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Sorani, Mohamad, Sogand Tourani, Hamid Reza Khankeh i Sirous Panahi. "Challenges of helicopter emergency medical service: A qualitative content analysis in Iranian context". Health Policy and Technology 7, nr 4 (grudzień 2018): 374–78. http://dx.doi.org/10.1016/j.hlpt.2018.09.001.
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Ebrahimian, Abbasali, Hesam Seyedin, Roohangiz Jamshidi-Orak i Gholamreza Masoumi. "Exploring Factors Affecting Emergency Medical Services Staffs’ Decision about Transporting Medical Patients to Medical Facilities". Emergency Medicine International 2014 (2014): 1–8. http://dx.doi.org/10.1155/2014/215329.
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Transfer of patients in medical emergency situations is one of the most important missions of emergency medical service (EMS) staffs. So this study was performed to explore affecting factors in EMS staffs’ decision during transporting of patients in medical situations to medical facilities. The participants in this qualitative study consisted of 18 EMS staffs working in prehospital care facilities in Tehran, Iran. Data were gathered through semistructured interviews. The data were analyzed using a content analysis approach. The data analysis revealed the following theme: “degree of perceived risk in EMS staffs and their patients.” This theme consisted of two main categories: (1) patient’s condition’ and (2) the context of the EMS mission’. The patent’s condition category emerged from “physical health statuses,” “socioeconomic statuses,” and “cultural background” subcategories. The context of the EMS mission also emerged from two subcategories of “characteristics of the mission” and EMS staffs characteristics’. EMS system managers can consider adequate technical, informational, financial, educational, and emotional supports to facilitate the decision making of their staffs. Also, development of an effective and user-friendly checklist and scoring system was recommended for quick and easy recognition of patients’ needs for transportation in a prehospital situation.
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Valtolina, Stefano, Barbara Rita Barricelli, Alessandro Rizzi, Sabrina Menghini i Ascanio Ciriaci. "Emergency Medical IT Services for Migrants Rescue Operations". Interaction Design and Architecture(s), nr 37 (10.06.2018): 143–58. http://dx.doi.org/10.55612/s-5002-037-007.
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This paper illustrates the research and development work done in the last 4 years in the frame of rescue operations of migrants who attempt to reach Italian coasts via sea journeys on Mediterranean routes. The context, characterized by humanitarian, social, and organizational issues, presents complex challenges that can only be tackled with a multidisciplinary, participatory, and internationalized approach. The ITHEALTH system and the results of its usability and user experience evaluations are presented. It takes inspiration from other projects developed for different purposes but acting in similar context and according to similar socio-technical dimensions.
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Reynolds, Patrick. "Medical Futility in the Context of ECMO". Ethics & Medics 42, nr 6 (2017): 1–4. http://dx.doi.org/10.5840/em201742610.
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Medical futility theory has become an enduring topic of discussion among medical practitioners and bioethicists of all persuasions. This is not necessarily surprising in light of the constant advances in pharmacokinetics and medical technology. Extracorporeal membrane oxygenation has existed since the early 1970s but was used primarily to treat neonates. Simplistically defined, an ECMO is a smaller, transportable version of the heart–lung bypass machine used during open-heart surgery. It can be used as a temporary rescue device for severe pulmonary or cardiac failure and is very frequently deployed during an acute cardiac emergency, such as cardiac arrest that does not respond to CPR or cardiogenic shock. The increasing use of ECMOs highlights the problem of identifying and understanding medical futility.
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Lund, Adam, Matthew Brendan Munn, Jamie Ranse i Sheila Turris. "Core Curriculum for Event Medical Leaders". Prehospital and Disaster Medicine 34, s1 (maj 2019): s112—s113. http://dx.doi.org/10.1017/s1049023x19002383.
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Introduction:The literature on mass gatherings has expanded over the last decade. However, no readily accessible curriculum exists to prepare and support event medical leaders. Such a curriculum has the potential to align event medical professionals on improving event safety, standardizing emergency response, and reducing community impacts.Methods:We organized collaborative expert focus groups on the proposed “core curriculum” and “electives.”Results:Key features of a mass gathering medical curriculum include operations-focused, evidence-informed, best-known practices offered via low barrier, modular, flexible formats with interactive options, and a multi-national focus.Core content proposed: Background (Definitions, Context, Risk, Legalities)Event Medical Planning - “The Seven Steps” - (1.) Assessment and Environmental Scan - Event Emergency Action Plan, (2.) Human Resources, (3.) Equipment/Supplies, (4.) Infrastructure/Logistics, (5.) Transportation (To, On, From), (6.)Communication (Pre, During, Post), and (7.) Administration/Medical DirectionEvent After-Action ReportingCase-based ActivitiesElectives mirror Core outline and serve as expanded case-studies of specific event categories. Initially proposed electives include: Concerts/Music FestivalsRunning EventsCycling EventsMulti-Sport EventsObstacle Adventure CoursesStaged Wilderness CoursesAmateur GamesPolitical Gatherings & OrationsReligious Gatherings & PilgrimagesCommunity Gatherings (e.g., Parades, Fireworks, etc.)Discussion:Complex team learning to standardize real-world approaches has been accomplished in other medical domains (e.g., ACLS, AHLS, ATLS, PALS, etc.). A course for event medicine should not re-teach medical content (i.e. first aid, paramedicine, nursing, medicine); it should make available a commonly understood, systematic approach to planning, execution, and post-event evaluation vis a vis health services at events. A ‘train the trainer’ model will be required, with business operations support for sustainable course delivery. The author team seeks community feedback at WCDEM 2019 in creating ‘the ACLS’ of Event Medicine.
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Xu, Yiming, Mingyang Wu, Wei Chen, Siyi Ge i Yi Liang. "Analysis on the registration and review system of emergency medical devices in China and abroad in the context of COVID-19". International Journal of Drug Regulatory Affairs 10, nr 2 (19.06.2022): 46–55. http://dx.doi.org/10.22270/ijdra.v10i2.522.
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Objective
In the context of COVID-19, the domestic and foreign demand for emergency medical devices, such as medical masks and protective suits, is surging, and it is urgent to complete the registration and review of emergency medical devices with high efficiency and quality, which requires a mature and perfect registration and review system as the support. This paper aims to compare and analyze the domestic and foreign registration and review system of emergency medical device, summarize the good experience, and provide feasible suggestions for improving China's emergency medical device registration and review system.
Method
USA, Canada, Japan and the European Union were selected to make a comparative analysis with China from the aspects of legal system and emergency registration and review procedure by literature research, comparative analysis and other theoretical methods.
Results
The legal system and review mechanism of emergency medical device registration in China have been relatively perfect, but the safety and risk balance mechanism and the comprehensiveness of emergency management measures need to be further improved.
Conclusion
On the basis of maintaining its own institutional advantages, China should learn from foreign experience to further optimize the registration and review system of emergency medical devices, so as to improve the ability of response and implementation of China in public health emergencies.
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Sepahvand, Elham, Hamidreza Khankeh, Mohammadali Hosseini i Behnam Akhbari. "Wrong Belief of Emergency Delay: A Qualitative Content Analysis in Iranian Context". Health in Emergencies & Disasters Quarterly 5, nr 4 (1.07.2020): 199–206. http://dx.doi.org/10.32598/hdq.5.4.209.2.
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Background: During traffic accidents, professional staff provide care to the patient at the scene of the accident and then transport the victim to the hospital by ambulance. But sometimes this transition is carried out by relatives and laypeople. The purpose of this study was to explore the factors affecting people’s involvement and transmission of the victims of the traffic accident. Materials and Methods: This study was done with a qualitative content analysis method in 2018. The study participants were 16 people. In this study, a purposeful sampling method with maximum diversity was used. Semi-structured interviews were used to collect data using guiding questions. To observe the research ethics, the researcher, after obtaining permission from the University Ethics Committee, conducted interviews (IR.USWR.REC.1395.399). Results: In total, 15 spinal cord injury victims and their relatives or laypeople and medical emergency technicians were interviewed. The class of wrong belief of delay was the main class in all interviews. Concepts such as past experiences, the pressure time, the lack of emergency time, cultural beliefs, and the tension explaining the wrong belief concept. Conclusion: Wrong belief of delay was a concept that was extracted from the present study. It is recommended that the scene of the accident be examined in-depth and how to create a spinal cord injury in the injured with a grounded theory approach.
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Yu, Lei. "A Review of Emergency Medical Rescue Network Optimization Problems". Academic Journal of Science and Technology 4, nr 3 (8.02.2023): 124–27. http://dx.doi.org/10.54097/ajst.v4i3.4918.
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This paper mainly reviews the research on the optimization of emergency medical treatment network, which mainly includes the location of emergency medical facilities and the transportation of the wounded, as well as the integration of the two, and finds that although many scholars have paid attention to the research of related issues, they mainly focus on the optimization of emergency medical treatment network in the context of major natural disasters such as earthquakes and typhoons, and there are few related studies on the optimization of emergency medical treatment network under infectious health emergencies.
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Wang, Mingyu, Shizhong Lian i Yibo Wu. "Overview of Emergency Management and Disaster Medicine in the Context of COVID-19". Journal of Emergency Management and Disaster Communications 01, nr 01 (październik 2020): 89–94. http://dx.doi.org/10.1142/s2689980920400059.
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Human production, scientific research and economic activities interact with the natural environment. The industrial revolution promotes the development of human social productivity, but at the same time, it also affects and destroys the living environment. The emergence of catastrophic accidents, the leakage of a large number of harmful substances, and the explosive spread of disease outbreaks have brought many new medical problems. In recent decades, natural disasters such as earthquakes and floods have occurred frequently, man-made disasters such as terrorist attacks and nuclear leakage, and public health emergencies such as SARS and COVID-19 have directly threatened the survival and development of mankind. This paper reviews the background, definition, content, and development of emergency management and disaster medicine, and illustrates the significance of emergency management, disaster medicine, and health communication for social security and stability in the context of the community with a shared future for mankind, based on China’s experience in fighting SARS and COVID-19.
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Foster, Crawford R. M. "Emergency preparedness: Ionising radiation incidents and medical management". BMJ Military Health 166, nr 1 (6.07.2018): 21–28. http://dx.doi.org/10.1136/jramc-2018-000958.
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Military personnel risk being exposed to ionising radiation through a variety of means, including industrial accidents with Ministry of Defence equipment, inadvertent exposure while on operations, terrorist activities and nuclear war. The aim of this review is to outline the possible acute health effects and immediate management of radiation casualties in the context of different exposure scenarios. It emphasises the most important principles for managing irradiated, and/or contaminated casualties, in the operational environment, as well as providing details of key references and other sources of reach-back support.
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Okhabska, Iryna, Vira Budzyn, Ivan Rybchych, Ivan Zyma i Yurii Kalichak. "Management of medical institutions on context of provision medical and preventive care in COVID-19 condition". International journal of health sciences 6, nr 1 (20.02.2022): 347–56. http://dx.doi.org/10.53730/ijhs.v6n1.4381.
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The aim of the study management of medical institutions in the context of providing medical and preventive care in conditions of COVID-19 is an urgent research problem because it provides detection of management’s effective mechanism in times of crisis. It was to identify the management’s peculiarities of medical institutions in the context of providing medical and preventive care in conditions of COVID-19. The article uses a qualitative content analysis method, a method of comparison, and a method of analysis of countries’ cases in the context of rendering medical and preventive care in Ukraine, Spain, Italy, Germany, and the Czech Republic. The article identifies the main elements of the health system management mechanism during the pandemic, which includes coordinated work by stakeholders to ensure a coordinated response to the emergency. The mechanism includes the organizational, legal, and financial components of cooperation between agencies and ministries of national, regional level, involvement international organizations in the process of development of policy and tactics, management crisis’ strategies. Strategic documents of the national level are one of the main elements of the management’s system.
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Friedman, N., i A. Goldberg. "(P2-22) Proposed Model for Cellular Medical Record in Emergency Medicine". Prehospital and Disaster Medicine 26, S1 (maj 2011): s142. http://dx.doi.org/10.1017/s1049023x11004663.
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IntroductionIn a hypothetical situation, an emergency services team is launched to treat a man who collapsed in the street. The team finds John Doe's mobile phone, and within seconds retrieves the required clinical parameters from his Mobile Medical Record (MMR), thus, providing a life-saving treatment suited to his personal health condition. This study seeks to determine if the necessary clinical parameters, required at emergency situations have ever been examined in order to best match both emergency situations and cellular technology.ObjectiveTo characterize the clinical parameters that make up an MMR in the context of saving lives, and to propose a model for an MMR in emergency medicine.MethodsThe essential emergency medicine clinical parameters in the context of life-saving treatments were characterized through interviews with prehospital and hospital experts in emergency medicine. The results were analyzed with the help of a cellular multimedia expert in order to best incorporate the clinical parameters into cellular phones as MMRs.ConclusionEmergency medicine teams chose individual and specific clinical parameters in a certain order of appearance from the general medical record that should assembly, in their opinion, an emergency medicine MMR. A MMR was chosen by the emergency medicine treatment teams as one of their preferred communication methods. The MMR model, if applied correctly, will provide the emergency medicine treatment teams an available, reliable, homogeneous database of real time clinical parameters adapted to life-saving conditions. The MMR model represents a conceptual revolution of taking the medical record from the caregiver and transferring it to the patient, which can be constantly at hand at any given time or place in their mobile phones.
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Herpen, Merel van, David Nieuwe Weme, Marcel de Leeuw, Renske Colenbrander, Miranda Olff i Hans te Brake. "Wellbeing of Helicopter Emergency Medical Services (HEMS) Personnel in a Challenging Work Context: A Qualitative Study". Prehospital and Disaster Medicine 38, S1 (maj 2023): s161. http://dx.doi.org/10.1017/s1049023x23004193.
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Introduction:Helicopter emergency medical services (HEMS) personnel provide on-scene trauma care to patients with high mortality risk. The HEMS work context is characterized by an exceptionally high exposure to critical incidents, emotionally demanding patient encounters, and having to perform under pressure with limited resources. The aim of this study was to further our understanding of the factors underlying HEMS personnel wellbeing given their challenging work context.Method:Sixteen semi-structured interviews were conducted with HEMS personnel from a University Hospital in The Netherlands. Interview topics included work context, personal characteristics, coping, work engagement, and psychosocial support. To analyze the data, a generic qualitative research approach was used inspired by grounded theory, including open, axial and selective coding.Results:The analysis revealed ten categories that provide insight into factors underlying the wellbeing of HEMS personnel and their work context: team and collaboration, coping, procedures, informal peer support, organizational support and follow-up care, drives and motivations, attitudes, other stressors, potentially traumatic events, and emotional impact. The findings show that HEMS personnel are highly motivated and have a strong team mentality. Various factors are important to their wellbeing, such as job resources and social support. The HEMS work can have an emotional impact but HEMS personnel use various coping strategies to deal with this. The perceived need for organizational support and follow-up care is low among participants.Conclusion:This study identifies factors and strategies that support the wellbeing of HEMS personnel. It also provides insight into the HEMS work culture and help-seeking behavior in this population. The findings may be beneficial to understand and support employee wellbeing in other emergency services work contexts as well.
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Caroline, Nancy L. "Emergency Medical Services (EMS) Lessons for Worldwide Health Care". Prehospital and Disaster Medicine 1, S1 (1985): 67–69. http://dx.doi.org/10.1017/s1049023x00043843.
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I should like in these remarks to try to place the discussions of this Congress in a larger perspective and perhaps to broaden somewhat our concept of what constitutes a medical emergency, and what should be labelled as a disaster. I should also like to ask whether emergency care and disaster planning as we usually think of these activities are either affordable or useful when viewed in a global context. What are the day-to-day emergencies and major disasters of this planet, and are we addressing them properly with the emergency medical services systems as now constituted?
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Zhao, Fei, Xi Wang, Beibei Liu, Wenzhuo Sun i Zheng Liu. "Research on Optimization of Medical Waste Emergency Disposal Transportation Network for Public Health Emergencies in the Context of Intelligent Transportation". Applied Sciences 13, nr 18 (8.09.2023): 10122. http://dx.doi.org/10.3390/app131810122.
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In order to build a more comprehensive emergency disposal and transportation network system for medical waste, it is necessary to consider various uncertain factors and data characteristics. Therefore, in the context of intelligent transportation, this article considers the uncertainty of the quantity and regional population density of infectious medical waste generation as well as the emergency disposal of infectious medical waste under multi-cycle and multi-objective conditions, and it constructs a multi-cycle emergency disposal logistics network optimization model for infectious medical waste under uncertain conditions. Through deterministic transformation of the model and data mining of the medical waste disposal logistics network in Wuhan, China, the multi-objective model under uncertain conditions was also solved and sensitivity analyzed using the MOPSO-NSGA2 intelligent algorithm, verifying the effectiveness and superiority of the algorithm.
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Akhmetzhanov, Kanadan Kanashevich. "Experience of the Pavlodar Regional Emergency Station in the context of the COVID-19 pandemic". Vrač skoroj pomoŝi (Emergency Doctor), nr 12 (1.12.2020): 63–66. http://dx.doi.org/10.33920/med-02-2012-03.
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Due to the complicated epidemiological situation in the region, the number of calls to the emergency station has increased. In order to prevent a decrease in operational work, a number of changes were introduced which made it possible to reduce the time of arrival of the teams from the moment the call was received at the 103 console to 7 minutes and contributed to the provision of high-quality medical care to the population by emergency medical teams.
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Bedson, Adam. "Non-medical prescribing by paramedics in emergency, urgent and critical care". Journal of Paramedic Practice 13, nr 5 (2.05.2021): 184–88. http://dx.doi.org/10.12968/jpar.2021.13.5.184.
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This article considers some of the unique considerations and challenges that are associated with non-medical prescribing in the context of paramedic emergency care. In contrast to primary care, advanced paramedics practicing in emergency settings are more likely to encounter patients who require an immediate supply or administration of medication and access to a range of controlled drugs. Furthermore, access to medical support for prescribing decision-making, restrictions on the prescribing of controlled drugs and potential challenges in obtaining access to patient records, may also impact non-medical prescribing in these settings. Currently, very little empirical evidence has been published on the topic of non-medical prescribing in paramedic practice. Further research is required to understand whether the anticipated benefits are being realised for patients and NHS services. This is particularly the case in the context of prehospital emergency, urgent and critical care settings.
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Zhang, Yongling, Xin Li, Nana Kong, Miao Zhou i Xiaobing Zhou. "Spatial Accessibility Assessment of Emergency Response of Urban Public Services in the Context of Pluvial Flooding Scenarios: The Case of Jiaozuo Urban Area, China". Sustainability 14, nr 24 (7.12.2022): 16332. http://dx.doi.org/10.3390/su142416332.
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Urban pluvial flooding has become an important factor in urban casualties and economic losses, thus, there is an urgent need to strengthen urban emergency management research and improve emergency response capabilities to flooding. The SCS–CN hydrological model combined with GIS spatial analysis were used to assess the spatial accessibility of the emergency response to key urban public services (medical and fire) for different pluvial flooding scenarios of the Jiaozuo urban area. The results show that the coverage area of the public service department (medical and fire) emergency response decreases as the period of pluvial flooding recurrence increases. The accessibility of the public service department (medical and fire services) emergency response shows a gradual decline from the center of the Jiaozuo urban area to the periphery. The depth and area of water accumulation in the northern part of the Zhongzhan District, the northeastern part of the Macun District, and the southwestern part of the Shanyang District gradually increased as the heavy rainfall recurrence period increased. Emergency response from public services (medical and fire services) could not arrive within 15 min.
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Knigavko, Oleksandr, Nadiia Baranova, Ievgen Bausov, Maryna Dolzhenko i Nataliia Lantukhova. "Organizing treatment in emergency health care facilities during COVID-19 pandemic conditions in Eastern European countries". International journal of health sciences 6, nr 1 (2.02.2022): 149–59. http://dx.doi.org/10.53730/ijhs.v6n1.3582.
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The purpose of the academic paper lies in identifying the practice of organizing treatment in emergency health care facilities in the conditions of the COVID-19 pandemic on the example of Poland and the Czech Republic. The qualitative content analysis of the organization of emergency medical care in the conditions of a pandemic in Poland and the Czech Republic has been used in the research. The COVID-19 Health System Response Monitor (HSRM) database and the Health Systems and Policy Monitor (HSPM) database have been used for conducting the analysis. In the course of the research, the following features of changes in the organization of treatment in emergency health care facilities in the context of the COVID-19 pandemic have been revealed, namely: postponement of scheduled examinations, non-urgent treatment, gradual reduction in the number of hospitalizations, especially for planned surgical interventions; limiting the availability of medical care; prohibition of regular vacations of medical workers; redeployment of personnel in case of deterioration of the condition of patients with COVID-19 and the need for the provision of emergency medical care; daily monitoring of intensive care beds and their filling status to predict the possible need for emergency care.
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Holovanova, Iryna A., Oksana I. Krasnovа, Svetlana M. Tanianskaia, Irina A. Kolenko, Mariya O. Rumyantseva, Natalia A. Lyakhova i Oleh H. Krasnov. "FEATURES OF THE ORGANIZATION AND PROVISION OF EMERGENCY MEDICAL CARE IN POLTAVA REGION". Wiadomości Lekarskie 74, nr 2 (2021): 351–54. http://dx.doi.org/10.36740/wlek202102132.
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The aim: Is to study and analyze the dynamics of the indicators of the emergency medical service of the Ukrainian and the Poltava region in the context of the reforms of the healthcare system in Ukraine. Materials and methods: In this work, the indicators of development of the emergency medical service of the Ukrainian and the Poltava region were studied and analyzed. Conclusions: The provision of emergency medical care in the Poltava region is provided by the Poltava Regional Center for Emergency Medicine and Disaster Medicine. The structure of the center includes 4 emergency medical stations, which are located in cities such as Poltava, Kremenchuk, Lubny, Mirgorod. А modern telemedicine center was built іn 2018 for emergency counseling on-line in new directions was carried out: ultrasound and endoscopic diagnostics, radiology, counseling during surgical interventions, laboratory diagnostics, etc. Emergency medical care reform Poltava Regional should be aimed at increasing the efficiency of the use of resources; provision of the EMC system by the relevant vehicles; qualitative training of doctors in emergency medicine; informatization of the EMC system.
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Subbe, C. P., R. A. Bottle i D. Bell. "Acute Medicine: Triage, timing and teaching in the context of medical emergency admissions". European Journal of Internal Medicine 22, nr 4 (sierpień 2011): 339–43. http://dx.doi.org/10.1016/j.ejim.2011.05.015.
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Pakhnenko, Olena, Viktor Kulibaba i Maksym Palienko. "Health Care Provision in State Institutions in the Context Of COVID-19". Health Economics and Management Review 3, nr 2 (2022): 17–25. http://dx.doi.org/10.21272/hem.2022.2-02.
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The main purpose of the research is to analyse the financial provision of health care in public institutions on the example of the State Emergency Service and to develop proposals for improving the medical system of the SES, taking into account the challenges of COVID-19. The paper presents the results of an empirical analysis of the amount of funding for health care facilities outside the structure of the Ministry of Health, on the example of the medical system of the State Emergency Service of the Ministry of Internal Affairs of Ukraine during 2017-2022. At a separate stage of the study, the volume and target of additional funding for health care from the Fund for Combating COVID-19 in 2020 were analysed. The analysis showed a lower level of remuneration of specialists and a worse financial situation of health care facilities subordinated to the Department of Medical and Biological Protection and Occupational Safety of the SES of Ukraine. In order to improve the health protection system of the SES, a number of proposals have been developed, namely: formation of a subdivision for analysis of problematic issues of the SES and legislative work to eliminate the identified shortcomings; digitalization and automation of reporting within the medical system of the SES of Ukraine; coverage of the activities of health care institutions of the SES in the media and social networks; advising and conducting licensing and accreditation of health care institutions of the SES; justification for increasing funding for the medical sector of the SES and increasing the salaries of medical workers; expanding the provision of paid services to the population; search for funding outside the budget of the SES within the national budget and outside the state budget from sources not prohibited by law, involvement of humanitarian and charitable organizations, patrons; maintaining and improving the level of qualification of medical staff, improving information and communication work with staff; conducting training and preparation of medical and support specialists for emergency response activities, conducting interdepartmental and local training with the involvement of specialists from local and international humanitarian organizations. The results of the study can be useful in the development of regulations and legislation in the field of medical care of the SES of Ukraine.
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Schulz, Fredrik, Quynh Nguyen, Anke Baetzner, Helmut Schrom-Feiertag i Lina Gyllencreutz. "Mixed Reality–Exploring the Requirements of Realism in the Context of Mass Casualty Incident Training". Prehospital and Disaster Medicine 38, S1 (maj 2023): s31. http://dx.doi.org/10.1017/s1049023x2300119x.
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Introduction:The occurrence of mass casualty incidents is increasing globally. Training is an essential cornerstone in achieving disaster preparedness, yet studies show that medical first responders perceive their level of readiness to face disaster incidents as inadequate. As real-world disaster training exercises can be characterized as resource-intensive in terms of cost and time, virtual training environments have been highlighted as a potential alternative to mass casualty incident training. In order to increase the preparedness of medical first responders, a deeper understanding of their requirements in the context of disaster training exercises is needed.Method:Individual, contextual interviews were conducted with a total of 26 medical first responders from four European emergency service organizations: Hellenic Rescue Team (Greece), Summa 112 (Spain), Sanitätspolizei Bern (Switzerland), and Johanniter Österreich (Austria). The interviews were analyzed using qualitative content analysis.Results:The preliminary results indicate that real-world disaster training exercises have limitations regarding realism. The participants described a need to train in an environment that accurately represents what they might face amidst a real-world incident site. This included the recreation of potential environmental dangers that had to be taken into consideration before approaching the incident site. The participants also highlighted the importance of realistic representations of injuries and reactions from the victims during training. The limited possibilities to provide a realistic training environment that corresponds to the set requirements lead to the participants feeling less prepared to face a real-world mass casualty incident.Conclusion:Medical first responders’ need for increased realism in real-world disaster training exercises deserves attention. Training solutions that could potentially increase the level of preparedness needs to be taken into consideration. How the degree of realism in Virtual or Mixed Reality based training platforms affects the perception of preparedness among medical first responders warrant further research.
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Miller, Alison K., Christopher B. Gage, Matthew Parrish, Isaac Toliver, Alexander Ulintz, Jonathan Powell, Jennifer A. Frey i Ashish R. Panchal. "Emergency Medical Services and Public Health Perspectives on Alternative Emergency Response Models". Journal of Public Health Management & Practice 30, nr 4 (12.06.2024): E188—E196. http://dx.doi.org/10.1097/phh.0000000000001969.
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Context: New approaches to emergency response are a national focus due to evolving needs and growing demands on the system, but perspectives of first responders and potential partners have not been evaluated. Objective: This project aimed to inform the development and implementation of alternative emergency response models, including interdisciplinary partnerships, by identifying the perspectives of the frontline workforce regarding their evolving roles. Design: An electronic survey was sent, querying respondents about their perceived roles in emergency response, interdisciplinary partnerships, and resources needed. Setting: This study took place in a metropolitan, midwestern county with participants from 2 public health agencies and 1 emergency medical services (EMS) agency. Participants: The survey was completed by 945 EMS clinicians and 58 public health workers. Main Outcome Measures: The main outcome measures were agreement levels on each group’s roles in prevention, response, and recovery after emergencies, as well as general feedback on new models. Results: Overall, 97% of EMS clinicians and 42% of public health workers agreed that they have a role in immediate response to 9-1-1 emergencies. In mental health emergencies, 87% of EMS clinicians and 52% of public health workers agreed that they have a role, compared to 87% and 30%, respectively, in violent emergencies. Also, 84% of respondents felt multidisciplinary models are a needed change. However, 35% of respondents felt their agency has the resources necessary for changes. Conclusions: We observed differences between EMS clinicians and public health workers in their perceived roles during emergency response and beliefs about the types of emergencies within their scope. There is strong support for alternative approaches and a perception that this model may improve personal well-being and job satisfaction, but a need for additional resources to develop and implement.
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Gumenyuk, S. A., A. M. Shchikota i V. I. Vechorko. "Work of Scientific and Practical Centre for Emergency Medical Care of Moscow City Health Department in Context of COVID-19 Pandemic". Disaster Medicine, nr 4 (grudzień 2020): 13–15. http://dx.doi.org/10.33266/2070-1004-2020-4-13-15.
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The activity is analyzed of specialists of the Scientific and practical centre for emergency medical care (CEMP) of Department of health of the city of Moscow (DZM) in the context of the COVID-19 pandemic. The structure of trips of CEMP teams in the fight against COVID-19 from March 1 to July 1, 2020 is presented. It is noted that although all the structures under the jurisdiction of the DZM, starting from March 2020, are working on high alert in connection with the threat of the spread of coronavirus, CEMP specialists continue to work on providing emergency medical care (EMP) and medical evacuation of victims of road accidents and other emergencies, as well as emergency somatic patients with various nosologies.
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Pont, Anna Veronica. "Legal Protection for Medical Volunteers in the Implementation of Emergency Medical Measures". Poltekita : Jurnal Ilmu Kesehatan 17, nr 3 (6.11.2023): 663–70. http://dx.doi.org/10.33860/jik.v17i3.2033.
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The presence of medical volunteers during a medical emergency is very much needed and expected. Their presence is temporary according to the duration of the crisis. However, the current regulations do not explicitly discuss legal protection for medical volunteers during a health emergency. This type of research is normative juridical research that focuses on examining the application of rules or norms in positive law, especially concerning legal synchronization. Due to the type of normative juridical research, the approach used is the statute approach, which is taken by examining various laws that have to do with the legal issues being handled. The results of the study explain that the form of legal protection for medical volunteers in an emergency period can be understood and developed in the context of health, disaster, and employment regulations, namely Law Number 36 the Year 2009 concerning Health, Law Number 29 the Year 2004 concerning Medical Practice, Law No. 36 of 2014 concerning Health Workers and Law Number 38 of 2014 concerning Nursing, Regulation of the Minister of Health of the Republic of Indonesia Number 75 of 2019 concerning Health Crisis Management, Law Number 11 of 2020 concerning Job Creation. For its implementation, several Decrees of the Minister of Health and Circular Letters of the Ministry of Manpower were issued which regulate and guarantee legal protection for health workers, including medical volunteers, during a health emergency which includes protection of work norms, protection of Occupational Health and Safety norms and protection labor social security norms.
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Wu, Tzu-Chi, i Chien-Ta Bruce Ho. "Blockchain Revolutionizing in Emergency Medicine: A Scoping Review of Patient Journey through the ED". Healthcare 11, nr 18 (8.09.2023): 2497. http://dx.doi.org/10.3390/healthcare11182497.
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Background: Blockchain technology has revolutionized the healthcare sector, including emergency medicine, by integrating AI, machine learning, and big data, thereby transforming traditional healthcare practices. The increasing utilization and accumulation of personal health data also raises concerns about security and privacy, particularly within emergency medical settings. Method: Our review focused on articles published in databases such as Web of Science, PubMed, and Medline, discussing the revolutionary impact of blockchain technology within the context of the patient journey through the ED. Results: A total of 33 publications met our inclusion criteria. The findings emphasize that blockchain technology primarily finds its applications in data sharing and documentation. The pre-hospital and post-discharge applications stand out as distinctive features compared to other disciplines. Among various platforms, Ethereum and Hyperledger Fabric emerge as the most frequently utilized options, while Proof of Work (PoW) and Proof of Authority (PoA) stand out as the most commonly employed consensus algorithms in this emergency care domain. The ED journey map and two scenarios are presented, exemplifying the most distinctive applications of emergency medicine, and illustrating the potential of blockchain. Challenges such as interoperability, scalability, security, access control, and cost could potentially arise in emergency medical contexts, depending on the specific scenarios. Conclusion: Our study examines the ongoing research on blockchain technology, highlighting its current influence and potential future advancements in optimizing emergency medical services. This approach empowers frontline medical professionals to validate their practices and recognize the transformative potential of blockchain in emergency medical care, ultimately benefiting both patients and healthcare providers.
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Psarra, Evgenia, Dimitris Apostolou, Yiannis Verginadis, Ioannis Patiniotakis i Gregoris Mentzas. "Context-Based, Predictive Access Control to Electronic Health Records". Electronics 11, nr 19 (24.09.2022): 3040. http://dx.doi.org/10.3390/electronics11193040.
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Effective access control techniques are in demand, as electronically assisted healthcare services require the patient’s sensitive health records. In emergency situations, where the patient’s well-being is jeopardized, different healthcare actors associated with emergency cases should be granted permission to access Electronic Health Records (EHRs) of patients. The research objective of our study is to develop machine learning techniques based on patients’ time sequential health metrics and integrate them with an Attribute Based Access Control (ABAC) mechanism. We propose an ABAC mechanism that can yield access to sensitive EHRs systems by applying prognostic context handlers where contextual information, is used to identify emergency conditions and permit access to medical records. Specifically, we use patients’ recent health history to predict the health metrics for the next two hours by leveraging Long Short Term Memory (LSTM) Neural Networks (NNs). These predicted health metrics values are evaluated by our personalized fuzzy context handlers, to predict the criticality of patients’ status. The developed access control method provides secure access for emergency clinicians to sensitive information and simultaneously safeguards the patient’s well-being. Integrating this predictive mechanism with personalized context handlers proved to be a robust tool to enhance the performance of the access control mechanism to modern EHRs System.
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Palmer, C. Eddie, Sheryl M. Gonsoulin, Ray Bias i Wanda Eaves. "Financial Triage: Strain, Stress, and Adaptation Within Today's Medical System". Prehospital and Disaster Medicine 7, nr 3 (wrzesień 1992): 293–300. http://dx.doi.org/10.1017/s1049023x00039662.
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AbstractIntroduction:This paper explores the interactional nexus surrounding the delivery of non-paying and/or uninsured patients by paramedics to hospital emergency departments (EDs).Methods:Interviews, direct observation, and participant observation were used as data-gathering techniques.Results:Twenty-four of 25 paramedics and 17 of 25 nurses in the sample responded affirmatively to a question which asked, “Does trouble ever arise regarding the ‘kind’ of patients …” brought to the emergency department. The majority of the respondents who said that trouble was produced by the kind of patient brought to the emergency department specifically mentioned that the poor financial or non-insured status of the patient produced trouble between paramedics and ED personnel.Conclusion:These circumstances present problematic situations in the United States especially within the context of recent COBRA and OBRA legislation.
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Elsenbast, Christian, i Vera Hagemann. "Technology commitment of emergency medical service practitioners and dispatchers". International Paramedic Practice 13, nr 3 (2.08.2023): 59–67. http://dx.doi.org/10.12968/ippr.2023.13.3.59.
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Background Digitalization and artificial intelligence (AI) have entered the emergency medical service (EMS). Successful use of them depends on employees’ personal attitudes towards modern technology and its use. Aims This study explored the technology commitment of EMS professionals, dispatchers and emergency physicians, including towards AI systems. Methods To assess attitudes in the context of AI systems in EMS, employees were asked to answer an online questionnaire between October 2021 and March 2022. Findings A total of 510 participants, including 184 EMS professionals, 199 dispatchers and 68 emergency physicians, participated. These professionals had moderate to high technology commitment values with minor differences. Technology commitment correlated negatively with age. Gender had no effect. Conclusion The EMS provides fertile ground for AI systems. It is important to keep in mind that people with uncertainties and reservations need support. The scales in the questionnaire proved to be reliable and valid.
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Elsenbast, Christian, i Vera Hagemann. "Technology commitment of emergency medical service practitioners and dispatchers". Journal of Paramedic Practice 16, nr 4 (2.04.2024): 155–63. http://dx.doi.org/10.12968/jpar.2024.16.4.155.
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Background: Digitalisation and artificial intelligence (AI) have entered the emergency medical service (EMS). Successful use of them depends on employees' personal attitudes towards modern technology and its use. Aims: This study explored the technology commitment of EMS professionals, dispatchers and emergency physicians, including towards AI systems. Methods: To assess attitudes in the context of AI systems in EMS, employees were asked to answer an online questionnaire between October 2021 and March 2022. Findings: A total of 510 participants, including 184 EMS professionals, 199 dispatchers and 68 emergency physicians, participated. These professionals had moderate to high technology commitment values with minor differences. Technology commitment correlated negatively with age. Gender had no effect. Conclusion: The EMS provides fertile ground for AI systems. It is important to keep in mind that people with uncertainties and reservations need support. The scales in the questionnaire proved to be reliable and validt.
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Mane,, Priyanka. "Medical Rescue System". INTERANTIONAL JOURNAL OF SCIENTIFIC RESEARCH IN ENGINEERING AND MANAGEMENT 08, nr 05 (16.05.2024): 1–5. http://dx.doi.org/10.55041/ijsrem33928.
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India's vast and diverse landscape presents significant challenges for delivering timely medical assistance to remote and inaccessible regions, particularly during emergencies and natural disasters. In response to this critical need, this paper introduces a specialized Medical Rescue System (MRS) designed specifically for the Indian context. In conclusion, the Medical Rescue System represents a promising solution to address the unique challenges of emergency medical response in India, contributing to the nation's efforts to ensure equitable access to healthcare for all its citizens. Continued research, development, and deployment of the MRS are essential to realize its full potential and save lives in emergencies across the subcontinent.
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Amorim, Marco, Sara Ferreira i António Couto. "Emergency Medical Service Response: Analyzing Vehicle Dispatching Rules". Transportation Research Record: Journal of the Transportation Research Board 2672, nr 32 (21.06.2018): 10–21. http://dx.doi.org/10.1177/0361198118781645.
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In an era of information and advanced computing power, emergency medical services (EMS) still rely on rudimentary vehicle dispatching and reallocation rules. In many countries, road conditions such as traffic or road blocks, exact vehicle positions, and demand prediction are valuable information that is not considered when locating and dispatching emergency vehicles. Within this context, this paper presents an investigation of different EMS vehicle dispatching rules by comparing them using various metrics and frameworks. An intelligent dispatching algorithm is proposed, and survival metrics are introduced to compare the new concepts with the classic ones. This work shows that the closest idle vehicle rule (classic dispatching rule) is far from optimal and even a random dispatching of vehicles can outperform it. The proposed intelligent algorithm has the best performance in all the tested situations where resources are adequate. If resources are scarce, especially during peaks in demand, dispatching delays will occur, degrading the system’s performance. In this case, no conclusion could be drawn as to which rule might be the best option. Nevertheless, it draws attention to the need for research focused on managing dispatch delays by prioritizing the waiting calls that inflict the higher penalty on the system performance. Finally, the authors conclude that the use of real traffic information introduces a considerable gain to the EMS response performance.
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Rodriguez, Allana, Steven Hochman i Eric Steinberg. "Learning preferences of emergency medicine residents: Does context matter?" MedEdPublish 14 (21.03.2024): 17. http://dx.doi.org/10.12688/mep.20143.1.
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Background Delivery of education varies between Emergency Medicine (EM) residencies. EM requires residents to be trained in three domains of foundational knowledge: pathophysiology, procedure skills, and clinical reasoning. The “Visual, Auditory, Read, and Kinesthetics” (VARK) learning model has been studied previously in the medical professions. These methods pertain to viewing material, listening to content, reading or writing content and to performing activities, respectively. EM residents may prefer different VARK methods, and furthermore their preferences may change depending on the foundational knowledge domain to be learned. Methods In a multi-site survey-based study, 90 EM residents of various post-graduate year (PGY) levels completed a 30-question questionnaire on SurveyMonkey™ about their learning preferences of the foundational knowledge based on the VARK learning model. Demographic information was obtained. Data was analyzed via a Kruskal-Wallis test and followed by post-hoc analyses for statistical significance. Results For clinical knowledge questions, EM residents favored Kinesthetics, followed closely by Vision (p = 0.0010). For pathophysiology, they overwhelmingly favored Vision over other learning methods (p <.0001). For procedure questions, they preferred Vision, followed closely by Kinesthetics (p <.0001). PGY1 residents had a higher preference for Kinesthetic (p = 0.0198) and PGY3-4 residents had a slightly higher preference for Read and Vision learning methods (Read p = 0.0234, Vision p = 0.0131). These results are statistically significant. There was no significant difference between residents of different genders in learning preferences. Conclusion Emergency medicine residents may prefer different learning methods depending on the content of material being learned. A relatively small sample size is a limitation of the study. Future studies could investigate if tailoring educational delivery to residents’ preferences may improve outcomes.
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Cheuk Wai, N., A. W. L. Cheung i E. Wong. "PNS387 MULTI-CRITERIA DECISIONAL ANALYSIS ON NON-EMERGENCY MEDICAL TRANSPORT IN HONG KONG CONTEXT". Value in Health 22 (listopad 2019): S830. http://dx.doi.org/10.1016/j.jval.2019.09.2287.
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Albina, Anthony, Laura Archer, Marlène Boivin, Hilarie Cranmer, Kirsten Johnson, Gautham Krishnaraj, Anali Maneshi, Lisa Oddy, Lynda Redwood-Campbell i Rebecca Russell. "International Emergency Medical Teams Training Workshop Special Report". Prehospital and Disaster Medicine 33, nr 3 (26.04.2018): 335–38. http://dx.doi.org/10.1017/s1049023x18000262.
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AbstractThe World Health Organization’s (WHO; Geneva, Switzerland) Emergency Medical Team (EMT) Initiative created guidelines which define the basic procedures to be followed by personnel and teams, as well as the critical points to discuss before deploying a field hospital. However, to date, there is no formal standardized training program established for EMTs before deployment. Recognizing that the World Association of Disaster and Emergency Medicine (WADEM; Madison, Wisconsin USA) Congress brings together a diverse group of key stakeholders, a pre-Congress workshop was organized to seek out collective expertise and to identify key EMT training competencies for the future development of training programs and protocols. The future of EMT training should include standardization of curriculum and the recognition or accreditation of selected training programs. The outputs of this pre-WADEM Congress workshop provide an initial contribution to the EMT Training Working Group, as this group works on mapping training, competencies, and curriculum. Common EMT training themes that were identified as fundamental during the pre-Congress workshop include: the ability to adapt one’s professional skills to low-resource settings; context-specific training, including the ability to serve the needs of the affected population in natural disasters; training together as a multi-disciplinary EMT prior to deployment; and the value of simulation in training.AlbinaA, ArcherL, BoivinM, CranmerH, JohnsonK, KrishnarajG, ManeshiA, OddyL, Redwood-CampbellL, RussellR. International Emergency Medical Teams training workshop special report. Prehosp Disaster Med. 2018;33(3):335–338.
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Wang, Yiche, Hai Li, Yong Shi i Qian Yao. "A Study on Spatial Accessibility of the Urban Stadium Emergency Response under the Flood Disaster Scenario". Sustainability 14, nr 24 (19.12.2022): 17041. http://dx.doi.org/10.3390/su142417041.
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In the context of global climate change and the rapid development of the sports industry, increasingly frequent flooding has become a significant challenge for Chinese cities today and one of the hot issues in risk management for sports events. In order to reveal the impact of flooding on the spatial accessibility of emergency response to stadiums in the central urban area within the outer ring of Shanghai, this article evaluates the accessibility of medical emergency services in the central urban area under the impact of flooding based on flood scenario simulations and GIS network analysis. Results show that under the different flooding scenarios, as the intensity of flooding increases, urban road traffic in flood-prone areas is blocked by ponding, and some stadiums are inaccessible to emergency vehicles. The scope of emergency response services for some medical institutions along the Huangpu River is significantly reduced, while emergency response times for stadiums in the riverside area are delayed considerably. Some stadiums are unable to access emergency medical services. The study’s results can offer a case reference for upgrading the level of emergency management of stadiums under urban-scale flooding and optimizing the quality of regional medical emergency services.
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Levy, Kirsten, Richard V. Aghababian, Erwin F. Hirsch, Domenic Screnci, Anna Boshyan, Robert C. Ricks i Massoud Samiei. "An Internet-based Exercise as a Component of an Overall Training Program Addressing Medical Aspects of Radiation Emergency Management". Prehospital and Disaster Medicine 15, nr 2 (czerwiec 2000): 18–25. http://dx.doi.org/10.1017/s1049023x00025048.
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AbstractThe use of ionizing radiation and radioactive materials continues to increase worldwide in industry, medicine, agriculture, research, electrical power generation, and nuclear weaponry. The risk of terrorism using weapons of mass destruction or simple radiological devices also has increased, leading to heightened concerns. Radiation accidents occur as a consequence of errors in transportation ofradionuclides, use of radiation in medical diagnosis and therapy, industrial monitoring and sterilization procedures, and rarely, nuclear power generation. Compared to other industries, a small number of serious radiation accidents have occurred over the last six decades with recent cases in the Republic of Georgia, Peru, Japan, and Thailand. The medical, psychological, and political consequences of such accidents can be considerable. A number of programs designed to train medical responders in the techniques of radiation accident management have been developed and delivered in many countries. The low frequency of serious radiation accidents requires constant re-training, as skills are lost and medical staff turnover occurs. Not all of the training involves drills or exercises in which responders demonstrate learning or communication over the broad spectrum of medical response capabilities. Medical preparedness within the context of a total emergency response program is lacking in many parts of the world, particularly in Central and Eastern Europe and the Newly Independent States. This paper describes an effort to enhance medical preparedness in the context of a total program of international cooperation and conventions facilitated by the International Atomic Energy Agency. The paper concludes that novel application of telecommunications technology as part of a training activity in radiation accident preparedness can help address gaps in training in this field in which preparedness is essential but experience and practical field exercises are lacking.
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Al-Moteri, Modi, Abeer Abdulaziz Alfuraydi, Aliya Z. Alsawat, Riyadh Saleh Almulhis, Bashaer Salem Alnadwi, Hanan A. M. Youssef i Ensherah Saeed Althobiti. "Shared Situational Awareness within the Hospital Emergency Context: A Scoping Review". Healthcare 10, nr 8 (15.08.2022): 1542. http://dx.doi.org/10.3390/healthcare10081542.
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Background. Shared Situation Awareness (SSA) has been applied in many fields such as sport, the military and aviation with promising outcomes on team performance. The application of SSA within the hospital emergency healthcare context has not been explored yet. The aim of this scoping review is to explore and map literature related to shared situational awareness within the hospital emergency healthcare context. Methods. The Arksey and O’Malley (2005) framework was used in which three electronic databases were searched for evidence investigating SSA within a hospital emergency healthcare context. Results. A review of the literature showed a clear lack of evidence that directly investigates SSA within the context of hospital emergency care. In the emergency medical field, the term SSA is seldom used and ‘team situation awareness’ is the most frequently used term. The most common framework was the three-level framework. Two techniques were reported in the selected studies to investigate SSA (1) freeze probe technique and (2) observer-based rating technique. The freeze probe technique mandates a simulation or artificial environment, while the observer-based rating technique could be applied in an ecological as well as an artificial environment. There is no standardized technique to calculate the score of the SSA. Finally, there was a significant impact of SSA on clinical team performance as well as some related skills such as leadership, task management, mindfulness and task prioritization. Conclusions. Reviewing the literature revealed a lack of studies investigating the use of SSA within the context of hospital emergency care. There is also a lack of agreement on how a SSA score should be calculated. Further studies are required to overcome these issues.
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Lăcătuș, Anca Maria, Ioana Anisa Atudorei, Andrea Elena Neculau, Laura Mihaela Isop, Cristina Agnes Vecerdi, Liliana Rogozea i Mihai Văcaru. "Inappropriate Use of Emergency Services from the Perspective of Primary Care Underutilization in a Local Romanian Context: A Cross-Sectional Study". Healthcare 12, nr 7 (6.04.2024): 794. http://dx.doi.org/10.3390/healthcare12070794.
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Background: The underutilization of primary care services is a possible factor influencing inappropriate emergency service presentations. The objective of this study was to evaluate the proportion and characteristics of patients inappropriately accessing emergency room services from the perspective of primary care underutilization. Methods: This cross-sectional study included patients who visited the emergency room of a County Hospital, initially triaged with green, blue, or white codes, during a 2-week period in May 2017. Two primary care physicians performed a structured analysis to correlate the initial diagnosis in the emergency room with the final diagnosis to establish whether the patient’s medical complaints could have been resolved in primary care. Results: A total of 1269 adult patients were included in this study. In total, the medical problems of 71.7% of patients could have been resolved by a primary care physician using clinical skills, extended resources, or other ambulatory care and out-of-hours services. Conclusions: Low awareness of out-of-hours centers and a lack of resources for delivering more complex services in primary care can lead to inappropriate presentations to the emergency services. Future research on this topic needs to be conducted at the national level.
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Sayari, N., A. Maamri, O. Charaa, A. Hajri i H. Zalila. "Tunisian’s largest Psychiatric emergency department in the context of the COVID-19 lockdown". European Psychiatry 65, S1 (czerwiec 2022): S586. http://dx.doi.org/10.1192/j.eurpsy.2022.1502.
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Introduction General Lockdown was first declared in Tunisia from March 20th to May 4th 2020 to contain the spread of COVID19 pandemic, the last sanitary lockdown period was declared from July 12th to august 1st in 2021. Psychiatric emergency access and consultation has been affected by the confinement. RAZI Hospital Emergency Department (RHED) is the only emergency department in Tunisia specialized in psychiatry. Thus making it the most representative psychiatric emergency health care service in Tunisia. Objectives To assess changes in patients flow and admission rates in RHED in the context of the COVID-19 lockdown Methods We examined emergency room records and the hospital’s computer admission database during the first and the last COVID19 lockdowns and compared it to the same period of the previous year. Results The number of consultations was significantly lower in 2020 lockdown (N = 577) compared the same period in 2019 (N = 1525) (p<10−3). We observed a drop in RHED emergency hospitalization rate from 45.57% to 29.81% during this study period. The number of consultations per day was significantly lower during the first lockdown (N= 12.44) compared to the last lockdown (N=26.61) (p<10−3), the hospitalization rate rose from 29.81% during the first lockdown to 44.36% during the last. Conclusions Fear of COVID19 contamination and lockdown limitation had a huge impact on RHED visits and admissions. Medical team had to adjust in order to prevent further delay in acute psychiatric care. Disclosure No significant relationships.
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Baker, David. "Civilian Exposure to Toxic Agents: Emergency Medical Response". Prehospital and Disaster Medicine 19, nr 2 (czerwiec 2004): 174–78. http://dx.doi.org/10.1017/s1049023x00001709.
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AbstractCivilian populations are at risk from exposure to toxic materials as a result of accidental or deliberate exposure. In addition to industrial hazards, toxic agents designed for use in warfare now are a potential hazard in everyday life through terrorist action. Civil emergency medical responders should be able to adapt their plans for dealing with casualties from hazardous materials (HazMat) to deal with the new threat.Chemical and biological warfare (CBW) and HazMat agents can be viewed as a continuous spectrum. Each of these hazards is characterized by qualities of toxicity, latency of action, persistency, and transmissibility. The incident and medical responses to release of any agent is determined by these characteristics.Chemical and biological wardare agents usually are classified as weapons of mass destruction, but strictly, they are agents of mass injury. The relationship between mass injury and major loss of life depends very much on the protection, organization, and emergency care provided.Detection of a civil toxic agent release where signs and symptoms in casualties may be the first indicator of exposure is different from the military situation where intelligence information and tuned detection systems generally will be available.It is important that emergency medical care should be given in the context of a specific action plan. Within an organized and protected perimeter, triage and decontamination (if the agent is persistent) can proceed while emergency medical care is provided at the same time.The provision of advanced life support (TOXALS) in this zone by protected and trained medical responders now is technically feasible using specially designed ventilation equipment. Leaving life support until after decontamination may have fatal consequences. Casualties from terrorist attacks also may suffer physical as well as toxic trauma and the medical response also should be capable of dealing with mixed injuries.
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Сопуев, А. А., Т. Ж. Белеков, М. Э. Эрнисова, А. Т. Атакозиев i М. К. Ормонов. "Emergency surgery in the context of the COVID-19 pandemic". Scientific and practical journal Healthcare of Kyrgyzstan, nr 3 (22.08.2024): 68–73. http://dx.doi.org/10.51350/zdravkg2024.3.9.9.68.73.
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Введение. В период пандемии системы здравоохранения всего мира подверглись перестройке из за усиления инфекционного контроля, необходимости соблюдения определенных мер защиты пациентов и медицинского персонала. Многие стационары были развернуты для больных с пневмонией, и медицинский персонал был перераспределен на борьбу с новой инфекцией. Количество пациентов с коронавирусной инфекцией увеличивалось с каждым днем, однако это не влияло на частоту острых хирургических состояний пациентов, что увеличивало сложность оказания медицинской помощи в условиях сложившейся ситуации. Цель исследования. Изучить влияние пандемии COVID-19 на оказание экстренной хирургической помощи. Материалы и методы. Исследование проведено в отделении для больных с COVID-19 и острой хирургической патологией, развернутого на базе Национального хирургического центра им. М.М. Мамакеева - единственной красной зоны для хирургических больных по всей Республике. В период пандемии с 18 марта по 18 мая 2020 года и в тот же период предыдущего года ретроспективно просматривались истории болезни пациентов, перенесших экстренную операцию и получавших консервативное лечение в Национальном хирургическом центре им. Академика М.М. Мамакеева. Всего в исследование было включено 271 пациентов. Число прооперированных больных контрольной группы (n = 157) и основной группы (n = 114). Результаты и обсуждения. Во время пандемии COVID-19 страх людей заболеть сократил количество госпитализаций. В общей сложности 114 пациента были прооперированы в срочном порядке в течение 2-месячного периода в группе пандемии. За 2-месячный период того же периода 2019 года мы определили, что это число составило 157. При анализе подгрупп операций не было никакой статистической разницы в частоте пациентов, перенесших операцию по поводу желудочно кишечного кровотечения, мезентериальной ишемии и перфорации желудочно кишечного тракта между группами. Заключение. Результаты этого исследования могут быть полезны при определении пациентов, которых можно вести консервативно или амбулаторно в случае неотложной хирургической ситуации в эти и аналогичные периоды пандемии или в обычное время. Introduction. During the pandemic, health systems around the world underwent restructuring due to increased infection control, the need to comply with certain measures to protect patients and medical personnel. Many hospitals have been deployed for patients with pneumonia, and medical staff have been reassigned to fight the new infection. The number of patients with coronavirus infection increased every day, but this did not affect the frequency of acute surgical conditions of patients, which increased the complexity of providing medical care in the current situation. The purpose of the study. To study the impact of the COVID-19 pandemic on the provision of emergency surgical care. Materials and methods. The study was conducted in the department for patients with COVID-19 and acute surgical pathology, deployed on the basis of the M.M. Mamakeev National Surgical Center, the only red zone for surgical patients throughout the Republic. During the pandemic period from March 18 to May 18, 2020 and on that day. Results and discussions. During the COVID-19 pandemic, people's fear of getting sick reduced the number of hospitalizations. A total of 114 patients underwent urgent surgery during a 2-month period in the pandemic group. For a 2-month period of the same period in 2019, we determined that this number was 157. When analyzing the subgroups of operations, there was no statistical difference in the frequency of patients undergoing surgery for gastrointestinal bleeding, mesenteric ischemia and gastrointestinal perforation between the groups. Conclusion. The results of this study may be useful in identifying patients who can be treated conservatively or on an outpatient basis in case of an emergency surgical situation during these and similar periods of the pandemic or at normal times. Киришүү. Пандемия учурунда дүйнө жүзү боюнча саламаттыкты сактоо системалары инфекциялык көзөмөлдүн күчөшүнөн, бейтаптарды жана медициналык персоналды коргоонун айрым чараларын сактоо зарылдыгынан улам кайра түзүлдү. Пневмония менен ооруган бейтаптар үчүн көптөгөн стационарлар жайгаштырылып, медициналык кызматкерлер жаңы инфекция менен күрөшүүгө бөлүштүрүлдү. Коронавирустук инфекция менен ооругандардын саны күн сайын көбөйүп жатты, бирок бул бейтаптардын курч хирургиялык абалынын жыштыгына таасирин тийгизген жок, Бул түзүлгөн кырдаалда медициналык жардам көрсөтүүнүн татаалдыгын күчөттү. Изилдөөнүн максаты. Шашылыш хирургиялык жардам көрсөтүү боюнча пандемиялык-19 таасирин иликтөө. Материалдар жана методдор. Изилдөө Улуттук хирургия борборунун базасында жайгаштырылган COVID-19 жана курч хирургиялык патология менен ооругандар бөлүмүндө жүргүзүлдү. Пандемия учурунда, 2018-жылдын 18-мартынан 2020-майына чейин жана өткөн жылдын ошол эле мезгилинде, Улуттук хирургия борборунда шашылыш операция жасалган жана консервативдүү дарыланган бейтаптардын тарыхы ретроспективдүү түрдө каралды. Жалпысынан 271 бейтап изилдөөгө киргизилген. Контролдук топтогу операция жасалган оорулуулардын саны (157) жана негизги топ (114). Натыйжалар жана талкуулар. Пандемия учурунда серед-19 адамдардын ооруп калуудан коркуусу ооруканага жаткырууну азайтты. Пандемия тобунда жалпысынан 114 бейтапка 2 айлык мөөнөттө шашылыш операция жасалган. 2-жылдын ушул эле мезгилиндеги 2019 айдын ичинде биз бул санды 157 деп аныктадык. Операциялардын кичи топторун талдоодо, топтордун ортосунда ашказан ичеги канынан, мезентериялык ишемиядан жана ашказан ичеги тешилишинен операция жасалган бейтаптардын жыштыгында эч кандай статистикалык айырма болгон эмес. Жыйынтыгы. Бул изилдөөнүн натыйжалары ушул жана ушул сыяктуу пандемия мезгилинде же кадимки убакта хирургиялык өзгөчө кырдаалдарда консервативдик же амбулатордук жол менен башкарыла турган бейтаптарды аныктоодо пайдалуу болушу мүмкүн.
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Finnigan, Gerard. "Designing a Robust Methodology to Evaluate Emergency Health and Medical Responses to Disasters". Prehospital and Disaster Medicine 38, S1 (maj 2023): s93. http://dx.doi.org/10.1017/s1049023x23002613.
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Introduction:Health and medical disciplines have traditionally preferred experimental and quasi-experimental methods to evaluate interventions. More recently, mathematical modeling was used to test intervention efficacy in the SARS-CoV-2 pandemic. The challenge for disaster researchers is neither approach suits examining phenomena about emergency health responses in disasters. This study applied an alternative methodology to examine questions of how and why emergency health and medical responses reduced mortality during six different natural hazard disaster events.Method:The case study methodology is orientated by the researcher’s perspective and ‘not assigned a fixed ontological, epistemological or methodological position’. This flexibility allows alignment of the researcher’s worldview with the methodology best fitting the research problem and its context, such as post-positivism. Qualitative case study design carefully links five key design elements and sequences, including research questions, propositions, a unit of analysis, data collection, and data analysis.Results:Six holistic single case studies described how and why the emergency health response reduced mortality risk of people affected by different disasters. An evidenced-based theoretical emergency health program logic model compared and contrasted inputs, activities, outputs, and outcomes between theoretical and actual responses. Rival explanations were tested before data collection for each single case and applied to challenge the logic model. Each case applied four strategies to increase the validity and reliability of the holistic single case study findings.Conclusion:Qualitative case study methodology provides a robust and flexible framework to examine complex questions about emergency health and medical responses, including questions about events, processes, activities, performance, and outcomes. The methodology is equally suited to real-time or retrospective studies. The strength of the approach is the high compatibility for examining phenomena within the context they occur, and linking program logic, data collection, and data analysis methods to the specific question being investigated.
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McSwain, Norman E. "Medical Anti-Shock Trousers: Pneumatic Anti-Shock Garment: Does it Work?" Prehospital and Disaster Medicine 4, nr 1 (wrzesień 1989): 42–44. http://dx.doi.org/10.1017/s1049023x00038541.
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The use of the Pneumatic Anti-Shock Garment (PASG) has created much controversy in prehospital care. It is interesting that such an inexpensive device and technique has created so much controversy regarding effectiveness when expensive devices and techniques, such as coronary artery bypass, carotid endarteroectomy, and laser angioplasty have been questioned as to effectiveness, but have not created as much controversy.Where do we stand on the PASG today? One well-done, randomized, prospective study has been reported as several different papers. In reality, these reports originate from only one study (1-5). This is compared to more than 200 other studies, many of which have been randomized, prospective studies in animals using the same quality as the randomized, prospective study done on humans. Such studies have the advantage of having better isolation of the specific condition being studied. It does not seem appropriate to base the clinical use or non-use on just one study. All studies should be reviewed and placed in context when attempting to identify the role the PASG has in patient care.
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Dhakal, Ajaya Kumar. "Nepalese context: Should physician treat themselves and their family members?" Journal of Kathmandu Medical College 3, nr 4 (16.09.2015): 174–76. http://dx.doi.org/10.3126/jkmc.v3i4.13379.
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Physicians are individuals with families and friends and it is their duty as well as moral and social obligation to look after their friends and relatives when they become sick. But what should be their role in looking after one’s own sick family members or friends? As far as it is not as a treating physician there should be no problem but if physicians are to take responsibility of treating their family members as a physician, a number of ethical issues arise. Medical advice and medical treatment of family members is a subject of debate. The current codes of ethics of in many countries advise physicians not to treat their family members except in emergency situations and for minor illnesses. What should Nepalese physicians do?Journal of Kathmandu Medical CollegeVol. 3, No. 4, Oct.-Dec., 2014Page: 174-176
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Berger, Israel, Celia Kitzinger i Sonja J. Ellis. "Using a category to accomplish resistance in the context of an emergency call". Pragmatics. Quarterly Publication of the International Pragmatics Association (IPrA) 26, nr 4 (1.12.2016): 563–82. http://dx.doi.org/10.1075/prag.26.4.02ber.
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We report a single case analysis of a recorded emergency call with particular reference to the use of the non-recognitional categorical person reference ‘a personal doctor’ in the sequential context created by the Medical Priority Dispatch System (MPDS) protocol routinely used by the emergency services. We describe both the position and the composition of the turn in which this categorical person reference is deployed in order to analyse the action accomplished by its selection. We show how this category reference is selected to support the action in which the speaker is otherwise engaged, which is to resist the sequential trajectory proposed by his interlocutor (giving instructions for cardiopulmonary resuscitation). Our analysis makes two key contributions: 1) it provides a concrete detailed exemplar of how analysts can ground claims about category-bound inferences in the empirical practices of talk in interaction and 2) it extends existing work on emergency calls by relating their sequential structure to the MPDS protocol.
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Morse, Kiriana A., Kamna S. Balhara, Nathan A. Irvin i Matthew J. Levy. "The Health Humanities and Emergency Medical Services (EMS): A Call to Action". Prehospital and Disaster Medicine 37, nr 2 (17.02.2022): 150–51. http://dx.doi.org/10.1017/s1049023x22000243.
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AbstractIn the context of an on-going global pandemic that has demanded increasingly more of our Emergency Medical Services (EMS) clinicians, the health humanities can function to aid in educational training, promoting resilience and wellness, and allowing opportunity for self-expression to help prevent vicarious trauma.As the social, cultural, and political landscape of the United States continues to require an expanded scope of practice from our EMS clinicians, it is critical that the health humanities are implemented as not only part of EMS training, but also as part of continued practice in order to ensure the highest quality patient-centered care while protecting the longevity and resilience of EMS clinicians.
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Hugelius, Karin. "Consular Crisis Management Operations: Special Considerations and Challenges". Prehospital and Disaster Medicine 35, nr 4 (29.05.2020): 447–50. http://dx.doi.org/10.1017/s1049023x20000655.
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AbstractAssisting the increasing number of tourists and foreign nationals exposed to crises situations in third countries—many of them far from home and extremely vulnerable—presents significant challenges. Despite the need to explore consular crisis management from an operational perspective, there are few studies that address the issue. This paper aims to describe the characteristics and context of consular crisis management operations based on personal experiences, scientific papers, grey literature, and key informant interviews.Consular crisis management operations are conducted in a context where the stakeholders and the legal environment may differ from humanitarian or civil protection operations. The physical distance causes logistical challenges and demands specific considerations for both civilian and medical evacuation. Consular crisis management operations often include medical care, psychosocial support activities, and disaster victim identification (DVI) activities. Political and media interest may also add significant challenges to such operations. Therefore, specific knowledge, skills, and preparations are needed for both diplomatic crisis management professionals and health professionals. Further research on consular crisis management activities—as well as the concept of consular crisis management itself—is strongly needed.
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Samidov, Anar. "Application of cyber-physical geosystems in Healthcare 4.0 environment: challenges, opportunities and perspectives". Problems of Information Society 15, nr 2 (2.07.2024): 88–93. http://dx.doi.org/10.25045/jpis.v15.i2.10.
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In modern times, the use of information technologies in the automation of emergency medical care processes is of great importance. This study offers the application of cyber-physical geosystems to optimize and improve emergency medical care processes using geospatial information. Moreover, it presents the methodology of creating cyber-physical geosystems including the collection, analysis, monitoring and integration of geospatial data into medical information systems and the application of telemedicine. The main goal of cyber-physical geosystems is to increase the efficiency of patient care in emergency situations. Real-time monitoring of the patient in the ambulance by a doctor-expert is very important during the transportation of the patient from the scene of the incident or from the medical institution to the hospital equipped with modern equipment. Consequently, medical experts can give emergency doctors important instructions about the patient in time. This results in a reduction in response time in emergency situations and an improvement in the quality of medical care. This article discusses the importance, limitations, and advantages of using the technologies of cyber-physical geosystems in the context of modern emergency medical care. Correspondingly, it analyzes the advantages and limitations of the system, its expansion and improvement methods. The results of this study highlight the successful implementation of cyber-physical geosystems (CPGS) in different regions. In this regard, it recommends the necessity of joint cooperation with the state and medical institutions.