A Mobile Prototype for Clinical Emergency Calls

A doctor often has to independently make decisions for the therapy or treatment of patients, such as during clinical emergency calls, some of the most challenging tasks for a doctor. Only if a doctor has highly sophisticated "professional knowledge" and rich "diagnosis and treatment experiences", can he or she be competent for these tasks. Therefore, the inheritance of experience from clinical emergency calls is an important connection in the formative education of doctors. The most traditional formative education of doctors is to have students simulate the diagnosis and treatment modes of their teachers, or carry handbooks containing clinical summaries to perform a diagnosis with them as guidelines. However, this temporary approach of finding answers in books is not only time-consuming, but also detrimental to the confidence of the patients in their doctors. Our research involves the aforementioned clinical practices: clinical emergency calls and doctor formative education. We use ophthalmology as an example and utilize the back-propagation algorithm of the artificial neural networks, to construct an approximate decision model of medical record to guide clinical diagnosis. The doctor can input information such as chief complaint, minor complaints, diagnosis, etc. into the decision model. Correct ophthalmologic approximation medical records are created by referencing diagnosis and treatment to improve the quality of medical treatment and medical care.

Download Full-text

Clinical Emergency Radiology

10.1017/cbo9780511551734 ◽

2008 ◽

Cited By ~ 2

Keyword(s):

Emergency Radiology ◽

Clinical Emergency

Download Full-text

Non Emergency Calls-Depression Coupling in Call Handlers of Rescue 1122 Punjab, Pakistan

Pakistan Journal of Psychological Research ◽

10.33824/pjpr.2019.34.1.3 ◽

2019 ◽

Vol 34 (Spring 2019) ◽

pp. 43-55

Author(s):

Syed Kamal Abid ◽

Mujahid Hussain ◽

Muhammad Raza ◽

Rizwan-ul Haq ◽

Rizwan Naseer ◽

...

Keyword(s):

Occupational Stress ◽

Independent Predictor ◽

Depression Score ◽

Demographic Variables ◽

Workplace Stress ◽

Control Group ◽

Control Room ◽

Emergency Calls ◽

And Control ◽

Evening Shift

The study was conducted to know whether bulk inflow of Non Emergency Calls (NECs) acts as an independent predictor for depression in call handlers of Rescue 1122, Punjab, Pakistan. Forty five (45) call handlers were recruited from evening shift of 9 districts. Similarly, same-sized control group was made out of field rescuers. The groups were compared for rate and severity level of depression using Beck’s Depression Inventory-II (BDI-II; Beck, Steer, & Brown, 1996). Probable predictors (except workplace stress) for depression in call handlers were evaluated through risk estimates. For workplace stress, a purposefully developed close- ended Workplace Stress Questionnaire including two subscales i.e. Non Emergency call and Control Room Environment of 30 items each was administrated. Twenty nine (64.4%) subjects of study group reported depression on BDI. Consequently, the same group had significantly higher mean depression score than control (18.2 vs. 12.6; p = .00). The scores also showed insignificant association with any of the probable predictors (demographic variables) of the call attendees. The respondents perceived more occupational stress against NECs. The findings attract the attention of authorities towards the severity of the concern.

Download Full-text

Medical dispatchers’ perception of the interaction with the caller during emergency calls - a qualitative study

Scandinavian Journal of Trauma Resuscitation and Emergency Medicine ◽

10.1186/s13049-021-00860-y ◽

2021 ◽

Vol 29 (1) ◽

Author(s):

Thea Palsgaard Møller ◽

Hejdi Gamst Jensen ◽

Søren Viereck ◽

Freddy Lippert ◽

Doris Østergaaard

Keyword(s):

Public Awareness ◽

Emergency Call ◽

Awareness Campaigns ◽

Emergency Calls ◽

Modifiable Factors ◽

Qualitative Interview Study ◽

Call Process ◽

Complex Procedure ◽

Call Handling ◽

Emergency Medical Dispatchers

Abstract Background Medical dispatching is a highly complex procedure and has an impact upon patient outcome. It includes call-taking and triage, prioritization of resources and the provision of guidance and instructions to callers. Whilst emergency medical dispatchers play a key role in the process, their perception of the process is rarely reported. We explored medical dispatchers’ perception of the interaction with the caller during emergency calls. Secondly, we aimed to develop a model for emergency call handling based on these findings. Methods To provide an in-depth understanding of the dispatching process, an explorative qualitative interview study was designed. A grounded theory design and thematic analysis were applied. Results A total of 5 paramedics and 6 registered nurses were interviewed. The emerging themes derived from dispatchers’ perception of the emergency call process were related to both the callers and the medical dispatchers themselves, from which four and three themes were identified, respectively. Dispatchers reported that for callers, the motive for calling, the situation, the perception and presentation of the problem was influencing factors. For the dispatchers the expertise, teamwork and organization influenced the process. Based on the medical dispatchers´ perception, a model of the workflow and interaction between the caller and the dispatcher was developed based on themes related to the caller and the dispatcher. Conclusions According to medical dispatchers, the callers seem to lack knowledge about best utilization of the emergency number and the medical dispatching process, which can be improved by public awareness campaigns and incorporating information into first aid courses. For medical dispatchers the most potent modifiable factors were based upon the continuous professional development of the medical dispatchers and the system that supports them. The model of call handling underlines the complexity of medical dispatching that embraces the context of the call beyond clinical presentation of the problem.

Download Full-text

Emergency physician’s dispatch by a paramedic-staffed emergency medical communication centre: sensitivity, specificity and search for a reference standard

Scandinavian Journal of Trauma Resuscitation and Emergency Medicine ◽

10.1186/s13049-021-00844-y ◽

2021 ◽

Vol 29 (1) ◽

Author(s):

Victor Nathan Chappuis ◽

Hélène Deham ◽

Philippe Cottet ◽

Birgit Andrea Gartner ◽

François Pierre Sarasin ◽

...

Keyword(s):

Reference Standard ◽

Medical Systems ◽

Operating Characteristics ◽

First Line ◽

Emergency Calls ◽

Emergency Medical ◽

Dispatch Centre ◽

Second Tier ◽

Low Sensitivity ◽

Level Of Risk

Abstract Background Some emergency medical systems (EMS) use a dispatch centre where nurses or paramedics assess emergency calls and dispatch ambulances. Paramedics may also provide the first tier of care “in the field”, with the second tier being an Emergency Physician (EP). In these systems, the appropriateness of the decision to dispatch an EP to the first line at the same time as the ambulance has not often been measured. The main objective of this study was to compare dispatching an EP as part of the first line emergency service with the severity of the patient’s condition. The secondary objective was to highlight the need for a recognized reference standard to compare performance analyses across EMS. Methods This prospective observational study included all emergency calls received in Geneva’s dispatch centre between January 1st, 2016 and June 30th, 2019. Emergency medical dispatchers (EMD) assigned a level of risk to patients at the time of the initial call. Only the highest level of risk led to the dispatch of an EP. The severity of the patient’s condition observed in the field was measured using the National Advisory Committee for Aeronautics (NACA) scale. Two reference standards were proposed by dichotomizing the NACA scale. The first compared NACA≥4 with other conditions and the second compared NACA≥5 with other conditions. The level of risk identified during the initial call was then compared to the dichotomized NACA scales. Results 97′861 assessments were included. Overall prevalence of sending an EP as first line was 13.11, 95% CI [12.90–13.32], and second line was 2.94, 95% CI [2.84–3.05]. Including NACA≥4, prevalence was 21.41, 95% CI [21.15–21.67], sensitivity was 36.2, 95% CI [35.5–36.9] and specificity 93.2 95% CI [93–93.4]. The Area Under the Receiver-Operating Characteristics curve (AUROC) of 0.7507, 95% CI [0.74734–0.75397] was acceptable. Looking NACA≥5, prevalence was 3.09, 95% CI [2.98–3.20], sensitivity was 64.4, 95% CI [62.7–66.1] and specificity 88.5, 95% CI [88.3–88.7]. We found an excellent AUROC of 0.8229, 95% CI [0.81623–0.82950]. Conclusion The assessment by Geneva’s EMD has good specificity but low sensitivity for sending EPs. The dichotomy between immediate life-threatening and other emergencies could be a valid reference standard for future studies to measure the EP’s dispatching performance.

Download Full-text

Increased Emergency Calls during the COVID-19 Pandemic in Saudi Arabia: A National Retrospective Study

Healthcare ◽

10.3390/healthcare9010014 ◽

2020 ◽

Vol 9 (1) ◽

pp. 14

Author(s):

Ahmed Al-Wathinani ◽

Attila J. Hertelendy ◽

Sultana Alhurishi ◽

Abdulmajeed Mobrad ◽

Riyadh Alhazmi ◽

...

Keyword(s):

Saudi Arabia ◽

Retrospective Study ◽

Emergency Medical Services ◽

Indirect Effect ◽

Mobile Application ◽

Healthcare Systems ◽

Emergency Calls ◽

The World ◽

Staffing Patterns ◽

The Impact

The coronavirus 2019 (COVID-19) pandemic has a direct and indirect effect on the different healthcare systems around the world. In this study, we aim to describe the impact on the utilization of emergency medical services (EMS) in Saudi Arabia during the COVID-19 pandemic. We studied cumulative data from emergency calls collected from the SRCA. Data were separated into three periods: before COVID-19 (1 January–29 February 2020), during COVID-19 (1 March–23 April 2020), and during the Holy Month of Ramadan (24 April–23 May 2020). A marked increase of cases was handled during the COVID-19 period compared to the number before pandemic. Increases in all types of cases, except for those related to trauma, occurred during COVID-19, with all regions experiencing increased call volumes during COVID-19 compared with before pandemic. Demand for EMS significantly increased throughout Saudi Arabia during the pandemic period. Use of the mobile application ASAFNY to request an ambulance almost doubled during the pandemic but remained a small fraction of total calls. Altered weekly call patterns and increased call volume during the pandemic indicated not only a need for increased staff but an alteration in staffing patterns.

Download Full-text

Training of emergency calls in BLS courses for laypersons

Resuscitation ◽

10.1016/j.resuscitation.2012.08.279 ◽

2012 ◽

Vol 83 ◽

pp. e108

Author(s):

Patrick Wagner ◽

Jan Breckwoldt

Keyword(s):

Emergency Calls

Download Full-text

The necessity of machine learning in clinical emergency medicine; a narrative review of the current literature

Materials Today Proceedings ◽

10.1016/j.matpr.2021.11.406 ◽

2021 ◽

Author(s):

Ratchana Rajendran ◽

Bhagyalaxmi Singirikonda ◽

Navpreet ◽

Neetu Jain ◽

Mohd Naved ◽

...

Keyword(s):

Machine Learning ◽

Emergency Medicine ◽

Current Literature ◽

Narrative Review ◽

Clinical Emergency

Download Full-text

Deep dissecting haematoma in patients with dermatoporosis: implications for home nursing

British Journal of Community Nursing ◽

10.12968/bjcn.2021.26.sup3.s6 ◽

2021 ◽

Vol 26 (Sup3) ◽

pp. S6-S13

Author(s):

Valentina Vanzi ◽

Elena Toma

Keyword(s):

Wound Healing ◽

Emergency Management ◽

Lower Limb ◽

Essential Role ◽

Early Recognition ◽

Wound Management ◽

Home Nursing ◽

High Prevalence ◽

Clinical Emergency

Dermatoporosis is a chronic cutaneous insufficiency/fragility syndrome with a high prevalence in older adults. Dermatoporotic skin becomes thin and fragile and tends to tear. It may lead to deep dissecting haematomas (DDHs) as a final stage of dermatoporosis, which is a clinical emergency. Management can be challenging, as patients with lower-limb haematomas are frequently older and affected by multiple comorbidities, or are probably on medications that negatively influence wound healing. This article describes the essential role of nurses in prevention, early recognition and wound management of DDHs in patients with dermatoporosis.

Download Full-text

Use of medical emergency call data as a marker of quality of emergency department care in the post-National Emergency Access Target era

Australian Health Review ◽

10.1071/ah17089 ◽

2018 ◽

Vol 42 (5) ◽

pp. 607

Author(s):

Lorraine Westacott ◽

Judy Graves ◽

Mohsina Khatun ◽

John Burke

Keyword(s):

Emergency Department ◽

Patient Safety ◽

Quality Of Care ◽

Emergency Admission ◽

Emergency Call ◽

Medical Emergency ◽

Negative Consequences ◽

Model Of Care ◽

Emergency Calls

Objectives Any new model of care should always be accompanied by rigorous monitoring to ensure that there are no negative consequences, especially any that impact upon patient safety. In 2013, ‘THERMoSTAT’ (Two- Hour Evaluation and Referral Model for Shorter Turnaround Times), an emergency department model of care developed by Royal Brisbane and Women’s Hospital staff was launched to gain efficiencies and improve hospital National Emergency Access Target (NEAT) compliance. The aim of this study was to trial the use of medical emergency call data as a novel marker of the quality of care delivered by our emergency department. Methods Incidence of medical emergency calls for hospital emergency admission patients for the 2 years pre- and 1 year post-THERMoSTAT were compared after standardising for overall hospital activity. Results During the study period, hospital activity increased 10%, and the emergency department experienced a total of 222 645 presentations, 68 000 (30.5%) of which converted into an admission. THERMoSTAT improved NEAT compliance by 17% (from 57.7% to 74.9%) with no change in any patient-safety indicators. A total of 8432 medical emergency calls were made on 5930 patients, 2831 of whom were emergency admissions. After adjusting for hospital activity, there was no change in the average number of patients per week who triggered a medical emergency call after the introduction of THERMoSTAT. These results were reproduced when data was analysed for: total number of inpatients triggering calls; emergency admission patients; and emergency admission patients within the first 24 h or first 4 h of admission. Conclusions This is the first report to investigate the correlation between inpatient medical emergency call incidence and emergency department model of care. Medical emergency call data showed significant promise as a measure of morbidity and as a more direct, objective, simple, quantitative and meaningful measure of patient safety. What is known about the topic? It is well established that extended emergency department lengths of stay are associated with poorer patient outcomes. The corollary of this is not always true however; shorter emergency department length of stay does not automatically translate into better care. Although the underlying philosophy of NEAT is to enhance patient care, there is a risk of negative consequences if NEAT is seen as an end in itself. Many of the commonly used emergency department key performance indicators focus on the timeliness of care and there is a scarcity of easily quantifiable markers that reliably reflect the quality of that care. What does this paper add? This study builds on the concept of medical emergency call incidence as a marker of safety and quality. It explores the utility of using the number of medical emergency calls made in the first few hours of an emergency admission as an indicator of the quality of care delivered by the emergency department. This is significant because it introduces a measure that has a focus that embraces more than the timeliness of care only. What are the implications for practitioners? If medical emergency call incidence in early emergency admissions can be proven to accurately reflect emergency department quality of care then it would provide an easily monitored, objective, quantitative and prompt measure that evaluates dimensions other than timeliness.

Download Full-text