategies, based on sliding techniques, were developed. Further research is required to design ambulance equipment that is not only better suited to the patients' needs, but also more appropriate for the ambulance technicians' work, in order to help prevent workplace accidents.
12
A. Torad, Mohamed, and Yahia H. Hossamel-din. "Smart ambulance using IoT for blood transfer facilities." Indonesian Journal of Electrical Engineering and Computer Science 22, no. 1 (April 1, 2021): 97. http://dx.doi.org/10.11591/ijeecs.v22.i1.pp97-103.
Full textAbstract:
<span>In case of an accident occurrence, ambulance try to transport wounded and injured people to the nearest hospital, but if the injured persons need an urgent blood transfer, the emergency reception (ER) can check the availability of the needed blood type and quantity. If it is available, the emergency reception accepts the injured person, but if it is not available, the reception reroutes the ambulance to the nearest hospital which have the required blood type and quantity. So, a system created that save that wasted time to save injured people life as possible. So, we create a system that save that wasted time to save injured people life as possible. So, the main contribution in this paper is selecting and determining the nearest hospital that own the proper blood types to save injurjed people lives using dijkstra algorithm. In this study, we use an android application at the ambulance which permit the paramedic to login and select the required blood type and quantity needed after determining the injured person’s blood type and the android application automatically determine the nearest hospital using the best shortest path algorithm (SPA) after checking the database and generate a pin code for the paramedic to deliver it with injured person to the ER and get the needed blood. This process will consequently decrease the used blood quantity from the database.</span>
13
Hoare, Sarah, Michael P. Kelly, Larissa Prothero, and Stephen Barclay. "Ambulance staff and end-of-life hospital admissions: A qualitative interview study." Palliative Medicine 32, no. 9 (June 11, 2018): 1465–73. http://dx.doi.org/10.1177/0269216318779238.
Full textAbstract:
Background: Hospital admissions for end-of-life patients, particularly those who die shortly after being admitted, are recognised to be an international policy problem. How patients come to be transferred to hospital for care, and the central role of decisions made by ambulance staff in facilitating transfer, are under-explored. Aim: To understand the role of ambulance staff in the admission to hospital of patients close to the end of life. Design: Qualitative interviews, using particular patient cases as a basis for discussion, analysed thematically. Participants/setting: Ambulance staff ( n = 6) and other healthcare staff (total staff n = 30), involved in the transfer of patients (the case-patients) aged more than 65 years to a large English hospital who died within 3 days of admission with either cancer, chronic obstructive pulmonary disease or dementia. Results: Ambulance interviewees were broadly positive about enabling people to die at home, provided they could be sure that they would not benefit from treatment available in hospital. Barriers for non-conveyance included difficulties arranging care particularly out-of-hours, limited available patient information and service emphasis on emergency care. Conclusion: Ambulance interviewees fulfilled an important role in the admission of end-of-life patients to hospital, frequently having to decide whether to leave a patient at home or to instigate transfer to hospital. Their difficulty in facilitating non-hospital care at the end of life challenges the negative view of near end-of-life hospital admissions as failures. Hospital provision was sought for dying patients in need of care which was inaccessible in the community.
14
Hoedemaker, N. P. G., R. J. de Winter, G. J. Kommer, H. Giesbers, R. Adams, S. E. van den Bosch, and P. Damman. "Expansion of off-site percutaneous coronary intervention centres significantly reduces ambulance driving time to primary PCI in the Netherlands." Netherlands Heart Journal 28, no. 11 (July 20, 2020): 584–94. http://dx.doi.org/10.1007/s12471-020-01466-2.
Full textAbstract:
Abstract Introduction In patients with ST-elevation myocardial infarction (STEMI), percutaneous coronary intervention (PCI)-mediated reperfusion is preferred over pharmacoinvasive reperfusion with fibrinolysis if transfer to a PCI centre can be ensured in ≤120 min. We evaluated the ambulance driving time to primary PCI centres in the Netherlands and assessed to what extent ambulance driving times were impacted by the expansion of off-site PCI centres. Methods and results We calculated the driving routes from every Dutch postal code to the nearest PCI centre with (on-site) or without (off-site) surgical back-up. We used data from ambulance records to estimate the ambulance driving time on each route. There were 16 on-site and 14 off-site PCI centres. The median (interquartile range) time to on-site PCI centres was 18.8 min (12.2–26.3) compared with 14.9 min (8.9–20.9) to any PCI centre (p < 0.001). In postal code areas that were impacted by the initiation of off-site PCI, the median driving time decreased from 25.4 (18.2–33.1) to 14.7 min (8.9–20.9) (p < 0.001). Ambulance driving times of >120 min were only seen in non-mainland areas. Conclusion Based on a computational model, timely ambulance transfer to a PCI centre within 120 min is available to almost all STEMI patients in the Netherlands. Expansion of off-site PCI has significantly reduced the driving time to PCI centres.
15
Misbahuddin, Syed, Junaid Ahmed Zubairi, Abdul Rahman Alahdal, and Muhammad Arshad Malik. "IoT-Based Ambulatory Vital Signs Data Transfer System." Journal of Computer Networks and Communications 2018 (November 11, 2018): 1–8. http://dx.doi.org/10.1155/2018/4071474.
Full textAbstract:
In emergencies or life-threatening situations, patients are generally shifted to hospitals in ambulances. The health conditions of on-board patients can become critical if they are not evaluated and treated in time. Chances of saving lives can increase significantly if patients’ vital signs inside an ambulance or on-site triage area are transferred to a hospital in real time. If the ambulances are linked to target hospitals, then the physicians in emergency rooms can monitor on-board patients’ vital signs and issue instructions to paramedics to stabilize patients’ medical conditions before they reach the assigned hospitals. Transferred vital signs data may also be archived for medical records. The Internet of things (IoT) is a paradigm which envisions Internet connectivity of virtually everything on the earth. In this paper, an IoT-based low-cost solution is proposed to monitor, archive, analyze, and tag the vital signs data of multiple patients and transfer them to the remote hospital in real time. This opens up a lot of possibilities in telemedicine and disaster management. As a proof of concept, the functionality of the proposed system was validated by developing a prototype model utilizing an IoT-enabled medical sensor board and a Linux server mimicking the remote hospital server. Results of actual data transmission obtained during experimentation are also provided. It is hoped that the proposed system can play a role in saving human lives in disaster situations.
16
Ohkusa, Yasushi, Yukihiko Kawaguchi, Tamie Sugawara, Tetsu Okumura, Kiyosu Taniguchi, and Nobuhiko Okabe. "An Experimental Study for Syndromic Surveillance in Ambulance Transfer." Nihon Kyukyu Igakukai Zasshi 17, no. 10 (2006): 712–20. http://dx.doi.org/10.3893/jjaam.17.712.
Full text
17
Anderson, Carmel. "The NSW air ambulance: an option for patient transfer." Australian Emergency Nursing Journal 1, no. 5 (October 1998): 17–18. http://dx.doi.org/10.1016/s1328-2743(98)80010-2.
Full text
18
Sugishita, Yoshiyuki, Tamie Sugawara, Yasushi Ohkusa, Takatoshi Ishikawa, Michihiko Yoshida, and Hiroyoshi Endo. "Syndromic surveillance using ambulance transfer data in Tokyo, Japan." Journal of Infection and Chemotherapy 26, no. 1 (January 2020): 8–12. http://dx.doi.org/10.1016/j.jiac.2019.09.011.
Full text
19
Iwata, Mitsunaga, and Katsuo Yamanaka. "Ambulance transfer of extremely old patients in Nagoya, Japan." Acute Medicine & Surgery 2, no. 1 (August 21, 2014): 72–73. http://dx.doi.org/10.1002/ams2.67.
Full text
20
Myers, V., and B. Nolan. "P054: Delay in decision to transfer time for critically ill patients transported by air ambulance in Ontario." CJEM 22, S1 (May 2020): S83. http://dx.doi.org/10.1017/cem.2020.260.
Full textAbstract:
Introduction: Delays in definitive management of critically ill patients are known to drive poor clinical outcomes. A scarcely studied time period in interfacility transfer is the time between initial patient presentation and the decision to transfer. This study seeks to identify patient, environmental and institutional characteristics associated with delays in decision to transfer critically ill patients by air ambulance to a tertiary care centre. Methods: Patients >18 years old who underwent emergent air ambulance interfacility transport to a tertiary care centre were included. Patient records were located in a provincial air ambulance database. The primary exposure variable was time from patient presentation to initial call to facilitate transfer. Patient, environmental and institutional characteristics were identified using stepwise variable selection at a significance of 0.1. These characteristics were then explored using quantile regression to identify significant factors associated with delay in transport initiation. Results: A total of 11231 patients were included in the analysis. There were 5009 females (44.60%) and 6222 males (55.4%). The median age of patients was 57. The median time to initiate the transfer was 3.05 hours. The variables identified with stepwise selection were gender, category of illness, heart rate, systolic blood pressure, Glasgow coma scale, vasopressor usage, blood product usage, time of day, and type of sending site. The following factors were significantly (p < 0.05) associated with an increase in time to initiate transfer compared to the reference category at the 90th centile of time: cardiac illness (+1.45h), gastrointestinal illness (+3.27h), respiratory illness (+4.90h), sepsis (+3.03h), vasopressors (+2.31h), and an evening hour of transport (+3.67h). The following factors were significantly (p < 0.05) associated with a decrease in time to initiate transfer compared to the reference category at the 90th centile of time: neurologic illness (-1.45h), obstetrical illness (-1.56h), trauma (-3.14h), GCS <8 (-0.98h), blood transfusion (-1.47h), and sending site being a community hospital >100 beds (-2.26h), <100 beds (-4.71h), or nursing station (-10.02h). Conclusion: Time to initiate transfer represents a significant window in a patient's transport journey. In looking at the predictors of early or late initiation of transfers, these findings provide education and quality improvement opportunities in decreasing time to definitive care in critically ill populations.
21
Cho, Jin-Seong, and Hyuk Jun Yang. "Introduction and contemporary condition of helicopter emergency medical services in Korea." Journal of the Korean Medical Association 63, no. 4 (April 10, 2020): 193–98. http://dx.doi.org/10.5124/jkma.2020.63.4.193.
Full textAbstract:
As most medical facilities in Korea have been concentrated in large cities, the need to improve emergency medical services in islands and mountainous areas has emerged. Consequently, the Ministry of Health and Welfare and local governments have introduced emergency medical helicopters (known as helicopter ambulances or air ambulances) with doctors in medically vulnerable areas. Having been introduced in two regions in 2011, air ambulances are operational in seven regions as of the end of 2019. The flight time is from sunrise to sunset, except in Gyeonggi province, which is open all day. Although the criteria for transport vary depending on whether an ambulance is available for operation, it is basically intended for emergency critical diseases, such as severe trauma, stroke, and acute myocardial infarction. From September 23, 2011 to December 31, 2018, a total of 10,367 transfer requests were received, which included 534 (5.2%) interruptions, 2,657 (25.6%) rejects, and 7,176 (69.2%) transfers. A total of 7,209 patients were transferred during this period, which included 1,693 (23.5%) patients of severe trauma, 1,149 (15.9%) patients of stroke, 802 (11.1%) patients of acute myocardial infarction, and 3,565 (49.5%) patients suffering from other emergency diseases. Some economic research on air ambulances in Korea has been reported to be cost-effective, but additional research should be performed. In the future, it is necessary to widen the area of operation of air ambulances and find alternative means of transporting patients during unfavorable conditions such as night or bad weather.
22
Hussein, Noor A., and Mohamed Ibrahim Shujaa. "Secure vehicle to vehicle voice chat based MQTT and CoAP internet of things protocol." Indonesian Journal of Electrical Engineering and Computer Science 19, no. 1 (July 1, 2020): 526. http://dx.doi.org/10.11591/ijeecs.v19.i1.pp526-534.
Full textAbstract:
The congestion of road traffic is one of the most problems facing the ambulance transportation to provide fast healthcare service for patient. In this work, ambulance tracking with messages transfer system has been designed and implemented such that a central monitoring and tracking unit can observe ambulance using MQTT IoT protocol. Where each vehicle is occupied with an intelligent embedded system (Raspberry Pi) unit. When an ambulance is being in the road, it will communicate with other vehicle or road traffic by means of CoAP IoT protocol as a direct device to device communication. The proposed system has been designed such that driver use voice chat and the system are completely hand free. The voice message is being transfer into text by using speech recognition based Google API library, and then the received text message is converted again to speech by using text to speech algorithm. An encryption–decryption process-based stream cipher has been used. The message between IoT nodes has been encrypted using One Time Pad (OTP) and DNA computing. Furthermore, the required key sequence was generated using a linear feedback shift register (LFSR) as a pseudo number key generator. This key sequence was combined to generate a unique key for each message.
23
Carter, Alix J. E., James B. Gould, Peter Vanberkel, Jan L. Jensen, Jolene Cook, Steven Carrigan, Mark R. Wheatley, and Andrew H. Travers. "Offload zones to mitigate emergency medical services (EMS) offload delay in the emergency department: a process map and hazard analysis." CJEM 17, no. 6 (May 21, 2015): 670–78. http://dx.doi.org/10.1017/cem.2015.15.
Full textAbstract:
AbstractIntroductionOffload delay is a prolonged interval between ambulance arrival in the emergency department (ED) and transfer of patient care, typically occurring when EDs are crowded. The offload zone (OZ), which manages ambulance patients waiting for an ED bed, has been implemented to mitigate the impact of ED crowding on ambulance availability. Little is known about the safety or efficiency. The study objectives were to process map the OZ and conduct a hazard analysis to identify steps that could compromise patient safety or process efficiency.MethodsA Health Care Failure Mode and Effect Analysis was conducted. Failure modes (FM) were identified. For each FM, a probability to occur and severity of impact on patient safety and process efficiency was determined, and a hazard score (probability X severity) was calculated. For any hazard score considered high risk, root causes were identified, and mitigations were sought.ResultsThe OZ consists of six major processes: 1) patient transported by ambulance, 2) arrival to the ED, 3) transfer of patient care, 4) patient assessment in OZ, 5) patient care in OZ, and 6) patient transfer out of OZ; 78 FM were identified, of which 28 (35.9%) were deemed high risk and classified as impact on patient safety (n=7/28, 25.0%), process efficiency (n=10/28, 35.7%), or both (n=11/28, 39.3%). Seventeen mitigations were suggested.ConclusionThis process map and hazard analysis is a first step in understanding the safety and efficiency of the OZ. The results from this study will inform current policy and practice, and future work to reduce offload delay.
24
Mahadevan, Kalaivani, Divyesh Sharma, Christopher Walker, Annette Maznyczka, Alex Hobson, Philip Strike, Huw Griffiths, and Ali Dana. "Impact of paramedic education on door-to-balloon times and appropriate use of the primary PCI pathway in ST-elevation myocardial infarction." BMJ Open 12, no. 2 (February 2022): e046231. http://dx.doi.org/10.1136/bmjopen-2020-046231.
Full textAbstract:
ObjectiveEvidence supports improved outcomes and reduced mortality with rapid reperfusion through primary percutaneous coronary intervention (PPCI) for ST-elevation myocardial infarction (STEMI). UK national audit data (Myocardial Ischaemia National Audit Project [MINAP]) demonstrates minor improvements in door-to-balloon times (DTB) of <90 min but increasing call-to-balloon times (CTB). We evaluate the effect of a regional Cardiologist delivered paramedic education programme (PEP) on DTB times and appropriate use of the PPCI pathway.MethodsThis was a prospective single-centre study of patients with STEMI brought directly to hospital via ambulance services. Data sources included ambulance charts, in-patient notes, British Cardiovascular Interventional Society (BCIS) database and local MINAP data. All DTB breaches were investigated. A local PEP was implemented with focus on ECG interpretation, STEMI diagnosis and appropriate use of the PPCI pathway. Non-parametric Wilcoxon rank test was used for comparisons of DTB and CTB times between direct versus ED-associated cath lab transfer.ResultsA total of 728 patients with STEMI were admitted directly to our centre via ambulance, 66% (n=484) directly to the Catheterisation Laboratory (Cath Lab) and 34% (n=244) via the Emergency Department (ED). There was a significant increase in median DTB, 83 vs 37 min (p<0.001) and median CTB 144 vs 97.5 min (p<0.001) when transfer to the Cath Lab occurred via the ED versus direct transfer. The PEP increased direct cath lab transfers (52%–85%) and generated annual reductions in median DTB times, with sustained improvement seen throughout the 7-year study period.ConclusionsParamedic education increases direct transfer of STEMI patients to the Cath Lab, and reduces DTB times. This is an effective and reproducible intervention to facilitate timely reperfusion in STEMI.
25
Porter, Alison, Anisha Badshah, Sarah Black, David Fitzpatrick, Robert Harris-Mayes, Saiful Islam, Matthew Jones, et al. "Electronic health records in ambulances: the ERA multiple-methods study." Health Services and Delivery Research 8, no. 10 (February 2020): 1–140. http://dx.doi.org/10.3310/hsdr08100.
Full textAbstract:
Background Ambulance services have a vital role in the shift towards the delivery of health care outside hospitals, when this is better for patients, by offering alternatives to transfer to the emergency department. The introduction of information technology in ambulance services to electronically capture, interpret, store and transfer patient data can support out-of-hospital care. Objective We aimed to understand how electronic health records can be most effectively implemented in a pre-hospital context in order to support a safe and effective shift from acute to community-based care, and how their potential benefits can be maximised. Design and setting We carried out a study using multiple methods and with four work packages: (1) a rapid literature review; (2) a telephone survey of all 13 freestanding UK ambulance services; (3) detailed case studies examining electronic health record use through qualitative methods and analysis of routine data in four selected sites consisting of UK ambulance services and their associated health economies; and (4) a knowledge-sharing workshop. Results We found limited literature on electronic health records. Only half of the UK ambulance services had electronic health records in use at the time of data collection, with considerable variation in hardware and software and some reversion to use of paper records as services transitioned between systems. The case studies found that the ambulance services’ electronic health records were in a state of change. Not all patient contacts resulted in the generation of electronic health records. Ambulance clinicians were dealing with partial or unclear information, which may not fit comfortably with the electronic health records. Ambulance clinicians continued to use indirect data input approaches (such as first writing on a glove) even when using electronic health records. The primary function of electronic health records in all services seemed to be as a store for patient data. There was, as yet, limited evidence of electronic health records’ full potential being realised to transfer information, support decision-making or change patient care. Limitations Limitations included the difficulty of obtaining sets of matching routine data for analysis, difficulties of attributing any change in practice to electronic health records within a complex system and the rapidly changing environment, which means that some of our observations may no longer reflect reality. Conclusions Realising all the benefits of electronic health records requires engagement with other parts of the local health economy and dealing with variations between providers and the challenges of interoperability. Clinicians and data managers, and those working in different parts of the health economy, are likely to want very different things from a data set and need to be presented with only the information that they need. Future work There is scope for future work analysing ambulance service routine data sets, qualitative work to examine transfer of information at the emergency department and patients’ perspectives on record-keeping, and to develop and evaluate feedback to clinicians based on patient records. Study registration This study is registered as Health and Care Research Wales Clinical Research Portfolio 34166. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 10. See the NIHR Journals Library website for further project information.
26
Pahlin, Torbjörn, and Janet Mattsson. "Digital Documentation Platforms in Prehospital Care- Do They Support the Nursing Care." International Journal of Higher Education 8, no. 1 (January 23, 2019): 84. http://dx.doi.org/10.5430/ijhe.v8n1p84.
Full textAbstract:
This study examines and describe the ambulance nurse's experience of nursing documentation in single responder and the transfer of the documentation to other care levels. A qualitative design was used with focus group interviews as data collection method to enhance knowledge of the everyday experience of nursing documentation. The ambulance service in Sweden is a profession in transition that evolved from being a transport organization to provide advanced medical care and nursing. However, all patients do not need advanced medical treatment and the Single responder is an alternative resource to the ambulance that is used when no life-threatening conditions exists. However, the nurse faces a number of challenges when documenting nursing care interventions related to technological development and the mismatch between the care offered and people's demands and needs. Even though nursing care documentation is key to enhance and develop patient safety within a young field as ambulance service. There is a lack of a coherent documentation system and two themes emerged through content analyzes which conveyed how nursing care becomes invisible and how nursing care interventions are communicated through a hidden language. There are serious shortcomings in the transfer of nursing documentation to other care levels as well as deficiencies in the nursing documentation. Which jeopardizes the quality of care and patient safety as well as a systematic development of nursing care in this field.
27
Asakawa, Yasuyoshi, Ryutaro Takahashi, and Jun Kagawa. "Falling Accidents among Metropolitan Elderly Resulting in Emergency Ambulance Transfer." Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics 38, no. 4 (2001): 534–39. http://dx.doi.org/10.3143/geriatrics.38.534.
Full text
28
Chipp, E., R. Warner, D. McGill, and N. Moiemen. "Air ambulance transfer of burns patients: Who needs to fly?" Burns 35 (September 2009): S14. http://dx.doi.org/10.1016/j.burns.2009.06.054.
Full text
29
Porter, Alison, Sarah Black, Jeremy Dale, Robert Harris-Mayes, Robin Lawrenson, Ronan Lyons, Suzanne Mason, et al. "PP32 Electronic records in ambulances – an observational study (ERA)." Emergency Medicine Journal 36, no. 10 (September 24, 2019): e14-e14. http://dx.doi.org/10.1136/emermed-2019-999abs.32.
Full textAbstract:
BackgroundThe introduction of information technology (IT) in emergency ambulance services to electronically capture, interpret and store patient data can support out of hospital care. Although electronic health records (EHR) in ambulances and other digital technology are encouraged by national policy across the UK, there is considerable variation across services in terms of implementation. We aimed to understand how electronic records can be most effectively implemented in a pre-hospital context, in order to support a safe and effective shift from acute to community-based care.MethodsWe conducted a mixed-methods study with four work packages (WPs): a rapid literature review, a telephone survey of all 13 freestanding UK ambulance services, detailed case studies in four selected sites, and a knowledge sharing workshop.ResultsWe found considerable variation in hardware and software. Services were in a state of constant change, with services transitioning from one system to another, reverting to paper, or upgrading. Ambulance clinicians were dealing with partial or unclear information, which may not fit comfortably with the EHR. Clinicians continued to use indirect data input approaches such as first writing on a glove. The primary function of EHR in all services seemed to be as a store for patient data. There was, as yet, limited evidence of their full potential being realised to transfer information, support decision making or change patient care.ConclusionsRealising the full benefits of EHR requires engagement with other parts of the local health economy, dealing with the challenges of interoperability. Clinicians and data managers are likely to want very different things from a data set, and need to be presented with only the information that they need.
30
Filippelli, Orazio Stefano Giovanni, Anna Maria Giglio, Simona Paola Tiburzi, Maria Teresa Archinà, Ercole Barozzi, Pietro Maglio, Stefano Candido, et al. "Management of Airways through Rapid Tracheostomy in a Severely Burnt Patient Attended to via Helicopter." Case Reports in Emergency Medicine 2021 (July 1, 2021): 1–3. http://dx.doi.org/10.1155/2021/5590275.
Full textAbstract:
In Catanzaro, Italy, an adult male with severe burns all over his body and in a state of coma was promptly rescued by the medical team at the air ambulance service (HEMS), who provided airway safety through laryngeal mask placement (LMA). The patient was subsequently transferred to the nearest Hub center, where an emergency tracheostomy was performed to ensure better airway management during the flight to the nearest available major burn center. This is the first documented case at regional level of a patient undergoing rapid tracheostomy through an imminent transfer with air ambulance.
31
Bayram, Jamil D., Shawki Zuabi, and Mazen J. El Sayed. "Disaster Metrics: Quantitative Estimation of the Number of Ambulances Required in Trauma-Related Multiple Casualty Events." Prehospital and Disaster Medicine 27, no. 5 (August 21, 2012): 445–51. http://dx.doi.org/10.1017/s1049023x12001094.
Full textAbstract:
AbstractIntroductionEstimating the number of ambulances needed in trauma-related Multiple Casualty Events (MCEs) is a challenging task.Hypothesis/ProblemEmergency medical services (EMS) regions in the United States have varying “best practices” for the required number of ambulances in MCE, none of which is based on metric criteria. The objective of this study was to estimate the number of ambulances required to respond to the scene of trauma-related MCE in order to initiate treatment and complete the transport of critical (T1) and moderate (T2) patients. The proposed model takes into consideration the different transport times and capacities of receiving hospitals, the time interval from injury occurrence, the number of patients per ambulance, and the pre-designated time frame allowed from injury until the transfer care of T1 and T2 patients.MethodsThe main theoretical framework for this model was based on prehospital time intervals described in the literature and used by EMS systems to evaluate operational and patient care issues. The North Atlantic Treaty Organization (NATO) triage categories (T1-T4) were used for simplicity.ResultsThe minimum number of ambulances required to respond to the scene of an MCE was modeled as being primarily dependent on the number of critical patients (T1) present at the scene any particular time. A robust quantitative model was also proposed to dynamically estimate the number of ambulances needed at any time during an MCE to treat, transport and transfer the care of T1 and T2 patients.ConclusionA new quantitative model for estimation of the number of ambulances needed during the prehospital response in trauma-related multiple casualty events has been proposed. Prospective studies of this model are needed to examine its validity and applicability.BayramJD, ZuabiS, El SayedMJ. Disaster metrics: quantitative estimation of the number of ambulances required in trauma-related multiple casualty events. Prehosp Disaster Med.2012;27(5):1-7.
32
Schwartz, Brian. "Transfer of care and offload delay: continued resistance or integrative thinking?" CJEM 17, no. 6 (March 24, 2015): 679–84. http://dx.doi.org/10.1017/cem.2014.62.
Full textAbstract:
AbstractThe disciplines of paramedicine and emergency medicine have evolved synchronously over the past four decades, linked by emergency physicians with expertise in prehospital care. Ambulance offload delay (OD) is an inevitable consequence of emergency department overcrowding (EDOC) and compromises the care of the patient on the ambulance stretcher in the emergency department (ED), as well as paramedic emergency medical service response in the community. Efforts to define transfer of care from paramedics to ED staff with a view to reducing offload time have met with resistance from both sides with different agendas. These include the need to return paramedics to serve the community versus the lack of ED capacity to manage the patient. Innovative solutions to other system issues, such as rapid access to trauma teams, reducing door-to-needle time, and improving throughput in the ED to reduce EDOC, have been achieved by involving all stakeholders in an integrative thinking process. Only by addressing this issue in a similar integrative process will solutions to OD be realized.
33
Ling, Rod, Andrew Searles, Jacqueline Hewitt, Robyn Considine, Catherine Turner, Susan Thomas, Kelly Thomas, et al. "Cost analysis of an integrated aged care program for residential aged care facilities." Australian Health Review 43, no. 3 (2019): 261. http://dx.doi.org/10.1071/ah16297.
Full textAbstract:
Objective To compare annual costs of an intervention for acutely unwell older residents in residential age care facilities (RACFs) with usual care. The intervention, the Aged Care Emergency (ACE) program, includes telephone clinical support aimed to reduce avoidable emergency department (ED) presentations by RACF residents. Methods This costing of the ACE intervention examines the perspective of service providers: RACFs, Hunter Medicare Local, the Ambulance Service of New South Wales, and EDs in the Hunter New England Local Health District. ACE was implemented in 69 RACFs in the Hunter region of NSW, Australia. Analysis used 14 weeks of ACE and ED service data (June–September 2014). The main outcome measure was the net cost and saving from ACE compared with usual care. It is based on the opportunity cost of implementing ACE and the opportunity savings of ED presentations avoided. Results Our analysis estimated that 981 avoided ED presentations could be attributed to ACE annually. Compared with usual care, ACE saved an estimated A$921214. Conclusions The ACE service supported a reduction in avoidable ED presentations and ambulance transfers among RACF residents. It generated a cost saving to health service providers, allowing reallocation of healthcare resources. What is known about the topic? Residents from RACFs are at risk of further deterioration when admitted to hospital, with high rates of delirium, falls, and medication errors. For this cohort, some conditions can be managed in the RACF without hospital transfer. By addressing avoidable presentations to EDs there is an opportunity to improve ED efficiency as well as providing care that is consistent with the resident’s goals of care. RACFs generate some avoidable ED presentations for residents who may be more appropriately treated in situ. What does this paper add? Telephone triaging with nursing support and training is a means by which ED presentations from RACFs can be reduced. One of the consequences of this intervention is ‘cost avoided’, largely through savings on ambulance costs. What are the implications for practitioners? Unnecessary transfer from RACFs to ED can be avoided through a multicomponent program that includes telephone support with cost-saving implications for EDs and ambulance services.
34
Jankovič, Peter, and Ľudmila Jánošíková. "Ambulance Locations in a Tiered Emergency Medical System in a City." Applied Sciences 11, no. 24 (December 20, 2021): 12160. http://dx.doi.org/10.3390/app112412160.
Full textAbstract:
This paper deals with optimizing the location of ambulance stations in a two-tiered emergency medical system in an urban environment. Several variants of station distribution are calculated by different mathematical programming models and are evaluated by a detailed computer simulation model. A new modification of the modular capacitated location model is proposed. Two ways of demand modelling are applied; namely, the aggregation of the ambient population and the aggregation of permanent residents at the street level. A case study of the city of Prešov, Slovakia is used to assess the models. The performance of the current and proposed sets of locations is evaluated using real historical data on ambulance trips. Computer simulation demonstrates that the modular capacitated location model, with the ambient population demand, significantly reduces the average response time to high-priority patients (by 79 s in the city and 62 s in the district) and increases the percentage of high-priority calls responded to within 8 min (by almost 4% in the city and 5% in the district). Our findings show that a significant improvement in the availability of the service can be achieved when ambulances are not accumulated at a few stations but rather spread over the city territory.
35
Mea, V. Della, D. Cortolezzis, and C. A. Beltrami. "The economics of telepathology – a case study." Journal of Telemedicine and Telecare 6, no. 1_suppl (February 2000): 168–69. http://dx.doi.org/10.1258/1357633001934555.
Full textAbstract:
There are several obstacles that slow down the diffusion of telepathology. One is related to uncertainty about the economic consequences of its adoption, possibly more so than in other fields of telemedicine. We have evaluated the economics of telepathology when used to provide a frozen-section service to a mountain hospital, in comparison with three current alternatives. In the specific situations studied, no one model was always less expensive than the others. In particular, owing to the very low cost of the ambulance service provided by the Red Cross, the ambulance model was least expensive when dealing with up to 73 frozen sections a year, while at higher case-loads telepathology was cheaper. If ambulance transfer is neglected, telepathology appears to be the most convenient approach to the remote frozen-section service. Although the consultant pathologist costs more than telemedicine, during free time he/she could perform other (routine) work, thus reducing the real cost of frozen sections.
36
Callaghan, Christopher, Sheila Turris, Haddon Rabb, Brendan Munn, and Adam Lund. "On the Way Out: An Analysis of Patient Transfers from Four, Large-Scale, North American Music Festivals Over Two Years." Prehospital and Disaster Medicine 34, s1 (May 2019): s39—s40. http://dx.doi.org/10.1017/s1049023x19000967.
Full textAbstract:
Introduction:Music festivals are globally attended events that bring together performers and fans for a defined period of time. These festivals often have onsite medical care to help reduce the impact on local healthcare systems. Historically, the literature suggests that patient transfers offsite are frequently related to complications of substance use. However, there is a gap in understanding as to why patients are transferred to a hospital when an onsite medical team, providing a higher level of care (HLC), is present.Aim:To better understand the causes that necessitate patient transportation to the hospital during festivals that have onsite physician-led coverage.Methods:De-identified patient data from a convenience sample of four, large-scale Canadian festivals (over two years) were extracted. Patient encounters that resulted in transfers to hospital, by ambulance, non-emergency transport vehicle (NETV), or self-transportation were analyzed for this study.Results:Each festival had an onsite medical team that included physicians, nurses, and paramedics. During 34 event days, there were 10,406 patient encounters, resulting in 156 patients requiring transfer to a hospital. A patient presentation rate of 16.5/1,000 was observed. The ambulance transfer rate was 0.12/1,000 of attendees. The most common reason for transport was musculoskeletal injuries (54%) that required imaging.Discussion:The presence of onsite teams capable of treating and releasing patients impacted the case mix of patients transferred to a hospital, and may reduce the number of transfers for intoxication. Confounding preconceptions, patients in the present study were transferred largely for injuries that required imaging. Results suggest that a better understanding of the specific effects onsite medical teams have on avoiding off-site transfers will aid in improving planning for music festivals. Findings also identify areas for further improvement in care, such as onsite radiology, which could potentially further reduce the impact of music festivals on local health services.
37
Senekal, A. C. G., and C. Vincent-Lambert. "Experiences of emergency care providers conducting critical care transfers in Gauteng Province, South Africa." Southern African Journal of Critical Care 37, no. 3 (December 20, 2021): 92–97. http://dx.doi.org/10.7196/sajcc.2021.v37i3.487.
Full textAbstract:
Background. Critical care transfer (CCT) involves the movement of high-acuity patients between facilities. Internationally, CCTs are commonly performed by a dedicated team using specialised vehicles and equipment. These transfers comprise a significant portion of the work of local ambulance services; however, there is a dearth of literature on current approaches and practices. Objectives. To investigate and describe the experiences of a sample of Gauteng Province-based emergency care (EC) providers conducting CCTs. Methods. A qualitative descriptive design used thematic analysis to gather data from 14 purposely selected participants during semi-structured focus group discussions, which were recorded and transcribed verbatim. Data were coded and analysed using ATLAS.ti to generate themes and sub-themes. Results. The two dominant themes that emerged from the study were that there is no common understanding or clear definition of a CCT in the local context, and that systemic challenges are experienced. Participants indicated that their undergraduate training did not sufficiently prepare them to conduct CCTs. Local ambulance services appear to lack a common definition and understanding of exactly what constitutes a CCT and how this differs from ‘normal’ ambulance operations. Participants felt undervalued and poorly supported, with several systemic challenges being highlighted. Conclusions. The absence of a contextually relevant definition of what constitutes a CCT, coupled with potential curriculum deficits in undergraduate EC programmes, negatively impacts on the experiences of EC providers conducting CCTs. Acknowledging CCT as an area of specialisation is an important step in addressing some of the frustrations and challenges experienced by EC providers tasked with conducting such transfers. Further research into formal postgraduate programmes in CCT is recommended.
38
Singh, Jasbir, Poonam Dalal, Geeta Gathwala, and Ravi Rohilla. "Transport characteristics and predictors of mortality among neonates referred to a tertiary care centre in North India: a prospective observational study." BMJ Open 11, no. 7 (July 2021): e044625. http://dx.doi.org/10.1136/bmjopen-2020-044625.
Full textAbstract:
ObjectiveThe paucity of specialised care in the peripheral areas of developing countries necessitates the referral of sick neonates to higher centres. Organised interhospital transport services provided by a skilled and well-equipped team can significantly improve the outcome. The present study evaluated the transport characteristics and predictors of mortality among neonates referred to a tertiary care centre in North India.DesignProspective observational study.SettingsTertiary care teaching hospital in North India.Patients1013 neonates referred from peripheral health units.Main outcome measuresMortality among referred neonates on admission to our centre.ResultsOf the 1013 enrolled neonates, 83% were transferred through national ambulance services, 13.7% through private hospital ambulances and 3.3% through personal vehicles. Major transfer indications were prematurity (35%), requirement for ventilation (32%), birth asphyxia (28%) and hyperbilirubinaemia (19%). Hypothermia (32.5%, 330 of 1013), shock (19%, 192 of 1013) and requirement for immediate cardiorespiratory support (ICRS) (10.4%, 106 of 1013) on arrival were the major complications observed during transfer. A total of 305 (30.1%, N=1013) deaths occurred. Of these, 52% (n=160) died within 24 hours of arrival. On multivariate logistic analysis, unsupervised pregnancy (<4 antenatal visits; p=0.037), antenatal complications (p<0.001), prematurity ≤30 weeks (p=0.005), shock (p=0.001), hypothermia (p<0.001), requirement for ICRS on arrival (p<0.001), birth asphyxia (p=0.004), travel time >2 hours (p=0.005) and absence of trained staff during transfer (p<0.001) were found to be significant predictors of mortality.ConclusionThe present study depicts high mortality among infants referred to our centre. Adequate training of peripheral health personnel and availability of pre-referral stabilisation and dedicated interhospital transport teams for sick neonate transfers may prove valuable interventions for improved outcomes.
39
Killick, Desmond, and Gerard Ward. "Prehospital use of supplemental oxygen therapy in the non-hypoxic patient." Journal of Paramedic Practice 11, no. 12 (December 2, 2019): 1–6. http://dx.doi.org/10.12968/jpar.2019.11.12.cpd1.
Full textAbstract:
Supplemental oxygen therapy in the prehospital setting can be life saving in the treatment of hypoxaemia. However, it is often administered liberally in a routine manner without clinical indication. In hyperoxaemia, it is associated with a higher risk of morbidity and mortality in acutely ill patients. An audit was performed on the use of supplemental oxygen therapy in the Irish ambulance service, which looked at: reasons for ambulance transfer; delivery device used to administer supplemental oxygen; oxygen saturation levels before and after therapy; and level of the practitioner giving the treatment. The audit results were screened against formal international guidelines, and recommendations were made to improve practice, with a view to re-auditing in the future.
40
Wong, A., A. McParland, and B. Nolan. "P141: Identifying causes of delay in interfacility transfer of patients by air ambulance." CJEM 21, S1 (May 2019): S115. http://dx.doi.org/10.1017/cem.2019.332.
Full textAbstract:
Introduction: Vast geography and low population density limit availability of specialized trauma and medical care in many areas of Ontario. As such, patients with severe illnesses often require a higher level of care than local facilities can provide and thus require an interfacility transfer to access tertiary or quaternary care. In Ontario, Ornge, a provincially run air ambulance, serves as the sole provider of air-based medical and critical care transport. Patient outcomes are impacted by the time to definitive care, yet little research about reasons for delay in interfacility transfer within Ontario has been conducted. This study aimed to identify causes of delay in interfacility transport by air ambulance in Ontario. Methods: Causes of delay were identified by manual chart review of electronic patient care records (ePCR). All emergent adult interfacility transfers for patients transported by Ornge between Jan. 1-Dec. 31, 2016 were eligible for inclusion. Patient records were flagged to be manually reviewed if they met one or more of the following criteria: 1) contained a standardized delay code; 2) the ePCR free text contained “delay”, “wait”, “duty-out”, or common misspellings therein; 3) were above the 75th percentile in total transport time; or 4) were above the 90th percentile in time to patient bedside, time spent at the sending hospital, or time to receiving facility. Each trip was categorized as having delays that fall into one or more of the following categories: time-to-sending delays, in-hospital delays, and time-to-receiving/handover delays. Results: Our search strategy identified 1,220 records for manual review and a total of 872 delays were identified. The most common delays cited included aircraft refuelling (234 delays); waiting for land EMS escort (144); and unstable patients requiring advanced care such as intubation, procedures, or transfusion (79). Other delays included handover or delays at the receiving facility (42); mechanical issues (36); dispatch-related issues (53); environmental hazards (43); staffing issues (47); and equipment problems (38). Conclusion: Some common causes of interfacility delay are potentially modifiable: better trip planning around refueling, and improved coordination with local EMS could impact many delayed interfacility trips in Ontario. Our analysis was limited by number and completeness of available records, and documentation quality. To better understand causes for delay, we would benefit from improved documentation and record availability.
41
Wong, Alanna, Aidan McParland, and Brodie Nolan. "Identifying causes of delay in interfacility transfer of patients by air ambulance." CJEM 22, S2 (September 2020): S30—S37. http://dx.doi.org/10.1017/cem.2019.444.
Full textAbstract:
ABSTRACTObjectivesPopulation density can limit the level of care that can be provided in local facilities in Ontario, and as such, patients with severe illnesses often require interfacility transfers to access specialized care. This study aimed to identify causes of delay in interfacility transport by air ambulance in Ontario.MethodsCauses of delay were identified by manual review of electronic patient care records (ePCRs). All emergent interfacility transfers conducted by Ornge, the sole provider of air-based medical transport in Ontario, between January 1, 2016 and December 31, 2016 were included. The ePCRs were reviewed if they met one or more of the following: (1) contained a standardized delay code; (2) contained free text including “delay”, “wait”, or “duty-out”; (3) were above the 75th percentile in total transport time; or (4) were above the 90th percentile in time to bedside, time at the sending hospital, or time to receiving facility.ResultsOur search strategy identified 1,220 ePCRs for manual review, which identified a total of 872 delays. Common delays cited included aircraft refueling (234 delays), waiting for land emergency medical service (EMS) escort (146), and staffing- or dispatch-related issues (124). Other delays included weather/environmental hazards (43); mechanical issues (36); and procedures, imaging, or stabilization (80).ConclusionsSome common causes of interfacility delay are potentially modifiable: better trip planning around refueling and improved coordination with local EMS, could reduce delays experienced during interfacility trips. To better understand causes of delay, we would benefit from improved documentation and record availability which limited the results in this study.
42
Zhang, Zizhen, Hu Qin, Kai Wang, Huang He, and Tian Liu. "Manpower allocation and vehicle routing problem in non-emergency ambulance transfer service." Transportation Research Part E: Logistics and Transportation Review 106 (October 2017): 45–59. http://dx.doi.org/10.1016/j.tre.2017.08.002.
Full text
43
Melton, J., S. Jain, B. Kendrick, and S. Deo. "Pre-hospital patient transfer using helicopter ambulance: Should triage criteria be changed?" Injury Extra 38, no. 4 (April 2007): 108–9. http://dx.doi.org/10.1016/j.injury.2006.12.049.
Full text
44
Schull, Michael J., Samuel Vaillancourt, Linda Donovan, Lucy J. Boothroyd, Dug Andrusiek, John Trickett, Sunil Sookram, Andrew Travers, Marian J. Vermeulen, and Jack V. Tu. "Underuse of prehospital strategies to reduce time to reperfusion for ST-elevation myocardial infarction patients in 5 Canadian provinces." CJEM 11, no. 05 (September 2009): 473–80. http://dx.doi.org/10.1017/s1481803500011672.
Full textAbstract:
ABSTRACTObjective:Timely reperfusion therapy for ST-elevation myocardial infarction (STEMI) is an important determinant of outcome, yet targets for time to treatment are frequently unmet in North America. Prehospital strategies can reduce time to reperfusion. We sought to determine the extent to which emergency medical services (EMS) use these strategies in Canada.Methods:We carried out a cross-sectional survey in 2007 of ground EMS operators in British Columbia, Alberta, Ontario, Quebec and Nova Scotia. We focused on the use of 4 prehospital strategies: 1) 12-lead electrocardiogram (ECG), 2) routine expedited emergency department (ED) transfer of STEMI patients (from a referring ED to a percutaneous coronary intervention [PCI] centre), 3) prehospital bypass (ambulance bypass of local EDs to transport patients directly to PCI centres) and 4) prehospital fibrinolysis.Results:Ninety-seven ambulance operators were surveyed, representing 15 681 paramedics serving 97% of the combined provincial populations. Of the operators surveyed, 68% (95% confidence interval [CI] 59%–77%) had ambulances equipped with 12-lead ECGs, ranging from 40% in Quebec to 100% in Alberta and Nova Scotia. Overall, 47% (95% CI 46%-48%) of paramedics were trained in ECG acquisition and 40% (95% CI 39%–41%) were trained in ECG interpretation. Only 18% (95% CI 10%–25%) of operators had prehospital bypass protocols; 45% (95% CI 35%–55%) had protocols for expedited ED transfer. Prehospital fibrinolysis was available only in Alberta. All EMS operators in British Columbia, Alberta and Nova Scotia used at least 1 of the 4 prehospital strategies, and one-third of operators in Ontario and Quebec used 0 of 4. In major urban centres, at least 1 of the 3 prehospital strategies 12-lead ECG acquisition, bypass or expedited transfer was used, but there was considerable variation within and across provinces.Conclusion:The implementation of widely recommended prehospital STEMI strategies varies substantially across the 5 provinces studied, and relatively simple existing technologies, such as prehospital ECGs, are underused in many regions. Substantial improvements in prehospital services and better integration with hospital-based care will be necessary in many regions of Canada if optimal times to reperfusion, and associated outcomes, are to be achieved.
45
Sakurai, Atsushi, Jun Oda, Takashi Muguruma, Shiei Kim, Sachiko Ohta, Takeru Abe, and Naoto Morimura. "Revision of the Protocol of the Telephone Triage System in Tokyo, Japan." Emergency Medicine International 2021 (April 21, 2021): 1–6. http://dx.doi.org/10.1155/2021/8832192.
Full textAbstract:
Introduction. The Emergency Telephone Consultation Center in Tokyo (#7119) was the first telephone triage system in Japan and has operated since 2007. This study examined the revision of the #7119 protocol by referring the linked data to each code of the triage protocol. Methods. We selected candidates based on the medical codes targeted by the revision, linking data from the nurses’ decisions in triage and the patients’ condition severity when the ambulance arrived at the hospital, gathering data from June 1, 2016, to December 31, 2017. Then, several emergency physicians evaluated the cases and decided whether the code should be moved to the more or less urgent category or if new protocols and codes would be established. Results. In this revision, 371 codes were moved to the less urgent category, 35 codes were moved to the more urgent category, and 128 codes were newly established. In all, 59 red codes (transfer to the ambulance dispatcher) were reduced, while 254 orange codes (attendance at hospital within 1 hour) and yellow codes (within 6 hours) were moved to less urgent, and 12 yellow and green codes (within 24 hours) were moved to more urgent. Conclusion. We adjusted the triage codes for the revision by linking the call data with the case data. This revision should decrease the inappropriate use of ambulances and reduce the primary care workload. To achieve a more accurate revision, we need to refine the process of evaluating the validity of patients’ acuity over the telephone during triage.
46
M Wildan Firdaus, Neneng Nurhasanah, and Siska Lis Sulistiani. "Analisis Hukum Islam dan UU Wakaf No. 41 Tahun 2004 terhadap Pengalihan Aset Wakaf di PC Persis Pangalengan." Jurnal Riset Hukum Keluarga Islam 1, no. 1 (July 5, 2021): 11–15. http://dx.doi.org/10.29313/jrhki.v1i1.83.
Full textAbstract:
Abstract. Waqf is a legal act of wakif to give up part of his property to be used forever or for a certain period of time. PC Persis Pangalengan District is a religious organization and has an organizational management structure that deals specifically with waqf issues. At PC Persis Pangalengan Subdistrict, the waqf pledge pledged Rp. 65,000,000 in cash waqf funds for the purchase of an ambulance, but because PC Persis Pangalengan received a grant of 1 ambulance from PD Persis Bandung Regency, the allocation of waqf funds was diverted to clinic renovation. The purpose of this study was to determine the transfer of waqf assets in the Pangalengan Islamic Union PC according to Islamic Law and Law no. 41 of 2004 concerning Waqf. This research method uses a qualitative approach. Data collection was done by means of literature study and interviews. It can be concluded that according to Islamic law it states that the majority allow the transfer of waqf assets with a note that it is intended for the general benefit. And according to Law No.41 of 2004 it is permissible because there are more articles that allow the transfer of waqf assets than articles that do not allow the transfer of waqf assets. According to Islamic law, the transfer of waqf assets is permitted with the aim of the usefulness of the object or waqf objects being sustainable even though they are exchanged, sold or converted, as long as they are based on the general benefit. As for according to Law no. 41 of 2004 concerning waqf the transfer of waqf assets is permitted provided that nadzir reports it to BWI.
Abstrak. Wakaf adalah perbuatan hukum wakif untuk menyerahkan sebagian harta benda miliknya untuk dimanfaatkan selamanya atau untuk jangka waktu tertentu. PC Persis Kecamatan Pangalengan merupakan sebuah organisasi keagamaan dan memiliki struktur kepengurusan organisasi yang khusus menangani masalah perwakafan. Di PC Persis Kecamatan Pangalengan,pada ikrar wakaf pihak wakif mengikrarkan dana wakaf uang senilai Rp.65.000.000 untuk pembelian mobil ambulance,namun dikarenakan PC Persis Pangalengan mendapatkan hibah 1 buah mobil ambulance dari PD Persis Kabupaten Bandung,maka alokasi dana wakaf tersebut dialihkan untuk renovasi klinik. Tujuan penelitian ini adalah untuk mengetahui pengalihan aset wakaf di PC Persatuan Islam Pangalengan menurut Hukum Islam dan UU No. 41 Tahun 2004 Tentang Wakaf.Metode Penelitian ini menggunakan pendekatan kualitatif. Pengumpulan data dilakukan dengan cara Studi Kepustakaan, dan Wawancara. Dapat disimpulkan menurut hukum Islam menyatakan bahwa mayoritas membolehkan pengalihan aset wakaf dengan catatan bertujuan untuk kemaslahatan umum.Dan menurut Undang-Undang No.41 Tahun 2004 itu dibolehkan karena lebih banyak Pasal yang membolehkan pengalihan aset wakaf dari pada Pasal yang tidak memperbolehkan pengalihan aset wakaf. Menurut hukum Islam pengalihan aset wakaf diperbolehkan dengan tujuan nilai kemanfaatan dari objek atau benda wakaf tersebut dapat berkesinambungan meskipun dengan cara ditukar, dijual atau dialih-fungsikan, selama didasarkan pada kemaslahatan umum. Adapun menurut UU No. 41 Tahun 2004 tentang wakaf pengalihan aset wakaf itu diperbolehkan dengan catatan nadzir melaporkan kepada pihak BWI.
47
Wong, Joseph Zhi Wen, Helen M. Dewey, Bruce C. V. Campbell, Peter J. Mitchell, Mark Parsons, Thanh Phan, Ronil V. Chandra, et al. "Door-in-door-out times for patients with large vessel occlusion ischaemic stroke being transferred for endovascular thrombectomy: a Victorian state-wide study." BMJ Neurology Open 5, no. 1 (January 2023): e000376. http://dx.doi.org/10.1136/bmjno-2022-000376.
Full textAbstract:
BackgroundTime to reperfusion is an important predictor of outcome in ischaemic stroke from large vessel occlusion (LVO). For patients requiring endovascular thrombectomy (EVT), the transfer times from peripheral hospitals in metropolitan and regional Victoria, Australia to comprehensive stroke centres (CSCs) have not been studied.AimsTo determine transfer and journey times for patients with LVO stroke being transferred for consideration of EVT.MethodsAll patients transferred for consideration of EVT to three Victorian CSCs from January 2017 to December 2018 were included. Travel times were obtained from records matched to Ambulance Victoria and the referring centre via Victorian Stroke Telemedicine or hospital medical records. Metrics of interest included door-in-door-out time (DIDO), inbound journey time and outbound journey time.ResultsData for 455 transferred patients were obtained, of which 395 (86.8%) underwent EVT. The median DIDO was 107 min (IQR 84–145) for metropolitan sites and 132 min (IQR 108–167) for regional sites. At metropolitan referring hospitals, faster DIDO was associated with use of the same ambulance crew to transport between hospitals (75 (63–90) vs 124 (99–156) min, p<0.001) and the administration of thrombolysis prior to transfer (101 (79–133) vs 115 (91–155) min, p<0.001). At regional centres, DIDO was consistently longer when patients were transported by air (160 (127–195) vs 116 (100–144) min, p<0.001). The overall door-to-door time by air was shorter than by road for sites located more than 250 km away from the CSC.ConclusionTransfer times differ significantly for regional and metropolitan patients. A state-wide database to prospectively collect data on all interhospital transfers for EVT would be helpful for future study of optimal transport mode at regional sites and benchmarking of DIDO across the state.
48
Lund, Adam, and Sheila A. Turris. "Mass-gathering Medicine: Risks and Patient Presentations at a 2-Day Electronic Dance Music Event." Prehospital and Disaster Medicine 30, no. 3 (April 14, 2015): 271–78. http://dx.doi.org/10.1017/s1049023x15004598.
Full textAbstract:
AbstractIntroductionMusic festivals, including electronic dance music events (EDMEs), increasingly are common in Canada and internationally. Part of a US $4.5 billion industry annually, the target audience is youth and young adults aged 15-25 years. Little is known about the impact of these events on local emergency departments (EDs).MethodsDrawing on prospective data over a 2-day EDME, the authors of this study employed mixed methods to describe the case mix and prospectively compared patient presentation rate (PPR) and ambulance transfer rate (ATR) between a first aid (FA) only and a higher level of care (HLC) model.ResultsThere were 20,301 ticketed attendees. Seventy patient encounters were recorded over two days. The average age was 19.1 years. Roughly 69% were female (n=48/70). Forty-six percent of those seen in the main medical area were under the age of 19 years (n=32/70). The average length of stay in the main medical area was 70.8 minutes. The overall PPR was 4.09 per 1,000 attendees. The ATR with FA only would have been 1.98; ATR with HLC model was 0.52. The presence of an on-site HLC team had a significant positive effect on avoiding ambulance transfers.DiscussionTwenty-nine ambulance transfers and ED visits were avoided by the presence of an on-site HLC medical team. Reduction of impact to the public health care system was substantial.ConclusionsElectronic dance music events have predictable risks and patient presentations, and appropriate on-site health care resources may reduce significantly the impact on the prehospital and emergency health resources in the host community.LundA, TurrisSA. Mass-gathering medicine: risks and patient presentations at a 2-day electronic dance music event. Prehosp Disaster Med. 2015;30(3):18
49
Swaminathan, Prakash, Kshitija Singh, Angel Rajan Singh, and Devender Kumar Sharma. "Establishing an ambulance dispatch system for intrahospital transfers in a large teaching hospital in India." Journal of Hospital Administration 10, no. 5 (October 19, 2021): 11. http://dx.doi.org/10.5430/jha.v10n5p11.
Full textAbstract:
During the Covid Pandemic, a lot of structural and process changes had to be made in a quick time in almost all the hospitals to accommodate the patients and admit them with the least exposure to the Hospital Staff and the bystanders of the patients. AIIMS Hospital in New Delhi India is a premier tertiary care teaching hospital, which is spread out in different areas. Two Hospital centers of AIIMS were designated as COVID Hospitals. Since there was no previous experience of intrahospital transfers of this magnitude, the hospital had to face lots of difficulties in such transfers and this translated into increased turnaround time. This paper concentrates on the mechanisms in which the Department of Hospital Administration found out the various issues plaguing this process. Later by Change Management, an Intervention was brought in, which helped in the framing of a standard operating procedure that helped in the easy transfer of the patients which was hassle-free and which continued to the second wave of the COVID pandemic.
50
Turris, Sheila A., Christopher W. Callaghan, Haddon Rabb, Matthew Brendan Munn, and Adam Lund. "On the Way Out: An Analysis of Patient Transfers from Four Large-Scale North American Music Festivals Over Two Years." Prehospital and Disaster Medicine 34, no. 1 (December 27, 2018): 72–81. http://dx.doi.org/10.1017/s1049023x18001188.
Full textAbstract:
AbstractIntroductionMusic festivals are globally attended events that bring together performers and fans for a defined period of time. These festivals often have on-site medical care to help reduce the impact on local health care systems. Historically, the literature suggests that patient transfers off-site are frequently related to complications of substance use. However, there is a gap in understanding why patients are transferred to hospital when an on-site medical team, capable of providing first aid services blended with a higher level of care (HLC) team, is present.ObjectiveThe purpose of this study is to better understand patterns of injuries and illnesses that necessitate transfer when physician-led HLC teams are accessible on-site.MethodsThis is a prospective, descriptive case series analyzing patient encounter documentation from four large-scale, North American, multi-day music festivals.Results/DiscussionOn-site medical teams that included HLC team members were present for the duration of each festival, so every team was able to “treat and release” when clinically appropriate. Over the course of the combined 34 event days, there were 10,406 patient encounters resulting in 156 individuals being transferred off-site for assessment, diagnostic testing, and/or treatment. A minority of patients seen were transferred off-site (1.5%). The patient presentation rate (PPR) was 16.5/1,000. The ambulance transfer rate (ATR) was 0.12/1,000 attendees, whereas the total transfer-to-hospital rate (TTHR), when factoring in non-ambulance transport, was 0.25/1,000. In contrast to existing literature on transfers from music festivals, the most common reason for transfer off-site was for musculo-skeletal (MSK) injuries (53.8%) that required imaging.ConclusionThe presence of on-site HLC teams impacted the case mix of patients transferred to hospital, and may reduce the number of transfers for intoxication. Confounding preconceptions, patients in the present study were transferred largely for injuries that required specialized imaging and testing that could not be performed in an out-of-hospital setting. These results suggest that a better understanding of the specific effects on-site HLC teams have on avoiding off-site transfers will aid in improving planning for music festivals. The findings also identify areas for further improvement in on-site care, such as integrated on-site radiology, which could potentially further reduce the impact of music festivals on local health services. The role of non-emergency transport vehicles (NETVs) deserves further attention.TurrisSA, CallaghanCW, RabbH, MunnMB, LundA. On the way out: an analysis of patient transfers from four large-scale North American music festivals over two yearsPrehosp Disaster Med. 2019;34(1):72–81.