scholarly journals Coordination of Emergency Medical Services for a Major Road Traffic Accident on a Swiss Suburban Highway

2009 ◽  
Vol 35 (3) ◽  
pp. 265-270 ◽  
Author(s):  
Fabrice Dami ◽  
Vincent Fuchs ◽  
Etienne Péclard ◽  
Mathieu Potin ◽  
Laurent Vallotton ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Road Traffic Accident ◽  
Traffic Accident ◽  
Road Traffic ◽  
Medical Services ◽  
Major Road ◽  
Emergency Medical

scholarly journals Strengthening the Capacity of Emergency Medical Services in Low and Middle Income Countries using Dispatcher-Coordinated Taxis

2020 ◽  
Vol 2674 (9) ◽  
pp. 338-345
Author(s):  
Vipul Mishra ◽  
Richa Ahuja ◽  
N. Nezamuddin ◽  
Geetam Tiwari ◽  
Kavi Bhalla
Keyword(s):  
Response Time ◽  
Emergency Medical Services ◽  
Road Traffic ◽  
International Standards ◽  
Medical Services ◽  
Road Traffic Crash ◽  
Middle Income ◽  
Middle Income Countries ◽  
Emergency Medical ◽  
Low And Middle Income

International standards recommend provision of one ambulance for every 50,000 people to fulfill demand for transporting patients to definitive care facilities in low and middle income countries (LMICs). Governments’ consistent attempt to build capacity of emergency medical services (EMS) in LMICs has been financially demanding. This study is an attempt to assess the feasibility of capacity building of existing EMS in Delhi, India by using taxis as an alternative mode of transport for emergency transportation of road traffic crash victims to enable improvement in response time for road traffic crashes where time criticality is deemed important. Performance of the proposed system is evaluated based on response time, coverage and distance. The system models the performance and quantifies the taxi–ambulance configuration for achieving EMS performance within international standards.

scholarly journals Helicopter and ground emergency medical services transportation to hospital after major trauma in England: a comparative cohort study

2020 ◽  
Vol 5 (1) ◽  
pp. e000508 ◽  
Author(s):  
Oliver Beaumont ◽  
Fiona Lecky ◽  
Omar Bouamra ◽  
Dhushy Surendra Kumar ◽  
Tim Coats ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Emergency Medical Services ◽  
Major Trauma ◽  
Road Traffic ◽  
Cohort Analysis ◽  
Primary Outcome Measure ◽  
Research Network ◽  
Medical Services ◽  
Emergency Medical ◽  
The Uk

BackgroundThe utilization of helicopter emergency medical services (HEMS) in modern trauma systems has been a source of debate for many years. This study set to establish the true impact of HEMS in England on survival for patients with major trauma.MethodsA comparative cohort design using prospectively recorded data from the UK Trauma Audit and Research Network registry. 279 107 patients were identified between January 2012 and March 2017. The primary outcome measure was risk adjusted in-hospital mortality within propensity score matched cohorts using logistic regression analysis. Subset analyses were performed for subjects with prehospital Glasgow Coma Scale <8, respiratory rate <10 or >29 and systolic blood pressure <90.ResultsThe analysis was based on 61 733 adult patients directly admitted to major trauma centers: 54 185 ground emergency medical services (GEMS) and 7548 HEMS. HEMS patients were more likely male, younger, more severely injured, more likely to be victims of road traffic collisions and intubated at scene. Crude mortality was higher for HEMS patients. Logistic regression demonstrated a 15% reduction in the risk adjusted odds of death (OR=0.846; 95% CI 0.684 to 1.046) in favor of HEMS. When analyzed for patients previously noted to benefit most from HEMS, the odds of death were reduced further but remained statistically consistent with no effect. Sensitivity analysis on 5685 patients attended by a doctor on scene but transported by GEMS demonstrated a protective effect on mortality versus the standard GEMS response (OR 0.77; 95% CI 0.62 to 0.95).DiscussionThis prospective, level 3 cohort analysis demonstrates a non-significant survival advantage for patients transported by HEMS versus GEMS. Despite the large size of the cohort, the intrinsic mismatch in patient demographics limits the ability to statistically assess HEMS true benefit. It does, however, demonstrate an improved survival for patients attended by doctors on scene in addition to the GEMS response. Improvements in prehospital data and increased trauma unit reporting are required to accurately assess HEMS clinical and cost-effectiveness.

Prehospital Trauma System Reduces Mortality in Severe Trauma: A Controlled Study of Road Traffic Casualties in Iraq

2012 ◽  
Vol 27 (1) ◽  
pp. 36-41 ◽  
Author(s):  
Mudhafar Karim Murad ◽  
Dara B. Issa ◽  
Farhad M. Mustafa ◽  
Hlwa O. Hassan ◽  
Hans Husum
Keyword(s):  
Treatment Group ◽  
Emergency Medical Services ◽  
Road Traffic Accident ◽  
Traffic Accident ◽  
Road Traffic ◽  
Prehospital Care ◽  
Trauma System ◽  
Controlled Study ◽  
Control Group ◽  
Trauma Mortality

AbstractIntroduction: In low-resource communities with long prehospital transport times, most trauma deaths occur outside the hospital. Previous studies from Iraq demonstrate that a two-tier network of rural paramedics with village-based first helpers reduces mortality in land mine and war-injured from 40% to 10%. However, these studies of prehospital trauma care in low-income countries have been conducted with historical controls, thus the results may be unreliable due to differences in study contexts. The aim of this study was to use a controlled study design to examine the effect of a two-tier prehospital rural trauma system on road traffic accident trauma mortality.Methods: A single referral surgical hospital was the endpoint in a single-blinded, non-randomized cohort study. The catchment areas consisted of some districts with no formal Emergency Medical Services (EMS) system, and other districts where 95 health center paramedics had been trained and equipped to provide advanced life support, and 5,000 laypersons had been trained to give on-site first aid. The hospital staff registered trauma mortality and on-admission physiological severity blindly. Assuming that prehospital care would have no significant impact on mortality in moderate injuries, only road traffic accident (RTA) casualties with an Injury Severity Score (ISS) ≥9 were selected for study.Results: During a three-month study period, 205 patients were selected for study (128 in the treatment group and 77 in the control group). The mean prehospital transit time was approximately two hours. The two groups were comparable with regards to demographic characteristics, distribution of wounds and injuries, and mean anatomical severity. The mortality rate was eight percent in the treatment group, compared to 44% in the control group (95% CI, 25%–48%). Adjusted for severity differences between the treatment and control groups, prehospital care was a significant contributor to survival.Conclusion: Where prehospital transport time is long, a two-tier prehospital system of trained paramedics and layperson first responders reduces trauma mortality in severe RTA injuries. The findings may be valid for civilian Emergency Medical Services interventions in other low-resource countries.

scholarly journals Dispatch accuracy of physician-staffed emergency medical services in trauma care in south-east Norway: a retrospective observational study

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Martin Samdal ◽  
Kjetil Thorsen ◽  
Ola Græsli ◽  
Mårten Sandberg ◽  
Marius Rehn
Keyword(s):  
Emergency Medical Services ◽  
Trauma Care ◽  
Injury Severity ◽  
Road Traffic ◽  
Medical Services ◽  
Data Systems ◽  
Hospital Data ◽  
Accurate Identification ◽  
Emergency Medical ◽  
Patient Pathways

Abstract Background Selection of incidents and accurate identification of patients that require assistance from physician-staffed emergency medical services (P-EMS) remain essential. We aimed to evaluate P-EMS availability, the underlying criteria for dispatch, and the corresponding dispatch accuracy of trauma care in south-east Norway in 2015, to identify areas for improvement. Methods Pre-hospital data from emergency medical coordination centres and P-EMS medical databases were linked with data from the Norwegian Trauma Registry (NTR). Based on a set of conditions (injury severity, interventions performed, level of consciousness, incident category), trauma incidents were defined as complex, warranting P-EMS assistance, or non-complex. Incident complexity and P-EMS involvement were the main determinants when assessing the triage accuracy. Undertriage was adjusted for P-EMS availability and response and transport times. Results Among 19,028 trauma incidents, P-EMS were involved in 2506 (13.2%). The range of overtriage was 74–80% and the range of undertriage was 20–32%. P-EMS readiness in the event of complex incidents ranged from 58 to 70%. The most frequent dispatch criterion was “Police/fire brigade request immediate response” recorded in 4321 (22.7%) of the incidents. Criteria from the groups “Accidents” and “Road traffic accidents” were recorded in 10,875 (57.2%) incidents, and criteria from the groups “Transport reservations” and “Unidentified problem” in 6025 (31,7%) incidents. Among 4916 patient pathways in the NTR, 681 (13.9%) could not be matched with pre-hospital data records. Conclusions Both P-EMS availability and dispatch accuracy remain suboptimal in trauma care in south-east Norway. Dispatch criteria are too vague to facilitate accurate P-EMS dispatch, and pre-hospital data is inconsistent and insufficient to provide basic data for scientific research. Future dispatch criteria should focus on the care aspect of P-EMS. Better tools for both dispatch and incident handling for the emergency medical coordination centres are essential. In general, coordination, standardisation, and integration of existing data systems should enhance the quality of trauma care and increase patient safety.

scholarly journals Study on patient satisfaction among patients with trauma admitted to trauma centre and emergency medical services ward

2019 ◽  
Vol 6 (4) ◽  
pp. 1219
Author(s):  
Mrutyunjay I. Uppin ◽  
Kapildev K. Hannurkar ◽  
Archana M. Uppin
Keyword(s):  
Patient Satisfaction ◽  
Emergency Medical Services ◽  
Trauma Center ◽  
Road Traffic ◽  
Trauma Centre ◽  
Medical Services ◽  
Research Centre ◽  
Trauma Patients ◽  
Quality Health Care ◽  
Emergency Medical

Background: Patient satisfaction is an important key factor for determining the quality health care and services offered by the emergency departments in the hospital. The objectives of the study were to assess the satisfaction of the trauma patients attending the trauma center with the services provided by the KLES Dr. Prabhakar Kore Hospital and Research Centre, Belagavi, Karnataka.Methods: Fifty trauma patients admitted and treated in trauma center and emergency medical services ward (TCEMS) at KLES Dr. Prabhakar Kore Hospital and Research Centre, Belagavi, over a period of 3 months (from November 2014 till January 2015) were interviewed. After obtaining an informed consent, the required data was collected using a pre-designed and pre-tested questionnaire.Results: Out of the 50 patients interviewed, 86% were males and 14% were females. Out of them 74% were road traffic accident victims. 67.5% of these victims were between the age group of 21 and 50 yrs. The overall satisfaction was good with all the services provided at the center. 80% were satisfied with the care provided by the doctors, 80% with communication by doctors, more than 75% with accessory services, more than 65% with the wait times at various levels and more than 85% satisfaction with amenities in the ward.Conclusions: In conclusion our study revealed that the availability of consultant in triage area, improvements in communication, quick service at the Casualty Pharmacy, reducing the perceived waiting times at various levels and improvement in the ambience of the unit would further enhance the patient satisfaction with TCEMS.

scholarly journals Implementation of Ambulance Hotspot Strategy in Reducing Ambulance Response Time

2020 ◽  
pp. 3
Author(s):  
Su Na Chin ◽  
Phee Kheng Cheah ◽  
Muhamad Yaakub Arifin ◽  
Hui Shan Kang ◽  
Zaturrawiah A Omar ◽  
...  
Keyword(s):  
Response Time ◽  
Emergency Medical Services ◽  
Traffic Congestion ◽  
Road Traffic ◽  
Mortality Rates ◽  
Medical Services ◽  
Congested Traffic ◽  
Emergency Medical ◽  
Road Traffic Congestion

Introduction: Ambulance response time (ART) has an inseparable relationship with mortality rates and therefore is important to be reduced. However, an unprecedented increase in road traffic congestion has led to longer ART, especially during peak hours. To reduce ART despite congested traffic, a pre-dispatched ambulance is deployed at hotspot locations during peak hours. This study aims to determine if the hotspot strategy is able to reduce ART in an Urban Emergency Medical Services system.

scholarly journals Risk Mapping of Road Traffic Incidents in Greater Kampala Metropolitan Area for Planning of Emergency Medical Services

2019 ◽  
Vol 34 (s1) ◽  
pp. s165-s165
Author(s):  
Joseph Kimuli Balikuddembe
Keyword(s):  
Emergency Medical Services ◽  
Metropolitan Area ◽  
Road Traffic ◽  
Methodological Approach ◽  
Risk Mapping ◽  
Medical Services ◽  
Delphi Panel ◽  
Cross Sectional ◽  
Traffic Incidents ◽  
Emergency Medical

Introduction:Compared to high-income countries, low and middle-income countries (LMICs) bear the heaviest brunt of road traffic incidents (RTIs), which is a serious public health and development burden. Like other LMICs, Uganda has been experiencing a worryingly high burden of RTIs and their associated impacts with the highest number of all the total registered RTIs in Uganda registered in the Greater Kampala Metropolitan Area (GKMA). This places a tremendous demand on the few existing emergency medical services (EMS) to adequately respond to those affected.Aim:To aid in better planning of EMS for the victims of RTIs by using risk mapping of RTIs in the GKMA.Methods:A mixed methodological approach involving a systematic review, Delphi panel technique, retrospective data analysis, and a cross-sectional method.Results:With Uganda progressing forward as envisaged in its “Vision 2040,” the GKMA, which is the country’s political and socioeconomic epicenter, is experiencing significant changes in terms of population growth. This has significantly increased RTIs, which puts pressure on the pre-hospital emergency care for those affected unless necessary actions are taken.Discussion:Therefore, the road safety vis-à-vis injury prevention measures, which are needed to reduce the burden of RTIs, should be multifaceted in nature so that they closely correlate with the ongoing dynamics that cause them, particularly in the GKMA which experiences the highest number of RTIs and Uganda as a whole. The WHO “Safe System Approach” is desirable for this purpose as it represents the most appropriate approach because it is broad enough to comprehensively manage any of the ongoing dynamics (political, socio-cultural or economical) that are known to contribute to RTIs.

Sign in / Sign up

Export Citation Format

Share Document