Pre-Hospital Care Quality Program

1985 ◽  
Vol 1 (S1) ◽  
pp. 48-51
Author(s):  
Emil Pascarelli ◽  
Anthony Ciorciari
Keyword(s):  
Cognitive Abilities ◽  
Prehospital Care ◽  
Public Awareness ◽  
Care Quality ◽  
Emergency Medical Technician ◽  
Mass Public ◽  
Emergency Medical ◽  
Quality Program ◽  
The Usa ◽  
Clinical Changes

Paramedic units have awakened a new concept in prehospital care in the USA. New emergency medical services (EMS) administrations, better educated personnel, and mass public awareness through media events have all contributed to the change.Operational changes designed to tighten control of the emergency medical technician (EMT) and paramedic came about through deployment of ambulances and categorization and designation of emergency hospitals. Clinical changes have given the EMS responder, particularly the paramedic, a great deal of freedom in the care given to patients. The paramedic, who uses subjective criteria, can administer care ranging from Standard First Aid to advanced cardiology. Subjective control should be rigid for the EMT or paramedic, when cognitive abilities include only knowledge, comprehension and application, but not for those who have had a chance to exercise analytic and synthetic skills in pre-hospital training programs.

The Institute of Medicine Report on Emergency Medical Services for Chi: Thoughts for Emergency Medical Technicians, Paramedics, and Emergency Physicians

PEDIATRICS ◽  
1995 ◽  
Vol 96 (1) ◽  
pp. 199-205
Author(s):  
Richard T. Cook
Keyword(s):  
Emergency Medical Services ◽  
Prehospital Care ◽  
Fellowship Training ◽  
Pediatric Emergency ◽  
Emergency Medical Technician ◽  
Medical Services ◽  
Institute Of Medicine ◽  
Emergency Physicians ◽  
Care Givers ◽  
Emergency Medical

The emergency medical technician, the paramedic, and the emergency physician, as well as emergency physicians who have additional expertise in emergency medical service (EMS) prehospital care or pediatric emergency medicine (through experience or formal fellowship training), will all find the Institute of Medicine's report, Emergency Medical Services for Chi (EMS-C), to be an invaluable background resource as well as a guide for EMS system and EMS-C-related planning. With both breadth and depth, it reviews many of the issues in EMS-C today from many perspectives and provides practical information to enable these care givers to understand better the "big picture" of EMS-C as well as to assist them in continuing to make a difference in the day-to-day emergency care for children. It is well referenced, engenders respect for all members of the team within the broad continuum of EMS-C, and provides encouragement to them to work together to identify and address issues and solve problems to improve the quality of care for our nation's children.

scholarly journals The Birth and Growth of the National Ambulance Service in Ghana

2016 ◽  
Vol 32 (1) ◽  
pp. 83-93 ◽  
Author(s):  
Ahmed Zakariah ◽  
Barclay T. Stewart ◽  
Edmund Boateng ◽  
Christiana Achena ◽  
Gavin Tansley ◽  
...  
Keyword(s):  
Emergency Services ◽  
Prehospital Care ◽  
Public Awareness ◽  
Ambulance Service ◽  
Local Health ◽  
Publication Type ◽  
Middle Income ◽  
Stable Case ◽  
Mean Response Time ◽  
Emergency Medical

AbstractIntroductionThis study aimed to document the growth and challenges encountered in the decade since inception of the National Ambulance Service (NAS) in Ghana, West Africa. By doing so, potentially instructive examples for other low- and middle-income countries (LMICs) planning a formal prehospital care system or attempting to identify ways to improve existing emergency services could be identified.MethodsData routinely collected by the Ghana NAS from 2004-2014 were described, including: patient demographics, reason for the call, response location, target destination, and ti1mes of service. Additionally, the organizational structure and challenges encountered during the development and maturation of the NAS were reported.ResultsIn 2004, the NAS piloted operations with 69 newly trained emergency medical technicians (EMTs), nine ambulances, and seven stations. The NAS expanded service delivery with 199 ambulances at 128 stations operated by 1,651 EMTs and 47 administrative and maintenance staff in 2014. In 2004, nine percent of the country was covered by NAS services; in 2014, 81% of Ghana was covered. Health care transfers and roadside responses comprised the majority of services (43%-80% and 10%-57% by year, respectively). Increased mean response time, stable case holding time, and shorter vehicle engaged time reflect greater response ranges due to increased service uptake and improved efficiency of ambulance usage. Specific internal and external challenges with regard to NAS operations also were described.ConclusionThe steady growth of the NAS is evidence of the need for Emergency Medical Services and the effects of sound planning and timely responses to changes in program indicators. The way forward includes further capacity building to increase the number of scene responses, strengthening ties with local health facilities to ensure timely emergency medical care and appropriateness of transfers, assuring a more stable funding stream, and improving public awareness of NAS services.ZakariahA, StewartBT, BoatengE, AchenaC, TansleyG, MockC. The birth and growth of the National Ambulance Service in Ghana. Prehosp Disaster Med. 2017;32(1):83–93.

Emergency Medical Services in India: The Present and Future

2014 ◽  
Vol 29 (3) ◽  
pp. 307-310 ◽  
Author(s):  
Mohit Sharma ◽  
Ethan S. Brandler
Keyword(s):  
Emergency Medical Services ◽  
Emergency Services ◽  
Prehospital Care ◽  
Emergency Medical Technician ◽  
Medical Services ◽  
Prehospital Emergency Care ◽  
Publication Type ◽  
Emergency Medical ◽  
Trauma Service ◽  
Care System

AbstractIndia is the second most populous country in the world. Currently, India does not have a centralized body which provides guidelines for training and operation of Emergency Medical Services (EMS). Emergency Medical Services are fragmented and not accessible throughout the country. Most people do not know the number to call in case of an emergency; services such as Dial 108/102/1298 Ambulances, Centralized Accident and Trauma Service (CATS), and private ambulance models exist with wide variability in their dispatch and transport capabilities. Variability also exists in EMS education standards with the recent establishment of courses like Emergency Medical Technician-Basic/Advanced, Paramedic, Prehospital Trauma Technician, Diploma Trauma Technician, and Postgraduate Diploma in EMS. This report highlights recommendations that have been put forth to help optimize the Indian prehospital emergency care system, including regionalization of EMS, better training opportunities, budgetary provisions, and improving awareness among the general community. The importance of public and private partnerships in implementing an organized prehospital care system in India discussed in the report may be a reasonable solution for improved EMS in other developing countries.SharmaM, BrandlerES. Emergency Medical Services in India: the present and future. Prehosp Disaster Med. 2014;29(3):1-4.

scholarly journals Retrospective chart review and survey to identify adverse safety events in the emergency medical services care of children with out-of-hospital cardiac arrest in the USA: a study protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e039215
Author(s):  
Carl Eriksson ◽  
Amanda Schoonover ◽  
Tabria Harrod ◽  
Garth Meckler ◽  
Matt Hansen ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Emergency Medical Services ◽  
Detection System ◽  
Prehospital Care ◽  
Medical Services ◽  
Emergency Medical ◽  
Increased Risk ◽  
Study Results ◽  
The Usa ◽  
Hospital Cardiac Arrest

IntroductionEfforts to improve the quality of emergency medical services (EMS) care for adults with out-of-hospital cardiac arrest (OHCA) have led to improved survival over time. Similar improvements have not been observed for children with OHCA, who may be at increased risk for preventable adverse safety events during prehospital care. The purpose of this study is to identify patient and organisational factors that are associated with adverse safety events during the EMS care of paediatric OHCA.Methods and analysisThis is a large multisite EMS study in the USA consisting of chart reviews and agency surveys to measure, characterise and evaluate predictors of our primary outcome severe adverse safety events in paediatric OHCA. Using the previously validated Paediatric prehospital adverse Event Detection System tool, we will review EMS charts for 1500 children with OHCA from 2013 to 2019 to collect details of each case and identify severe adverse safety events (ASEs). Cases will be drawn from over 40 EMS agencies in at least five states in geographically diverse areas of the USA. EMS agencies providing charts will also be invited to complete an agency survey to capture organisational characteristics. We will describe the frequency and proportion of severe ASEs in paediatric OHCA across geographic regions and clinical domains, and identify patient and EMS organisational characteristics associated with severe ASEs using logistic regression.Ethics and disseminationThis study has been approved by the Oregon Health & Science University Institutional Review Board (IRB Approval# 00018748). Study results will be disseminated through scientific publications and presentations, and to EMS leaders and staff through local EMS medical directors, quality and training officers and community engagement activities.

Development and Implementation of a Novel Prehospital Care System in the State of Kerala, India

2016 ◽  
Vol 31 (6) ◽  
pp. 663-666 ◽  
Author(s):  
Heather A. Brown ◽  
Katherine A. Douglass ◽  
Shafi Ejas ◽  
Venugopalan Poovathumparambil
Keyword(s):  
Prehospital Care ◽  
Public Awareness ◽  
Public Private Partnership ◽  
The State ◽  
Western World ◽  
College Hospital ◽  
Private Partnership ◽  
Awareness Campaigns ◽  
Emergency Medical ◽  
Care System

AbstractMost low- and middle-income countries (LMICs) have struggled to find a system for prehospital care that can provide adequate patient care and geographical coverage while maintaining a feasible price tag. The emergency medical systems of the Western world are not necessarily relevant in developing economic systems, given the lack of strict legislation, the scarcity of resources, and the limited number of trained personnel. Meanwhile, most efforts to provide prehospital care in India have taken the form of adapting Western models to the Indian context with limited success. Described here is a novel approach to prehospital care designed for and implemented in the State of Kerala, India. The Active Network Group of Emergency Life Savers (ANGELS) was launched in 2011 in Calicut City, the third largest city in the Indian State of Kerala. The ANGELS integrated an existing fleet of private and state-owned ambulances into a single network utilizing Global Positioning System (GPS) technology and a single statewide call number. A total of 85 volunteer emergency medical certified technicians (EMCTs) were trained in basic first aid and trauma care principles. Public awareness campaigns accompanied all activities to raise awareness amongst community members. Funding was provided via public-private partnership, aimed to minimize costs to patients for service utilization. Over a two-year period from March 2011 to April 2013, 8,336 calls were recorded, of which 54.8% (4,569) were converted into actual ambulance run sheets. The majority of calls were for medical emergencies and most patients were transported to Medical College Hospital in Calicut. This unique public-private partnership has been responsive to the needs of the population while sustaining low operational costs. This system may provide a relevant template for Emergency Medical Services (EMS) development in other resource-limited settings.BrownHA, DouglassKA, EjasS, PoovathumparambilV. Development and implementation of a novel prehospital care system in the State of Kerala, India. Prehosp Disaster Med. 2016;31(6):663–666.

scholarly journals Validity and risk factor analysis for helicopter emergency medical services in Japan: a pilot study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Noriaki Yamada ◽  
Yuichiro Kitagawa ◽  
Takahiro Yoshida ◽  
Sho Nachi ◽  
Hideshi Okada ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pilot Study ◽  
Hospital Admission ◽  
Prehospital Care ◽  
Emergency Medical Technician ◽  
Emergency Intervention ◽  
Emergency Calls ◽  
Emergency Medical ◽  
Life Threatening ◽  
Medical Emergencies

Abstract Background Some emergency departments use triage scales, such as the Canadian Triage and Acuity Scale and Japan Urgent Stroke Triage Score, to detect life-threatening situations. However, these protocols have not been used for aeromedical services. Therefore, we investigated the factors predicting these life-threatening situations in aeromedical services as a pilot study for establishing the protocol. Method We retrospectively evaluated helicopter emergency medical service cases from 1 April 2015 to 31 March 2020 at Gifu University Hospital using the mission records. We only evaluated cases dealing with suggested internal medicine issues. We excluded cases influenced by external factors such as trauma or cases that included hospital-to-hospital transportation, focusing only on prehospital care. We evaluated the validity of the medical emergencies based on the needs for emergency interventions and hospital admission and of the suggested diagnoses and associated risk factors. Result A total of 451 cases were suitable for inclusion in the study. In the analysis for all emergency calls, 235 (52.11%) cases needed emergency intervention and 300 (64.4%) required hospital admission. The suggested diagnosis was valid for 261 (57.87%) cases. After the first assessment by emergency medical technicians, 75 cases were removed. Analysis after this first assessment found that 52.31% cases required emergency intervention, 70.26% needed admission, and the suggested diagnosis was valid for 69.41% of cases. In the analysis of emergency calls, the multivariate analysis of some key variables identified age, playing sports, and gasping as risk factors for emergency intervention. Hospital admission risk factors included being age only. The suggested diagnosis was valid only for sports situations. In the analysis after the first assessment by an emergency medical technician, risk factors for emergency intervention included being age being male, playing sports, and gasping, and those for hospital admission was being age, being male, and experiencing stroke symptoms and/or disturbance of consciousness. The suggested diagnosis was valid only for sports situations. Conclusion Some ‘second’ keywords/phrases predict medical emergencies. Therefore, the dispatch commander should gather these keyword/phrases to assess.

Integration of Emergency Medical Services and Special Weapons and Tactics (SWAT) Teams: The Emergence of the Tactically Trained Medic

1992 ◽  
Vol 7 (3) ◽  
pp. 285-288 ◽  
Author(s):  
David Q. McArdle ◽  
David Rasumoff ◽  
John Kolman
Keyword(s):  
Prehospital Care ◽  
Penetrating Trauma ◽  
The United States ◽  
Emergency Medical Technician ◽  
Care Providers ◽  
Law Enforcement Agencies ◽  
Small Unit ◽  
Emergency Medical ◽  
Swat Team ◽  
Special Environment

AbstractThe emphasis of training for paramedics that function in the civilian sector in the United States has focused on the management of blunt trauma. The personal risks they face generally are the result of accidents or public health threats. The management of penetrating trauma under the threat of intentional personal harm is a different matter.Law enforcement agencies have responded to the threat of apprehending heavily armed felons by forming special units highly trained in military-style, small-unit tactics. To provide care in this special environment, and support a special weapons and tactics (SWAT) team in fulfilling its mission, there is a requirment for a unique body of knowledge and special skills. (Prehospital care providers with at least emergency medical technician [EMT] skills and SWAT training will be referred to as tactical medics.)

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