Thèses : « Emergency Medical Services (EMS) »

1

Carlson, Greg P. « Hostile workplace violence directed toward rural emergency medical services (EMS) personnel / ». Menomonie, WI : University of Wisconsin--Stout, 2007. http://www.uwstout.edu/lib/thesis/2007/2007carlsong.pdf.

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Thor, Danielle Claire. « Ethics in Emergency Medical Services : A Contextual Analysis ». Master's thesis, Temple University Libraries, 2019. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/592304.

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Urban Bioethics
M.A.
The modern concept of Emergency Medical Services (EMS) has grown from its humble volunteerism origins to a multidisciplinary enterprise, outstretched into the realms of both healthcare and public service. As the American EMS community continues to assume greater responsibilities and further develop its professional standards, the moral foundations of this field open themselves to more thorough scrutiny. Upon examination, the major deficit in the ethical structuring of EMS becomes glaringly obvious: it exists as a piecemeal collection of its medical and militaristic counterparts unified by theoretical generalizations that avoid its inherently unique structure. If EMS wishes to matriculate into complete professionalism, or even continue its assumption of critical responsibilities surrounding the health and safety of others, then it must also develop and maintain its own individual ethical framework from which it operates. In doing so, an urban bioethical approach rooted in context-driven analysis and pragmatic solutions may provide the best guidance and protections for all those who interact with the EMS system while respecting the values of this distinctively prideful service.
Temple University--Theses

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George, Taylor A., et Taylor A. George. « 2016 Arizona Statewide Emergency Medical Services Needs Assessment (ASENA) ». Diss., The University of Arizona, 2017. http://hdl.handle.net/10150/626310.

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Emergency Medical Services (EMS) is an institution and product of public health, health care, and public safety that is chopped and scattered across multiple jurisdictional deployment methodologies throughout Arizona. To fully-asses the EMS needs of the state, those jurisdictions are considered as a whole; for it is the whole that makes a system, and a system is what truly impacts patient outcomes. Evaluating the ""whole"" is the genesis and driver of the 2016 Arizona Statewide EMS Needs Assessment (ASENA). The primary objective of ASENA is to establish a current ""snap-shot"" of EMS in the state while simultaneously identifying needs and/or areas that can be targeted for further analysis and/or improvement as part of Population Health Management and Emergency Medical Services Integration under the AZ Flex Grant funded by the U.S. Health Resources and Services Administration (HRSA). In addition, the secondary objective of ASENA is to compare and contrast this current ""snap-shot"" with data obtained in a more narrow needs assessment conducted in 2001, allowing comparison of changes in Arizona's critical access EMS system over 15 years. To accomplish this, a 105-question needs assessment survey tool was developed and distributed to EMS agencies throughout the state. The fully-vetted survey tool collected information pertaining to sixteen core functional sections. Eighty-six agencies fully-completed the needs assessment survey tool, with respondents evenly distributed across the state's four EMS coordinating regions and representative of the various service-delivery methodologies. The combined service areas of the respondents cover over 85% of the state's population. Arizona's statewide EMS system is well organized and positioned to deliver advanced levels of prehospital care for the vast majority of its citizens and visitors, with some variation between urban and rural regions. Key needs identified relate to: patient care reporting between EMS providers, emergency departments and receiving hospitals; quality assurance activities; education and skills training programs; dispatch system capabilities; mass casualty and public health preparedness; equipment and supplies; and more robust use of data and analyses to inform continuous EMS system improvement.

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Sullivan, Kendra. « Simulating rural Emergency Medical Services during mass casualty disasters ». Thesis, Manhattan, Kan. : Kansas State University, 2008. http://hdl.handle.net/2097/779.

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Price, Devin Todd. « Emergency Medical Services First Responder Certification Level's Impact on Ambulance Scene Times ». ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5933.

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The foundation of modern-day emergency medical service (EMS) systems began in 1966, based on hospital medical care. Demand for evidence to support prehospital practices that have been in existence for the past half-century has continued to grow; yet, researchers have not adequately explored the relationship between the medical certification level of emergency first responders and the amount of time an ambulance spends on the scene. The purpose of this quantitative study was to examine and compare ambulance scene times for emergency responses when basic life support (BLS) certified first responders or advanced life support (ALS) first responders are first on the scene, and whether the level of first responder training reduces the time spent on the scene by a paramedic ambulance. A final research question dealt with whether there is a relationship between how long the first responder is on the scene and the amount of time an ambulance spends at the scene of an emergency. The publicly available archival data used for the study were from a community that had BLS and ALS first responders. Data analysis involved t-tests of the hypotheses for the first 2 research questions and a linear regression analysis of the hypotheses for the third research question. The findings showed that there is a clear difference in ambulance scene times based on the certification level of the first responders. Advanced life support first responders significantly reduced the scene time of ambulances when they arrived at the scene prior to the ambulance. Positive social change could result from this study if understanding the impact that ALS first responders have on ambulance scene times leads EMS planning managers to deploy resources more strategically, thus improving the efficiency of the public safety system and saving lives.

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Baldridge, Kenan Stone. « Emergency Medical Services in the Rochester Region of New York State : Organization, Services and Systems ». University of Akron / OhioLINK, 2007. http://rave.ohiolink.edu/etdc/view?acc_num=akron1177640876.

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Mims, Leeanna. « Improving Emergency Medical Services (EMS) in the United States through improved and centralized federal coordination ». Thesis, Monterey, California. Naval Postgraduate School, 2011. http://hdl.handle.net/10945/5785.

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CHDS State/Local
Approved for public release; distribution is unlimited
Emergency Medical Services (EMS) is an important discipline in the arena of first responders. Unlike other first response disciplines, EMS does not have strong representation at the federal level. This thesis argues that representation is necessary and identifies the federal agency in which it should reside. Current federal agencies that have a role in EMS are evaluated. These agencies include the National Highway Traffic Safety Administration (NHTSA), the Departments of Homeland Security (DHS) and Health and Human Services. These agencies are evaluated to determine where the federal oversight for EMS should be placed. Existing overlaps are shown. EMS strategy needs are conveyed by examining the components of interest-based strategy and identifying EMS as a megacommunity. The application of megacommunity components identifies what needs to be eliminated and reduced combined with what issues need to be raised and how this will create a stronger network for EMS support for both everyday needs and in times of national disaster. The recommendation is made that the federal oversight of EMS be a newly created office of United States EMS Administration (USEMSA) within the Health and Human Services. The recommendation includes what should be considered in forming the USEMSA.

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Saini, Devashish. « Development and testing of feed a feedback expert system for EMS documentation / ». Thesis, Birmingham, Ala. : University of Alabama at Birmingham, 2007. http://www.mhsl.uab.edu/dt/2007m/saini.pdf.

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Kling, Michael Patrick. « Needs Assessment for Mental Health Support Towards Emergency Medical Service (EMS) Personnel ». Thesis, Regent University, 2021. http://pqdtopen.proquest.com/#viewpdf?dispub=27961789.

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Understanding and assessing the needs of Emergency Medical Service (EMS) personnel and other first responders is crucial for providing these individuals with the resources needed within their community. The literature discusses how EMS personnel are at risk for psychological impairment due to routine exposure to traumatic events and occupational stressors within EMS organizations. Additionally, the research has supported the importance of positive coping abilities, organizational belongingness, and social support within the lives of EMS personnel to enable them to resiliently handle the occupational stress of their job. This study investigated the occupational needs of EMS providers to determine if they are receiving resources within their organization to cope with occupational stressors. Participants for this study comprised (n=153) paramedics and fire-fighters from the Tidewater EMS Council organization. A needs assessment was conducted to explore correlations between quality of life, resiliency, years of service, level of education, burnout, secondary traumatic stress, interpersonal support, positive and negative religious coping, and the occupational needs of EMS personnel. The results revealed that burnout (r=4.27**) and secondary traumatic stress (r.215*) were important factors for determining occupational turnover among EMS personnel. Furthermore, EMS providers reported occupational needs such as easier access to mental health, improved staff relations, adequate staffing, and improved shift hours are needed within their organization. Future research should explore differences in occupational needs with EMS providers among EMS organizations in metropolitan and rural communities. Keywords: Emergency Medical Services (EMS), Burnout, Occupational Stress, Traumatic Critical Incidents

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Woods, Ginger Lee. « Post Traumatic Stress Symptoms and Critical Incident Stress Debriefing (CISD) in Emergency Medical Services (EMS) Personnel ». Digital Commons @ East Tennessee State University, 2007. https://dc.etsu.edu/etd/2035.

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EMS personnel were examined for Post Traumatic Stress symptoms and the usefulness of Critical Incident Stress Debriefing (CISD) using the Los Angeles Symptom Checklist (LASC) and a demographics questionnaire. This study revealed that women in this group show higher PTSD symptoms than male coworkers. Level of Training (LOT) of the EMS provider did not demonstrate a significant difference in whether a provider developed PTSD. EMS personnel receiving debriefing actually suffered greater levels of PTSD than those that did not receive debriefing. And 16% of EMS providers in this study suffered from PTSD, while approximately 20% suffered from partial PTSD or PTSS. The results suggest that there are high levels of PTSD within the EMS community, especially in women. This study also suggests that CISD does not help with PTSD symptoms and may actually worsen them.

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Muza, Matej. « Development of a Spatial Decision Support System for Emergency Medical Service Facility Siting ». Thesis, Virginia Tech, 2011. http://hdl.handle.net/10919/42583.

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Improved strategic location of an Emergency Medical Service (EMS) facility can significantly increase EMS efficiency. Urban planners need to consider a location that satisfies multiple criteria in order to make an informed decision about a future EMS facility site. Apart from basic criteria such as parcel value and size, decision-makers need to consider area and population coverage from potential parcels. Geographic Information Systems (GIS) provide an adequate analysis environment for EMS facility siting as many considered criteria are of a spatial nature. However, urban planners making decisions about an EMS facility site often lack the necessary expertise to make full use of challenging GIS tools. In order to help urban planners in the analysis process, this research developed a Spatial Decision Support System (SDSS) for EMS facility siting. The system was developed in ESRI ArcGIS (9.3) using the Visual Basic for Applications (VBA) programming environment. The objective of the system was to integrate spatial data, analysis, and visualization in a single system to help users evaluate a facility siting problem. The systemâ s performance was tested using data for the Town of Blacksburg, VA. In addition, the system was evaluated by local planners and GIS staff with experience in EMS facility siting. Planners agreed the system enables more comprehensive and straightforward use of GIS for EMS facility siting analysis than other available siting tools. Potential improvements include a simpler user interface, synthesis of geoprocessing techniques, reduction of analysis time through automation, and better decision-making by improved visualization of results.
Master of Science

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Drury, Caroline. « The Function of Internet Memes in Helping EMS Providers Cope with Stress and Burnout ». Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/honors/499.

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EMS personnel tend to face higher burnout rates than those in similar professions, which makes them more likely to make mistakes, engage in safety-compromising behaviors, and get injured. This project examines humor used in the form of Internet memes as a coping mechanism. Internet memes are modifiable, replicable units of cultural transmission that are passed and gain influence through the Internet. I applied the Maslach Burnout Inventory to EMS related memes on the website Reddit. I found that memes that dealt with burnout typically referenced non-traumatic factors as being the source of burnout, and that these memes would often lead to conversations that allowed EMS personnel to share their experiences with one another. I concluded that internet memes can provide a way for EMS personnel to express their feelings anonymously and through a façade of humor, and can also let other people who may be going through similar experiences know that they are not alone.

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Fossum, Benjamin, et Johan Hedborg. « Resource management analysis at the prehospital emergency care unit in north-western Skåne ». Thesis, Linköpings universitet, Kommunikations- och transportsystem, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-130004.

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The purpose of this study is to investigate the preparedness at the prehospital emergency care unit in north-western Skåne. Measuring preparedness is important to ensure that the ability to respond on emergency calls is satisfactory. To do this for north-western Skåne historical data from 2015 was extracted from SOS Alarms database. It was used to calculate preparedness using workload and coverage as measurements. The workload was calculated by taking the busy periods and comparing them to the ambulances working times. The coverage was calculated by defining neighbouring stations to cover for each station and then finding the amount of hours when there was no ambulance at either station. These calculations show that two of the six stations in north-western Skåne are in need of improvement. To increase the preparedness to a good level resources will have to be added at the liable stations. These resources would be new ambulances. There is a possibility to relocate ambulances from stations within the district but that would lead to a worsened preparedness for the stations which these ambulances belonged to in the first place.

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Alsalloum, Othman Ibraheem. « Locating and allocating emergency medical services : a goal-programming model applied to the EMS system at Riyadh City, Saudi Arabia ». Thesis, Lancaster University, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.246141.

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Bonilla, Erich Jimenez. « We Are Constantly Expected To Disregard Ourselves And Our Personal Needs : Addressing The Daily Stressors Of Private Emergency Medical Services ». CSUSB ScholarWorks, 2019. https://scholarworks.lib.csusb.edu/etd/910.

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ABSTRACT Background Private Emergency Medical Services serve a vital role in the community, as such they are subject to job related stress. Currently, there is a limited amount of research related to the stressors related to the job. Objective The purpose of this study was to define the type of daily stressors faced by Private EMS personnel and investigate how they impact their Sense of Coherence. Study Design A mixed methods approach was used in this study to obtain the necessary data. Semi-structured one-on-one interviews were conducted with current employees of an EMS agency that provides 911 service in their area. After the interviews, the participants were administered a survey. Participants/setting Current EMS employees were invited to participate in an interview, in a location and time of their choosing. Both Paramedics and Emergency Medical Technicians (EMT) were invited to participate. Results Critical call incidents, while impacting the mental health of EMS provides, it does not impact them with the same magnitude of operational stress. Operational stress originates from the daily task, interactions and availability of resources. Operational stress was demonstrated to have a large impact on Sense of Coherence. Conclusion Operational stress can have a larger impact on Sense of Coherence of EMS personnel. Research is needed to determine which EMS model helps mitigate the impacts of operational stress on the EMS personnel.

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Boldt, Faith Joy. « The Relationship between Personal Factors, Work Factors, PTSD, and Suicide Ideation in Emergency Medical Service Providers ». TopSCHOLAR®, 2016. http://digitalcommons.wku.edu/theses/1625.

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EMS providers work in a high-stress environment and are routinely exposed to critical incidents. Many providers are left to deal with the chronic stress on their own, either because of lack of effective employer-based programs or a culture that discourages its use. The extent to which these factors -- as well as personal characteristics such as resilience, PTG, and coping skills -- influence PTSD and suicide ideation among EMS providers has not been well studied among EMS providers. An online survey was administered to a convenience sample of EMS providers. Of the 2,683 respondents, more than one quarter (27.7%) met the PTSD criteria of 50 or higher on the PCL-M. Close to half of the respondents (42.0%) reported having contemplated suicide in the last six months. Of those who had contemplated suicide in the last 30 days, nearly one third (27.1%) thought about suicide 10 or more days in the last 30 days. EMS culture and resilience were negatively associated with PTSD, while positive associations were found with some coping styles. PTSD scores and suicide ideation frequency were highest when post-incident services were not available in the workplace. No significant relationships were found between personal factors and suicide ideation.

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Heyns, Tanya. « Core competencies of the A&E (accident and emergency) nurse in life-threatening situations in the emergency care environment in South Africa ». Diss., University of Pretoria, 2003. http://hdl.handle.net/2263/28216.

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Pan, Yuhan. « Examining Opioid-related Overdose Events in Dayton, OH using Police, Emergency Medical Services and Coroner’s Data ». The Ohio State University, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=osu1586441323153728.

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Knoops, Lorinde, et Tilda Lundgren. « Modeling ambulance dispatching rules for EMS-systems ». Thesis, KTH, Optimeringslära och systemteori, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-189023.

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This thesis presents a study on efficient dispatching rules in ambulance dispatching. By efficient dispatching rules, we mean such dispatching rules that lower response times for priority 1 calls while keeping response times for priority 2 calls at an adequate level. A Markov process and a simulation model were developed in order to evaluate the performance of several existing and newly designed dispatching rules. On four different response areas, five different dispatching rules were tested and their performances were compared. Particular focus was put upon the dispatch rule currently used by the Swedish emergency service provider SOS Alarm; the Closest rule. Our findings indicate that the four priority-based dispatching rules all outperform the Closest rule in decreasing the mean response time for calls of priority degree 1. Furthermore, implementing restrictions on the travel time for priority 2 calls was proven an efficient way to control the trade-off between the mean response time of priority 1 and 2 calls. The conclusion was drawn that the possibilities for more efficient ambulance dispatching are many and that SOS Alarm should consider implementing priority-based dispatching rules, alike the ones presented in this thesis, in their dispatching process. A study of the ambulance operator and controller profession, and the operator’s and controller’s interplay with the decision support system used by SOS Alarm in the ambulance dispatching process, was conducted in parallel. The properties of the interaction dynamics between operator and automation and the dangers linked to it were mapped out, described and analyzed.
Denna kandidatexamensuppsats behandlar effektiva dirigeringsstrategier inom ambulansdirigering. Effektiva dirigeringsstrategier åsyftar dirigeringsstrategier som lyckas sänka svarstiden för inkommande prioritet 1-samtal, samtidigt som svarstiden för prioritet 2-samtal hålls på en tillfredsställande nivå. I syfte att utvärdera olika dirigeringsstrategier utvecklades både en Markovsk modell och en simuleringsmodell. På fyra olika geografiska områden testades och jämfördes. Fem olika dirigeringsstrategier, varav två existerande och tre nyutvecklade. Särskilt fokus riktades mot Closest rule, vilket är den dirigeringsstrategi som används i SOS Alarms verksamhet idag. Från resultaten kunde utläsas att de prioritets-baserade dirigeringsstrategierna resulterade i en lägre genomsnittlig svarstid för prioritet 1-fall än Closest rule. Dessutom konstaterades det att en begränsning av svarstiderna för prioritet 2-samtal var ett effektivt sätt att kontrollera balansen mellan de genomsnittliga svarstiderna för samtal av prioritet 1, respektive 2. Slutsatsen drogs att möjligheterna för att utveckla nya effektiva dirigeringsstrategier är många och att SOS Alarm bör överväga att implementera prioritetsbaserade dirigeringsstrategier likt dem som presenterats i denna uppsats. Parallellt studerades ambulansoperatörens och -dirigentens yrkeskunnande, samt operatörens och dirigentens samspel med det beslutsstödssystem som används i SOS Alarms dirigeringsverksamhet. Interaktionen mellan operatör och automatisering samt de relaterade riskerna kartlades, beskrevs och analyserades.

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Xu, Yilun. « The Efficacy of a Lifting Strap as an Ergonomic Intervention for EMS Providers : Does it make it easier to raise a Patient from Supine Lying Posture to Upright Sitting Posture ? » The Ohio State University, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=osu1566175038221903.

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Wrentz-Hudson, Debra Ann. « Emergency Medical Service Worker Knowledge of and Compliance with Occupational Exposures to Infectious Diseases ». ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1953.

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Firefighter Emergency Medical Service (EMS) responder personnel are at a high risk for occupational exposures to bloodborne and airborne infectious pathogens due to their unpredictable work duties in the pre-hospital environment. Not much is known about the compliance with Universal Precautions (UP) among firefighter EMS responders' personnel with regards to occupational exposures to infectious diseases. The purpose of this cross-sectional research study was to determine the relationship between compliance with UP, knowledge of UP, attitudes towards UP, occupational practices, and occupational exposures to bloodborne and airborne pathogens to prevent transmission of infectious disease among firefighter EMS responder personnel in the pre-hospital environment. A convenience sample (n = 246, 99% response) was gathered from the 6 career fire service departments in Miami-Dade County Florida. The participants completed a 40-question, self-administered survey questionnaire. Research questions and related hypotheses were evaluated with Pearson's product moment correlation, t test, analysis of variance, and linear regression models. In this study, the correlation between knowledge and compliance with UP was statistically significant (p = 0.005). This suggest that the compliance with UP among firefighter EMS responder participants increased with increase in knowledge. However, firefighter EMS personnel are not consistently complying with UP to prevent exposures to infectious diseases in the pre-hospital work environment. This research contributed to positive social change by increasing innovative knowledge that will allow the firefighter EMS responders to improve occupational practices and compliance with universal precautions.

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Johnson, Keith H. « Changing the paradigm : implementation of combined law enforcement, fire, and emergency medical service (EMS) cross-disciplinary response to hostile events ». Thesis, Monterey, California : Naval Postgraduate School, 2014. http://hdl.handle.net/10945/44587.

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Approved for public release; distribution is unlimited
Our nation relies on law enforcement, fire, and emergency medical services to protect citizens when confronted with emergent and hostile events. Mass shootings such as those that occurred at Columbine High School; Virginia Tech University; Mumbai, India; and Aurora Movie Theatre in Colorado require first responders to incorporate methods and tactics that integrate operations and challenge first responders to collaborate and operate in a unified manner. This research examines how public safety agencies can effectively implement a first responder cross-disciplinary plan to better coordinate police, fire, and EMS responses. This study begins with a historical review of past incidents that demonstrate the need for cross-disciplinary teams. Next, new policies that support the use of cross-disciplinary teams are examined. Central to this research was an empirical study of the enablers and barriers to cross-disciplinary teams during a full-scale active shooter exercise. Illustrative findings among the participants in the exercise include a moderately high level of confidence in the concept and use of cross-disciplinary teams, the ability of various disciplines to trust each other’s ability to work together, and the ability to communicate and share information. To establish and enhance the cross-disciplinary response, joint operational policies and procedures must be established.

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Smith, Leanne. « Modelling Emergency Medical Services ». Thesis, Cardiff University, 2013. http://orca.cf.ac.uk/47743/.

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Emergency Medical Services (EMS) play a pivotal role in any healthcare organisation. Response and turnaround time targets are always of great concern for the Welsh Ambulance NHS Trust (WAST). In particular, the more rural areas in South East Wales consistently perform poorly with respect to Government set response standards, whilst delayed transfer of care to Emergency Departments (EDs) is a problem publicised extensively in recent years. Many Trusts, including WAST, are additionally moving towards clinical outcome based performance measures, allowing an alternative system-evaluation approach to the traditional response threshold led strategies, resulting in a more patient centred system. Three main investigative parts form this thesis, culminating in a suite of operational and strategic decision support tools to aid EMS managers. Firstly, four novel allocation model methods are developed to provide vehicle allocations to existing stations whilst maximising patient survival. A detailed simulation model then evaluates clinical outcomes given a survival based (compared to response target based) allocation, determining also the impact of the fleet, its location and a variety of system changes of interest to WAST (through ‘what-if?’ style experimentation) on entire system performance. Additionally, a developed travel time matrix generator tool, enabling the calculation and/or prediction of journey times between all pairs of locations from route distances is utilised within the aforementioned models. The conclusions of the experimentation and investigative processes suggest system improvements can in fact come from better allocating vehicles across the region, by reducing turnaround times at hospital facilities and, in application to South East Wales, through alternative operational policies without the need to increase resources. As an example, a comparable degree of improvement in patient survival is witnessed for a simulation scenario where the fleet capacity is increased by 10% in contrast to a scenario in which ideal turnaround times (within the target) occur.

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Gleby, Fia. « Ambulance in Red Zones in Cape Town, South Africa : Waiting time for patients when ambulance requires armed escort ». Thesis, Högskolan i Borås, Akademin för vård, arbetsliv och välfärd, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-14723.

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Background. In South Africa violence related crimes are frequent, and interpersonal violence is one of the most common causes of injury and death. Violence can be related to social structures, poverty and income inequality. In South Africa 25% of the population live in extreme poverty, and 16% of households in Western Cape live in Informal dwellings. Drug and alcohol miss-use is a big problem. EMS personnel all over the world are exposed to violence. The last couple of years the rate of incidents of violence against the ambulances and EMS personnel in Western Cape and Cape Town has escalated, and a protocol to protect the personnel has been established. The protocol of Red Zones requires an armed escort for the ambulance and EMS personnel when working in certain areas. The red zones are often in low income areas, which makes United Nations’ Sustainable Development Goal of Reduced inequality relevant. The Purpose of this study is to describe how red zones affect patient waiting times and mission times for the ambulance in the Western Cape province of South Africa. Method. Quantitative analysis of priority 1 assignments in one month periods in 2016, 2017 and 2018 to Hanover Park, a suburb of Cape Town. Hanover Park has been considered a red zone since September 2016. Result. Seven different time periods in the missions were analyzed, comparing the City of Cape Town and Hanover park in 2016, 2017 and 2018. Conclusion. The result shows an increase in waiting times for EMS in Hanover Park, even though the precise response time could not be described. Call times and mission times for the entire City of Cape Town seem to have increased, indicating a problem beyond the red zones, potentially affecting everyone in need of an ambulance in the city. Further studies are encouraged.
Bakgrund. I Sydafrika är våldsrelaterade brott vanligt förekommande, och interpersonellt våld är en av de vanligaste orsakerna till skada och död. Våldet kan relateras till sociala strukturer, fattigdom och inkomstskillnad. I Sydafrika lever 25% av befolkningen i extrem fattigdom och 16% av hushållen i Western Cape lever i informella bostäder. Missbruk av droger och alkohol är ett stort problem. Ambulanspersonal över hela världen utsätts för våld. De senaste åren har graden av våldshändelser mot ambulanser och dess personal i Western Cape och Kapstaden eskalerats och ett protokoll för att skydda personalen etablerats. Protokollet för Röda Zoner kräver en beväpnad eskort för ambulans och personal vid arbete i vissa områden. De röda zonerna är ofta i låginkomstområden, vilket gör FN: s hållbara utvecklingsmål för minskad ojämlikhet relevant. Syftet med denna studie är att beskriva hur röda zoner påverkar patienters väntetid och uppdragstider för ambulansen i Western Cape i Sydafrika. Metod. Kvantitativ analys av prio 1-uppdrag under en månadsperiod i 2016, 2017 och 2018 till Hanover Park, en förort till Kapstaden. Hanover Park har ansetts vara en röd zon sedan september 2016. Resultat. Sju olika tidsperioder i uppdragen analyserades, och jämfördes mellan hela Kapstaden och Hanover Park 2016, 2017 och 2018. Slutsats. Resultatet visar ökad väntetid för ambulansvård i Hanover Park, även om den exakta framkörningstiden inte kunde beskrivas. Uppdragstider för hela staden Cape Town verkar ha ökat, vilket indikerar ett problem bortom de röda zonerna, vilket potentiellt kan påverka alla som behöver en ambulans i staden. Ytterligare studier rekommenderas.

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Baldridge, Kenan S. « Emergency medical services in the Rochester region of New York state organization, services and systems / ». Akron, OH : University of Akron, 2007. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=akron1177640876.

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Thesis (Ph. D.)--University of Akron, Dept. of Public Affairs and Urban Studies, 2007.
"May, 2007." Title from electronic dissertation title page (viewed 05/06/2008). Advisor, Raymond Cox, III; Committee members, Ralph Hummel, Nancy Grant, Lawrence Keller, Dena Hanley; Department Chair, Sonia Alemagno; Dean of the College, Ronald F. Levant; Dean of the Graduate School, George R. Newkome. Includes bibliographical references.

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Anderson, Mindi S. « Integrating Emergency Medical Services Into the Patient-Centered Medical Home ». Thesis, Capella University, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10288192.

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Abstract Emergency medical services (EMS) for nonemergent or low-acuity calls is a new normal. EMS agencies spend a majority of time providing primary care services through the 911 system. They are utilized currently to fill the primary care gap subconsciously. The EMS system is activated as a patient navigator for primary care services. EMS agencies in the state where the research occurred have responded to the gap in care management by creating innovative programs such as community health emergency medical services (CHEMS). Creation of CHEMS programs have become one of the most monumental concepts for change in the field on both a state and national level. EMS has sought ways to meet the goals of the Triple Aim by exploring CHEMS as the state transitions to value-based care. Leaders are searching for innovative ways to close the gap in the primary health care system through a patient-centered medical home (PCMH) model. The action research study stimulated innovative thinking to support coordinated care across the evolving continuum of the health care system. The study captured the current awareness from community health care leaders who have had a recent opportunity to explore the idea of integrating EMS into the PCMH model through semi-structured interview sessions. Major findings in the thematical analysis discovered the current way both EMS and a PCMH function in a silo system that could potentially utilize each other to effectively provide managed care. Joint efforts could offset overutilization of EMS services for calls that have no apparent life threats. EMS would allow for a PCMH to conform to the Patient Protection and Affordable Care Act standards of care management, contributing to the integration of Triple Aim objectives. Collaboratively, EMS and an established PCMH will impact the delivery of preventative, quality and cost-efficient care. The theory of organizational culture change is based on three common characteristics: culture is shared, is intangible, and affects human behavior. The conceptual framework of the research study was based on the chronic care model. Patients with comorbidities potentially utilize the health care system more than a healthy patient to seek reassurance that their health is managed.

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Letzner, Josefine. « Analysis of Emergency Medical Transport Datasets using Machine Learning ». Thesis, KTH, Skolan för datavetenskap och kommunikation (CSC), 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-215162.

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The selection of hospital once an ambulance has picked up its patient is today decided by the ambulance staff. This report describes a supervised machinelearning approach for predicting hospital selection. This is a multi-classclassification problem. The performance of random forest, logistic regression and neural network were compared to each other and to a baseline, namely the one rule-algorithm. The algorithms were applied to real world data from SOS-alarm, the company that operate Sweden’s emergency call services. Performance was measured with accuracy and f1-score. Random Forest got the best result followed by neural network. Logistic regression exhibited slightly inferior results but still performed far better than the baseline. The results point toward machine learning being a suitable method for learning the problem of hospital selection.
Beslutet om till vilket sjukhus en ambulans ska köra patienten till bestäms idag av ambulanspersonalen. Den här rapporten beskriver användandet av övervakad maskininlärning för att förutsåga detta beslut. Resultaten från algoritmerna slumpmässig skog, logistisk regression och neurala nätvärk jämförs med varanda och mot ett basvärde. Basvärdet erhölls med algorithmen en-regel. Algoritmerna applicerades på verklig data från SOS-alarm, Sveriges operatör för larmsamtal. Resultaten mättes med noggrannhet och f1-poäng. Slumpmässigskog visade bäst resultat följt av neurala nätverk. Logistisk regression uppvisade något sämre resultat men var fortfarande betydligt bättre än basvärdet. Resultaten pekar mot att det är lämpligt att använda maskininlärning för att lära sig att ta beslut om val av sjukhus.

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Bryan, Cornelia. « Gender Pay Disparities Within the Emergency Medical Services ». Youngstown State University / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=ysu1299768239.

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Carrington, Jody L. « The nature and impact of emergency medical services work ». Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/MQ60218.pdf.

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Elliott, Ross W. « Measuring disaster preparedness of local emergency medical services agencies ». Thesis, Monterey, California. Naval Postgraduate School, 2010. http://hdl.handle.net/10945/5112.

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CHDS State/Local
Approved for public release; distribution is unlimited
Emergency Medical Services (EMS) plays a key role in disaster response. Yet, determining how much preparedness is enough to achieve an acceptable level of preparedness is challenging. After conducting an extensive literature review, it is evident no nationally accepted method exists to evaluate an EMS system's level of disaster preparedness systematically. Research was conducted to define the skills and equipment that local emergency medical services agencies (LEMSA) or a similar entity needs to perform strategic disaster response duties and identify performance indicators for measuring preparedness. Using an appreciative inquiry approach, surveys and interviews of EMS personnel from across the nation were conducted. Interview questions focused on the positive aspects of each response with an effort to understand what might be possible in future events. Research subjects had first-hand experience in managing the EMS response during a disaster. Multiple types and sizes of events were studied. A framework for defining minimum standards for adequate disaster preparedness for LEMSAs is constructed, including core EMS disaster response roles; essential competencies; skills needed to perform the core roles; and tools or equipment used for core roles. Training strategies for developing experience, competencies, and skills are identified, and metrics listed for measuring the level of preparedness.

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Studnek, Jonathan R. « Evaluation of Back Problems among Emergency Medical Services Professionals ». The Ohio State University, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=osu1225909761.

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Smith, Michael William. « Utilizing Control in Emergency Medical Services : Expertise in Paramedics ». The Ohio State University, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=osu1291139651.

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Crowe, Remle. « An Assessment of Burnout among Emergency Medical Services Professionals ». The Ohio State University, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=osu1531751856368551.

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Lin, Junwei, et 林俊伟. « Overcrowding in emergency departments in Hong Kong and interventions to improve emergency care ». Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193798.

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Background Emergency department (ED) overcrowding has become a worldwide problem over the past few years, which has been reported in USA, Canada, New Zealand and Australia. For the past two decades, ED overcrowding has also become a controversial issue in Hong Kong, due to high demand for emergency service and misuse of emergency services. In 2002, although there was a charge for emergency department visit which led to a markedly decrease (19.1%) of total attendance, but now the rising trend of ED overcrowding seems to resurface during past few years. This paper aims to review and synthesis causes of ED overcrowding and possible interventions so as to provide possible recommendations for emergency care in Hong Kong. Methods Literatures on ED overcrowding and potential interventions were searched from PubMed, Google Scholar and Google to locate all relevant articles in English up to May 2013. Through PubMed, ED was described using “Emergency Medicine [MeSH]” OR “emergency department” OR “emergency”, and overcrowding was described using “Crowding [MeSH]” OR “crowded” OR “overcrowding” OR “overcrowded” OR “congestion”, and interventions was described using “interventions” OR “solutions”. Besides, relevant emergency medicine literatures published from the Hong Kong Journal of Emergency Medicine were also reviewed. Results I identified and reviewed relevant articles and found that ED attendance has been steadily rising during the past decades in Hong Kong. Although the causes may be somewhat different between different countries, causes of ED overcrowding could be related to easy access to emergency services, barriers to primary care as well as specialist care, and the rising aging population which might be an important underlying cause. As the problem of ED overcrowding will have significant negative impact on patient outcomes, such as unnecessary death, two common interventions to the problem are increasing the resources and demand management. Apart from increasing resources within emergency departments to cater for the increasing demand, it is of highly significance to improve community and primary care for the needs of older people who will contribute a great proportion to ED overcrowding in the future. Conclusion Semi-urgent and non-urgent visits do account for a great proportion among the total attendance, so it is important triage these patients to alleviate the overcrowding. What’s more, pressure on EDs can be related to a significant increase in the number of elderly patients who may require more investigation or admissions, and need much longer time to manage. As a result, future health policies should focus more on the aging population to improve emergency care.
published_or_final_version
Public Health
Master
Master of Public Health

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Kemp, Malcolm. « Expanding the Role of Emergency Medical Services in Homeland Security ». Monterey California. Naval Postgraduate School, 2013. http://hdl.handle.net/10945/32845.

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CHDS State/Local
Emergency Medical Services (EMS) has an established nationwide workforce that has not participated in homeland security as a full partner. EMS is a profession in transition that is looking to establish its identity and expand in ways that enhance its overall mission. This thesis explores the role of EMS in response, recovery, acting as intelligence sensors, participation in fusion centers, and syndromic surveillance to see if there are practical applications and logical integrations that could provide value to homeland security. EMS has an opportunity to take advantage of new models and technologies to meet the needs of the citizens and to improve the outcomes of patients. EMS should consider what expanded roles in homeland security enhances the EMS profession, improves security at home, and meets current goals of EMS across the nation. Comparative analysis, application, evaluation, measurement, and vulnerability assessment provided several potential new roles for EMS in homeland security.

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Al-Mutairi, Daifallah. « Emergency medical services physicians in the SRCS : a case study ». Thesis, University of Essex, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.433543.

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Nagula, Prasad. « Redesigning the patient care delivery processes at an emergency department ». Diss., Online access via UMI:, 2006.

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Tan, Huiyi. « A study on prehospital emergency medical service system status in Guangzhou / ». View the Table of Contents & ; Abstract, 2007. http://sunzi.lib.hku.hk/hkuto/record/B38479886.

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Cimona-Malua, T. C. « “Waiting time of patients who present at Emergency department of Saint Rita’s hospital, Limpopo Province, South Africa.” ». Thesis, University of Limpopo (Medunsa Campus), 2010. http://hdl.handle.net/10386/539.

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Thesis (M. Med. (Family Medicine)) -- University of Limpopo (Medunsa Campus), 2010.
Title: Waiting time of patients who present at Saint Rita’s hospital Emergency Department (ED), Limpopo province, South Africa. Objective: To determine the waiting time for stable patients who present at Saint Rita’s hospital ED, to determine where the longest time is spent by patients in ED and to identify the area of inefficient patients flow. Methods: A descriptive cross-sectional study was conducted in the ED of Saint Rita’s Regional hospital in the province of Limpopo, South Africa. During a one week period, Monday to Friday in July 2010, a daily random sample of 30 patients was monitored. The time In and Out of each step in the process of care was recorded. Waiting time was defined as the time from arrival of the patient in the ED until the start of the consultation by the Medical Officer. Time elapsed was calculated for various steps in care. Demographic data, diagnosis and acuity based on the SATS were obtained from patient’s record. Data capturing was done in window excel and data analysis done using the statistical software SPSS 17. Results: The mean waiting time for stable patients was 252.3 minutes. The mean EDLOS was 360 minutes for stable patients. Result show that 80% of patient attending Saint Rita’s ED are non-urgent (SATS: Green) cases. There was fluctuation of waiting times from Monday to Friday; with Monday having the longest waiting time and Tuesday the shortest waiting time. The waiting time for unstable patients (SATS: Red or Orange) is Zero minute. Patients spent the longest time waiting for registration (60 minutes) and for triage (57 min waiting for vitals and 28 minutes waiting for history taking). Interestingly the extremity of age: the youngest and oldest had lowest waiting time in ED. Areas of inefficient patient flow were registration and triage. Conclusion: This study has determined the waiting time for stable patients attending Saint Rita’s Regional Hospital ED. It has shown that waiting time in ED fluctuates with the day of the week. It has also shown that waiting time in ED varies with age of the patient and volume of patients in ED. Registration and triage have been identified as areas of inefficiency patients flow and recommendations for improvement have been formulated. Sustainability of the performance requires regular follow up from the hospital management.

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Wong, Chi-pang, et 黃志鵬. « The impact of the establishment of emergency medicine ward at accident& ; emergency department on hospital admission ». Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B45174416.

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Holland, William Mark. « Fire/Emergency Medical Services and coping methods mitigating traumatic stress symptomatology / ». Lynchburg, Va. : Liberty University, 2008. http://digitalcommons.liberty.edu.

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Crowe, Remle P. « An Assessment of Burnout among Nationally-Certified Emergency Medical Services Professionals ». The Ohio State University, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=osu1452245440.

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Van, Huyssteen Nina. « A legal analysis of the emergency medical services in South Africa ». Diss., University of Pretoria, 2016. http://hdl.handle.net/2263/60108.

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The purpose of this dissertation is to analyse the Emergency Medical Services (EMS) in South Africa from a legal point of view. The researcher has practical experience in the EMS and this has given her insight as to how the EMS operates, the grey areas in this unique profession and how the EMS is regulated by the South African law. A brief background of the EMS is given as well as how the system operates now and what EMS providers deal with on a day-to-day basis. This provides a clear picture of how diverse and unpredictable the EMS profession truly is. How the law regulates the EMS is discussed and all the grey areas from a medico-legal point of view are pointed out and analysed. During this discussion, the researcher makes use of her practical experience to explain why certain situations EMS providers have to deal with on a regular basis are so complex and why the EMS is in need of a better regulatory framework. The grounds of justification in medical law are also discussed and applied to the pre-hospital environment. The researcher made use of the EMS of the United States of America (USA) and the EMS of Australia in the comparative section, analysed how their respective EMS systems operates and how it is regulated by the law. This is ultimately compared to the EMS of South Africa and recommendations were made as to how the regulation of the EMS system, as a whole, can improve in the future.
Dissertation (LLM)--University of Pretoria, 2016.
Public Law
LLM
Unrestricted

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Bertrang, Allyn L. « Highway and roadway risk management techniques for emergency responders ». Online version, 2009. http://www.uwstout.edu/lib/thesis/2009/2009bertranga.pdf.

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Brim, Carla B. « A descriptive analysis of non-urgent emergency department utilization ». Online access for everyone, 2006. http://www.dissertations.wsu.edu/Thesis/Spring2006/c%5Fbrim%5F040606.pdf.

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Tan, Huiyi, et 譚惠儀. « A study on prehospital emergency medical service system status in Guangzhou ». Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2007. http://hub.hku.hk/bib/B40052163.

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Wheater, Kerry Lee. « Spouses’ experience of secondary trauma among emergency services personnel ». University of the Western Cape, 2016. http://hdl.handle.net/11394/5004.

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Magister Artium (Social Work) - MA(SW)
Emergency services personnel are potentially exposed to events involving trauma, suffering and tragedy on a daily basis, which could consequently lead to secondary trauma and post- traumatic stress symptoms. The images and feelings that are associated with continuously being exposed to traumatic situations are not limited to the emergency services personnel, who are primarily exposed to the event, but these events can also have an effect on the significant others in their environment, such as their spouses. The aim of this study was to explore and describe the experiences of secondary trauma among the spouses of emergency services personnel. The research study followed a qualitative research approach, which provided in-depth descriptions and understandings of the participants’ secondary trauma experiences. The research design was explorative and descriptive in nature. Purposive sampling was used to select eight (8) participants, who were the spouses of emergency services personnel. The data was collected by means of semi-structured individual interviews and was analysed according to Creswell. Various research findings indicated that secondary trauma was prevalent in the emergency services industry and, in this current study, most participants indicated that it impacted their marital relationships. The experiences of secondary trauma among the spouses of emergency services personnel stemmed from their partners’ repeated exposure to trauma, managing everyday job stress, safety fears, behavioural changes, dealing with their partners’ emotional reactivity and emotional withdrawal from the family, following trauma exposure. Based on some of the suggestions provided by all the participants, the researcher concluded the study with recommendations for future practice and future research, the main recommendation being that organisational support systems be made available to spouses and families of emergency services personnel.

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Adamiak, Grazyna Teresa. « Påverkan av organisatoriska och miljömässiga faktorer på tillgänglighet till akutsjukvården / ». Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3997.

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Millar, Bernadette Theresa. « Becoming and being : a critical realist study into the emergence of identity in emergency medical science students, and the construct of graduate attributes ». Thesis, Rhodes University, 2014. http://hdl.handle.net/10962/d1013175.

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This critical realist thesis seeks to understand how student, graduate and professional identities emerge in Emergency Medical Science (EMS) students at a South African University of Technology (UoT) as well as in professional paramedics in the Emergency Medical Care Services (EMCS). It further considers the construct of graduate attributes (GAs) and its relationship to emergence of identity and influence on curriculum design. The research design is that of a case study. The theoretical framework is critical realism whose depth ontology posits three domains of reality. Causal powers and generative mechanisms exist in the Real domain which cause events or phenomena to emerge in the Actual domain that are experienced in the Empirical domain. Using retroduction one may come to explore some of the causes for the event. Using Bhaskar’s concepts of identity, the self, absence and emergence, ontology and four-planar social being, a Bhaskarian explanatory framework of identity to explore the emergence of identity has been created. In exploring graduate attributes, a critical realist question is posed: “What must the world be like for GAs to exist” to explore the possibilities of the existence of GAs. It was found that student identity emerges diachronically in three moments, while professional paramedic identity starts to emerge during the third year of study mainly through the structure, culture and agency of workplace-based learning. In answer to the critical realist question it was found that GAs emerge from the neoliberalist commodification of universities. In seeking an alternative to GAs, traits and attitudes were explored. It was found that these emerge from curriculum, interplay of departmental structure, culture and agency of and from students’ being which makes them ontologically radically different from GAs. This study concludes that student, graduate and professional identities emerge from a person’s core constellational identity diachronically within four-planar social being and the interplay of structure, culture and agency. GAs cannot be related to the emergence of identity and curriculum design because of their ontology; however, if traits and attitudes are substituted for GAs, a close relationship does exist between emergence of identity, traits and attitudes and curriculum design.

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Wani, Bhavika. « Systems Engineering of a Medical Emergency Drone – AmbiFly ». University of Cincinnati / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1613740749331087.

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Thèses sur le sujet « Emergency Medical Services (EMS) »

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