Emergency Medical Services (EMS) Lessons for Worldwide Health Care

1985 ◽  
Vol 1 (S1) ◽  
pp. 67-69
Author(s):  
Nancy L. Caroline
Keyword(s):  
Health Care ◽  
Emergency Medical Services ◽  
Emergency Care ◽  
Disaster Planning ◽  
Medical Emergency ◽  
Medical Services ◽  
Global Context ◽  
Emergency Medical

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?

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.

Guidelines for Pediatric Emergency Care Facilities

PEDIATRICS ◽  
1995 ◽  
Vol 96 (3) ◽  
pp. 526-537
Author(s):  
Keyword(s):  
Health Care ◽  
Emergency Medical Services ◽  
Emergency Care ◽  
Pediatric Emergency ◽  
Medical Services ◽  
Emergency Medical ◽  
Care Facilities ◽  
Trained Personnel ◽  
Pediatric Emergency Care

Emergency care for life-threatening pediatric illness and injury requires specialized resources including equipment, drugs, trained personnel, and facilities. The American Medical Association Commission on Emergency Medical Services has provided guidelines for the categorization of hospital pediatric emergency facilities that have been endorsed by the American Academy of Pediatrics (AAP).1 This document was used as the basis for these revised guidelines, which define: 1. The desirable characteristics of a system of Emergency Medical Services for Children (EMSC) that may help achieve a reduction in mortality and morbidity, including long-term disability. 2. The role of health care facilities in identifying and organizing the resources necessary to provide the best possible pediatric emergency care within a region. 3. An integrated system of facilities that provides timely access and appropriate levels of care for all critically ill or injured children. 4. The responsibility of the health cane facility for support of medical control of pre-hospital activities and the pediatric emergency care and education of pre-hospital providers, nurses, and physicians. 5. The role of pediatric centers in providing outreach education and consultation to community facilities. 6. The role of health cane facilities for maintaining communication with the medical home of the patient. Children have their emergency care needs met in a variety of settings, from small community hospitals to large medical centers. Resources available to these health care sites vary, and they may not always have the necessary equipment, supplies, and trained personnel required to meet the special needs of pediatric patients during emergency situations.

Apart from the Medical Complaints, Why do Patients Use Emergency Medical Services? Results of a Patient Survey

2021 ◽  
Author(s):  
Silke Piedmont ◽  
Anna Katharina Reinhold ◽  
Jens-Oliver Bock ◽  
Janett Rothhardt ◽  
Enno Swart ◽  
...  
Keyword(s):  
Health Care ◽  
Emergency Medical Services ◽  
Emergency Care ◽  
Logistic Models ◽  
Patient Survey ◽  
Insurance Companies ◽  
Medical Services ◽  
Prehospital Emergency Care ◽  
Care Providers ◽  
Emergency Medical

Abstract Introduction Many countries face an increased use of emergency medical services (EMS) with a decreasing percentage of life-threatening complaints. Though there is a broad discussion among experts about the cause, patients' self-perceived, non-medical reasons for using EMS remain largely unknown. Methods The written survey included EMS patients who had≥1 case of prehospital emergency care in 2016. Four German health insurance companies sent out postal questionnaires to 1312 insured patients. The response rate was 20%; 254 questionnaires were eligible for descriptive and interferential analyses (t-tests, chi2-tests, logistic models). Results The majority of respondents indicated that their EMS use was due to an emergency or someone else’s decision (≥84%; multiple checks allowed); 56% gave need for a quick transport as a reason. Other frequently stated reasons addressed the health care system (e. g., complaints outside of physicians’ opening hours) and insecurity/anxiety about one’s state of health (>45% of the respondents). “Social factors” were similarly important (e. g., 42% affirming, “No one could give me a ride to the emergency department or doctor’s office.”). Every fifth person had contact with other emergency care providers prior to EMS use. Respondents negating an emergency as a reason were less likely to confirm wanting immediate medical care on site or quick transports compared to those affirming an emergency. Patients using EMS at night more often denied having an emergency compared to patients with access to care during the day. Conclusion The study identified a bundle of reasons leading to EMS use apart from medical complaints. Attempts for needs-oriented EMS use should essentially include optimization of the health care and social support system and measures to reduce patients’ insecurity.

scholarly journals Digital Infrastructure as a Component of Emergency Medical Services Transformation

2020 ◽  
Vol 47 (4) ◽  
pp. 138-146
Author(s):  
Svitlana MALONOHA
Keyword(s):  
Health Care ◽  
Emergency Medical Services ◽  
Information Transfer ◽  
Medical Services ◽  
Modular Architecture ◽  
Public Authorities ◽  
Digital Infrastructure ◽  
Emergency Medical ◽  
Patient Health ◽  
Definition Of

The importance of digital infrastructure for the transformation of emergency medical services as one of the priority areas of public policy and public authorities are considered. Some approaches to the definition of digital infrastructure are studied. This study made it possible to identify the components of the digital infrastructure of emergency medical services and outline its role in the health care ecosystem. The approach to the application of the modular architecture of the digital infrastructure of emergency medical services as a conceptual basis for the integration of information systems of different departments into a single emergency system is considered. Exist two groups of mechanisms that influence the formation of the digital infrastructure of emergency medical services and indicate the causal links that explain how their use can lead to the transformation of emergency medical services. The range of tasks that are solve due to the digital infrastructure aimed at improving the efficiency, accuracy of diagnosis and provision of emergency medical services is outlined. New opportunities are opening up to improve the quality of emergency medical services provision in a human-centered health care system based on a digital infrastructure, the central elements of which are the exchange of information contained in electronic records and patient health cards and mobile digital devices, diagnostics and information transfer. The list of problems on the way of emergency medical services transformation is formulated and some recommendations for their solution are offered, the formulation of which is based on the analysis of existing practices and own long-term experience at the emergency medical services system.

Abstract WP261: Non-English-preferring Patients Have No Differences in Stroke Symptom Recognition or Emergency Care Time Metrics

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Shaw Natsui ◽  
Khawja A Siddiqui ◽  
Betty L Erfe ◽  
Nicte I Mejia ◽  
Lee H Schwamm ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Emergency Care ◽  
Medical Services ◽  
Similar Response ◽  
Language Preference ◽  
Emergency Department Care ◽  
Hospital Arrival ◽  
Stroke Symptom ◽  
Emergency Medical ◽  
Significant Difference

Introduction: The influence of patients’ language preference on the delivery of acute ischemic stroke (AIS) care in the pre-hospital and in-hospital emergency care settings is scarcely known. We hypothesize that stroke knowledge differences may be associated with non-English preferring (NEP) patients having slower time from symptom discovery to hospital presentation and less engagement of emergency medical services (EMS) than English preferring (EP) patients. Language barriers may also interfere with the delivery of time-sensitive emergency department care. Objectives: To identify whether language preference is associated with differences in patients’ time from stroke symptom discovery to hospital arrival, activation of emergency medical services, door-to-imaging time (DIT), and door-to-needle (DTN) time. Methods: We identified consecutive AIS patients presenting to a single urban, tertiary, academic center between 01/2003-04/2014. Data was abstracted from the institution’s Research Patient Data Registry and Get with the Guidelines-Stroke Registry. Bivariate and regression models evaluated the relationship between language preference and: 1) time from symptom onset to hospital arrival, 2) use of EMS, 3) DIT, and 4) DTN time. Results: Of 3,190 AIS patients who met inclusion/exclusion criteria, 9.4% were NEP (n=300). Time from symptom discovery to arrival, and EMS utilization were not significantly different between NEP and EP patients in unadjusted or adjusted analyses (overall median time 157 minutes, IQR 55-420; EMS utilization: 65% vs. 61.3% p=0.21). There was no significant difference between NEP and EP patients in DIT or in likelihood of DIT ≤ 25 minutes in unadjusted or adjusted analyses (overall median 59 minutes, IQR 29-127; DIT ≤ 25 minutes 24.3% vs. 21.3% p=0.29). There was also no significant different in DTN time or in likelihood of DTN ≤ 60 minutes in unadjusted or adjusted analyses (overall median 53 minutes, IQR 36-73; DTN ≤ 60 minutes 62.5% vs. 58.2% p=0.60). Conclusion: Non-English-preferring patients have similar response to stroke symptoms as reflected by EMS utilization and time from symptom discovery to hospital arrival. Similarly, NEP patients have no differences in in-hospital AIS care metrics of DIT and DTN time.

The Group Process: A Regional Disaster Planning Methodology for Multidisciplinary Consensus

1987 ◽  
Vol 3 (1) ◽  
pp. 68-73
Author(s):  
Frank L. Brown ◽  
Sharon L. Connelly
Keyword(s):  
Human Resources ◽  
Emergency Medical Services ◽  
Group Process ◽  
Disaster Planning ◽  
The United States ◽  
Medical Services ◽  
Design And Implementation ◽  
Emergency Medical ◽  
Physical Resources ◽  
Planning Methodology

In accordance with the 1973 Emergency Medical Services Systems Act in the United States, one of the 15 functions to be performed by every EMS (Emergency Medical Services) system is disaster planning. The predicate of success in remediating such a macrosystem challenge as regional disaster planning requires the consensus of multidisciplinary health care and public safety human resources prior to the effective cataloging of physical resources. As the emergency physician is the medical leader of EMS system design and implementation, it is important that he explore newly developing disaster planning methodologies to facilitate consensus disaster planning.

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.

scholarly journals Evaluation of the Quality of Medical Care to the Population at the Level of Day Stations and Emergency Stations

2022 ◽  
Vol 8 (1) ◽  
pp. 114-121
Author(s):  
B. Niyazov ◽  
S. Niyazovа
Keyword(s):  
Medical Care ◽  
Emergency Medical Services ◽  
Chronic Diseases ◽  
Emergency Care ◽  
Rural Population ◽  
Medical Services ◽  
Emergency Medical ◽  
Medical Institutions ◽  
Quality Of Medical Care

Insufficient availability of emergency medical services to the rural population is noted. The dynamics of the growth of calls to emergency medical services testifies to the fact that emergency medical institutions have taken over part of inpatient services for the provision of emergency care to patients with chronic diseases and acute colds.

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