scholarly journals A review on initiatives for the management of daily medical emergencies prior to the arrival of emergency medical services

2021 ◽  
Author(s):  
Niki Matinrad ◽  
Melanie Reuter-Oppermann
Keyword(s):  
Emergency Medical Services ◽  
Emergency Services ◽  
Response Times ◽  
Medical Emergency ◽  
Medical Services ◽  
Staff Shortage ◽  
Medical Response ◽  
Emergency Medical ◽  
Emergency Managers ◽  
Medical Emergencies

AbstractEmergency services worldwide face increasing cost pressure that potentially limits their existing resources. In many countries, emergency services also face the issues of staff shortage–creating extra challenges and constraints, especially during crisis times such as the COVID-19 pandemic–as well as long distances to sparsely populated areas resulting in longer response times. To overcome these issues and potentially reduce consequences of daily (medical) emergencies, several countries, such as Sweden, Germany, and the Netherlands, have started initiatives using new types of human resources as well as equipment, which have not been part of the existing emergency systems before. These resources are employed in response to medical emergency cases if they can arrive earlier than emergency medical services (EMS). A good number of studies have investigated the use of these new types of resources in EMS systems, from medical, technical, and logistical perspectives as their study domains. Several review papers in the literature exist that focus on one or several of these new types of resources. However, to the best of our knowledge, no review paper that comprehensively considers all new types of resources in emergency medical response systems exists. We try to fill this gap by presenting a broad literature review of the studies focused on the different new types of resources, which are used prior to the arrival of EMS. Our objective is to present an application-based and methodological overview of these papers, to provide insights to this important field and to bring it to the attention of researchers as well as emergency managers and administrators.

Flood Disaster in the Czech Republic in July, 1997 — Operations of the Emergency Medical Service

1999 ◽  
Vol 14 (1) ◽  
pp. 39-41 ◽  
Author(s):  
Jiri R. Pokorny
Keyword(s):  
Czech Republic ◽  
Emergency Medical Services ◽  
Emergency Services ◽  
Medical Emergency ◽  
Medical Services ◽  
The Czech Republic ◽  
Surface Transport ◽  
Emergency Medical ◽  
Rescue System ◽  
Medical Emergency Services

AbstractThis report is a review of the response and the activities of the Emergency Medical Services during a huge flood that devastated one-third of the territory of the Czech Republic in July 1997. The Emergency Medical Services personnel extracted by helicopter a great number of citizens who were trapped in their flats and homes. For diabetics and cardiacs who were isolated from the surface transport, the EMS personnel supplied necessary medication, and transported patients to hemodialysis.The cooperation between non-medical emergency services and the district crisis staff of the Integrated Rescue System, varied in different districts. However, in most flooded districts, the cooperation was satisfactory. In addition, a large number of volunteers helped in the first days of the flood.Unfortunately, 49 people died because of the flood. Nevertheless, since the EMS was able to manage the extraordinary needs, the number of emergencies and hospitalizations was low.

Incidence and Outcomes after Out-of-Hospital Medical Emergencies in Gambia: A Case for the Integration of Prehospital Care and Emergency Medical Services in Primary Health Care

2018 ◽  
Vol 33 (6) ◽  
pp. 650-657
Author(s):  
Sunkaru Touray ◽  
Baboucarr Sanyang ◽  
Gregory Zandrow ◽  
Isatou Touray
Keyword(s):  
Health Care ◽  
Emergency Medical Services ◽  
Emergency Care ◽  
Prehospital Care ◽  
The Gambia ◽  
Medical Emergency ◽  
Medical Services ◽  
Primary Health ◽  
Emergency Medical ◽  
Medical Emergencies

AbstractBackgroundThe Gambia is going through a rapid epidemiologic transition with a dual disease burden of infections and non-communicable diseases occurring at the same time. Acute, time-sensitive, medical emergencies such as trauma, obstetric emergencies, respiratory failure, and stroke are leading causes of morbidity and mortality among adults in the country.ProblemData on medical emergency care and outcomes are lacking in The Gambia. Data on self-reported medical emergencies among adults in a selection of Gambian communities are presented in this report.MethodsA total of 320 individuals were surveyed from 34 communities in the greater Banjul area of The Gambia using a survey instrument estimating the incidence of acute medical emergencies in an adult population. Self-reported travel time to a health facility during medical emergencies and patterns of health-seeking behavior with regard to type of facility visited and barriers to accessing emergency care, including cost and medical insurance coverage, are presented in this report.ResultsOf the 320 individuals surveyed, 262 agreed to participate resulting in a response rate of 82%. Fifty-two percent of respondents reported an acute medical emergency in the preceding year that required urgent evaluation at a health facility. The most common facility visited during such emergencies was a health center. Eighty-seven percent of respondents reported a travel time of less than one hour during medical emergencies. Out-of-pocket cost of medications accounted for the highest expenditure during emergencies. There was a low awareness and willingness to subscribe to health insurance among individuals surveyed.Conclusion: There is a high incidence of acute medical emergencies among adults in The Gambia which are associated with adverse outcomes due to a combination of poor health literacy, high out-of-pocket expenditures on medications, and poor access to timely prehospital emergency care. There is an urgent need to develop prehospital acute care and Emergency Medical Services (EMS) in the primary health sector as part of a strategy to reduce mortality and morbidity in the country.TourayS, SanyangB, ZandrowG, TourayI. Incidence and outcomes after out-of-hospital medical emergencies in Gambia: a case for the integration of prehospital care and Emergency Medical Services in primary health care. Prehosp Disaster Med. 2018;33(6):650–657.

scholarly journals IMPACT OF AGING POPULATIONS ON MUNICIPAL EMERGENCY MEDICAL SERVICES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S956-S956
Author(s):  
Nidya Velasco Roldan ◽  
Caitlin E Coyle ◽  
Michael Ward ◽  
Jan Mutchler
Keyword(s):  
Emergency Medical Services ◽  
Assisted Living ◽  
Local Governments ◽  
Emergency Services ◽  
Medical Services ◽  
Assisted Living Facilities ◽  
Older Population ◽  
Emergency Medical ◽  
Age Related ◽  
Aging Populations

Abstract The services that residents require from their local governments vary depending on the demographics of their populations. While municipalities have long sought to consider how changes in the young population may impact their school system needs, few systematic considerations have been developed relating to how aging populations may impact municipal service provision. This study aims to address this issue by focusing on demands on emergency services at the municipal level. Using data from the Massachusetts Ambulance Trip Record Information System (MATRIS) we explore the association between emergency medical services (EMS) demand and population age-structure. The data shows an overrepresentation of older people among EMS users. People age 65 and older represent 16% of Massachusetts’ population but account for 31% of the transported emergent calls —e.g., 911 calls— and 60% of the scheduled transports. Results from the OLS regression analysis suggest that communities with larger shares of older residents have significantly higher numbers of EMS calls. The type of community and other age-related community features such as the percentage of older residents living alone and the percentage of older population dually eligible for Medicare and Medicaid are also significantly associated with the number of EMS calls. Contrary to our expectations, other resources available in the community such nursing homes or assisted living facilities were not significantly associated with number of EMS calls. Our research indicates that if growth in the older population occurs as projected, the demand placed on the EMS system by older populations will grow considerably in coming decades.

Privatization and Emergency Medical Services

1997 ◽  
Vol 12 (1) ◽  
pp. 22-29 ◽  
Author(s):  
Stephan G. Reissman
Keyword(s):  
Emergency Medical Services ◽  
Customer Service ◽  
Public Perception ◽  
Response Times ◽  
Selection Process ◽  
The United States ◽  
Medical Services ◽  
Emergency Medical ◽  
Essential Components ◽  
The Government

AbstractIntroduction:Osborne and Gaebler's Reinventing Government has sparked discussion amongst elected officials, civil servants, the media, and the general public regarding advantages of privatizing government services. Its support stems from an effort to provide services to municipalities while reducing taxpayer expenditure. Many echo the sentiment of former New York Governor Mario Cuomo, who said, “It is not government's obligation to provide services, but to see that they're provided.” Even in the area of public safety, privatization has found a “market.”In many localities, privatizing Emergency Medical Services (EMS) is a popular and successful method for providing ambulance services. Privately owned ambulance services staff and respond to medical emergencies in a given community as part of the 9–1–1 emergency response system. Regulations for acceptable response times, equipment, and other essential components of EMS systems are specified by contract. This allows the municipality oversight of the service provided, but it does not provide the service directly. As will be discussed, this “contracting-out” model has many benefits.Privatizing EMS services is a decision based not only on cost-savings, but on accountability. A thorough evaluation must be utilized in the selection process. Issues of efficiency, effectiveness, quality, customer service, responsiveness, and equity must be considered by the government, in addition to cost of service.The uncertain future of health care in the United States has led those in EMS to look beyond the field's internal market to explore additional opportunities for expanding and redefining its roles beyond emergency care. It is important, however, to consider how emergency medical care, the original role of EMS, can be best delivered. Responding to emergencies is not just one of the functions involved in this field, it is the principal function from which public perception of EMS is formed, and from which support for entering other markets can be fostered.The purpose of this paper is to present several important concepts and considerations that public officials, medical directors, and the public must be aware of when contemplating the possibility of privatizing their Emergency Medical Services. A review of the general concepts of privatization and issues of accountability will be presented, referencing policy experts, followed by an examination of how advocates of privatization might see these issues as they relate to providing EMS. The conclusion will present prescriptions for both municipal and commercial ambulance providers.

scholarly journals Collaboration for preliminary design of a mobile health solution for ambulance dispatch in Rwanda

2020 ◽  
Vol 3 (2) ◽  
pp. 1-5
Author(s):  
Ashley Rosenberg ◽  
◽  
Rob Rickard ◽  
Fraterne Zephyrin Uwinshuti ◽  
Gabin Mbanjumucyo ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Emergency Services ◽  
Prehospital Care ◽  
Capital City ◽  
Medical Services ◽  
Middle Income ◽  
Golden Hour ◽  
Middle Income Countries ◽  
Emergency Medical ◽  
Prehospital Emergency

The first 60 minutes after a trauma are described as “the golden hour.” For each minute of prehospital time, the risk of dying increases by 5% (Sampalis et al., 1999). Since 90% of the global burden of injuries occur in low- and middle-income countries and lead to 5.8 million deaths annually, addressing rapid access to emergency services is critical in these settings (Nielsen et al., 2012). In most low- and middle-income countries (LMICs), there are no formal trauma systems, and many lack organized prehospital care (Nielsen et al., 2012). Emergency medical dispatch and communication systems are a foundational component of emergency medical services (World Health Organization, 2005). Yet there are no established recommendations of creating these systems inLMICs.Rwanda, a country of over 12 million people, is a rapidly developing leader in East Africa. The Ministry of Health of Rwanda established the Service d’Aide Medicale Urgente (SAMU) in 2007, recognizing the need for public emergency medical services. SAMU’s national dispatch center receives roughly 3,000 calls per month through a national 912 hotline. It organizes regional transportation with 260 total ambulances located at hospitals throughout the country and provides prehospital emergency services in the capital city of Kigali with a fleet of 12 ambulances. In the city, each ambulance has a driver, nurse and anesthetist dispatched for every call. Emergency department nursing and anesthetist staff are dispatched from hospitals around the country to respond to regional emergencies. No formal prehospital cadre of the workforce exists although the SAMU staffhave extensive field experience in prehospital care. SAMU has several challenges to rapid prehospital emergency care including lack of addresses beyond the capital city, unclear location data in densely populated areas, complex communication processes with little information about health facility capacity, and no established electronic dispatch system. The average response time for SAMU ambulances was 59 minutes in 2018, but 39% of calls were not completed within the golden hour.

scholarly journals Effect of Prehospital Epinephrine Use on Survival from Out-of-Hospital Cardiac Arrest and on Emergency Medical Services

2021 ◽  
Vol 11 (1) ◽  
pp. 190
Author(s):  
Song Yi Park ◽  
Daesung Lim ◽  
Seong Chun Kim ◽  
Ji Ho Ryu ◽  
Yong Hwan Kim ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Emergency Medical Services ◽  
Chest Compression ◽  
Response Times ◽  
Discharge Rate ◽  
Medical Services ◽  
Neurological Outcomes ◽  
Mechanical Chest Compression ◽  
Emergency Medical ◽  
Hospital Cardiac Arrest

This study was to identify the effect of epinephrine on the survival of out-of-hospital cardiac arrest (OHCA) patients and changes in prehospital emergency medical services (EMSs) after the introduction of prehospital epinephrine use by EMS providers. This was a retrospective observational study comparing two groups (epinephrine group and norepinephrine group). We used propensity score matching of the two groups and identified the association between outcome variables regarding survival and epinephrine use, controlling for confounding factors. The epinephrine group was 339 patients of a total 1943 study population. The survival-to-discharge rate and OR (95% CI) of the epinephrine group were 5.0% (p = 0.215) and 0.72 (0.43–1.21) in the total patient population and 4.7% (p = 0.699) and 1.15 (0.55–2.43) in the 1:1 propensity-matched population. The epinephrine group received more mechanical chest compression and had longer EMS response times and scene times than the norepinephrine group. Mechanical chest compression was a negative prognostic factor for survival to discharge and favorable neurological outcomes in the epinephrine group. The introduction of prehospital epinephrine use in OHCA patients yielded no evidence of improvement in survival to discharge and favorable neurological outcomes and adversely affected the practice of EMS providers, exacerbating the factors negatively associated with survival from OHCA.

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