Physician Leadership of Emergency Medical Services (EMS)

1985 ◽  
Vol 1 (S1) ◽  
pp. 115
Author(s):  
Eugene Nagel
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Emergency Medical Services ◽  
Health Care System ◽  
Delivery Systems ◽  
Medical Services ◽  
Physician Leadership ◽  
Design And Implementation ◽  
Emergency Medical ◽  
Medical Delivery

I would hope that there is no question regarding the need for physician leadership in an EMS system; and that the question, if there is any, concerns the amount required, where it is to be applied, and its quality. EMS, I would remind you, stands for emergencymedicalservices. Medical delivery systems, in my opinion, require physicians for their design and implementation. That does not mean that all the services have to be delivered by physicians, but they need physician leadership.If this outlines the area of physician authority, then there is by definition a concomitant responsibility—authority without responsibility would be tyranny. The responsibility should provide an appropriate level of medical care that is current in concept, appropriate to the needs, considerate of the resources available, and coherent with the overall health care system. It must not be just an isolated EMS system.

scholarly journals Hospital Referral Patterns: How Emergency Medical Care Is Accessed in a Disaster

2010 ◽  
Vol 4 (3) ◽  
pp. 226-231 ◽  
Author(s):  
Michael J. Reilly ◽  
David Markenson
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Emergency Medical Services ◽  
Medical Services ◽  
Major Incident ◽  
Emergency Medical Care ◽  
Referral Patterns ◽  
Disaster Victims ◽  
Emergency Medical ◽  
The Impact

ABSTRACTBackground:A prevalent assumption in hospital emergency preparedness planning is that patient arrival from a disaster scene will occur through a coordinated system of patient distribution based on the number of victims, capabilities of the receiving hospitals, and the nature and severity of illness or injury. In spite of the strength of the emergency medical services system, case reports in the literature and major incident after-action reports have shown that most patients who present at a health care facility after a disaster or other major emergency do not necessarily arrive via ambulance. If these reports of arrival of patients outside an organized emergency medical services system are accurate, then hospitals should be planning differently for the impact of an unorganized influx of patients on the health care system. Hospitals need to consider alternative patterns of patient referral, including the mass convergence of self-referred patients, when performing major incident planning.Methods:We conducted a retrospective review of published studies from the past 25 years to identify reports of patient care during disasters or major emergency incidents that described the patients' method of arrival at the hospital. Using a structured mechanism, we aggregated and analyzed the data.Results:Detailed data on 8303 patients from more than 25 years of literature were collected. Many reports suggest that only a fraction of the patients who are treated in emergency departments following disasters arrive via ambulance, particularly in the early postincident stages of an event. Our 25 years of aggregate data suggest that only 36% of disaster victims are transported to hospitals via ambulance, whereas 63% use alternate means to seek emergency medical care.Conclusions:Hospitals should evaluate their emergency plans to consider the implications of alternate referral patterns of patients during a disaster. Additional consideration should be given to mass triage, site security, and the potential need for decontamination after a major incident.(Disaster Med Public Health Preparedness. 2010;4:226-231)

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.

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.

The emergency medical system

2021 ◽  
pp. 65-75
Author(s):  
Olivier Hoogmartens ◽  
Michiel Stiers ◽  
Koen Bronselaer ◽  
Marc Sabbe
Keyword(s):  
Medical Care ◽  
Emergency Medical Services ◽  
Emergency Medical Service ◽  
Medical Service ◽  
Tertiary Care ◽  
Medical Services ◽  
High Quality ◽  
Emergency Medical ◽  
High Quality Medical Care ◽  
The Moment

The mission of the emergency medical services is to promote and support a system that provides timely, professional and state-of-the art emergency medical care, including ambulance services, to anyone who is victim of a sudden injury or illness, at any time and any location. A medical emergency has five different phases, namely: population awareness and behaviour, occurrence of the problem and its detection, alarming of trained responders and help rendered by bystanders and trained pre-hospital providers, transport to the nearest or most appropriate hospital, and, if necessary, admission or transfer to a tertiary care centre which provides a high degree of subspecialty expertise. In order to meet these goals, emergency medical services must work aligned with local, state officials; with fire and rescue departments; with other ambulance providers, hospitals, and other agencies to foster a high performance network. The term emergency medical service evolved to reflect a change from a straightforward system of ambulances providing nothing but transportation, to a complex network in which high-quality medical care is given from the moment the call is received, on-scene with the patient and during transportation. Medical supervision and/or participation of emergency medicine physicians (EP) in the emergency medical service systems contributes to the quality of medical care. This emergency medical services network must be capable to respond instantly and to maintain efficacy around the clock, with well-trained, well-equipped personnel linked through a strong communication system. Research plays a pivotal role in defining necessary resources and in continuously improving the delivery of high-quality care. This chapter gives an overview of the different aspects of emergency medical services and calls for high quality research in pre-hospital emergency care in a true partnership between cardiologists and emergency physicians.

Emergency Medical Services Response to Active Shooter Incidents: Provider Comfort Level and Attitudes Before and After Participation in a Focused Response Training Program

2014 ◽  
Vol 29 (4) ◽  
pp. 350-357 ◽  
Author(s):  
Jerrilyn Jones ◽  
Ricky Kue ◽  
Patricia Mitchell ◽  
Sgt. Gary Eblan ◽  
K. Sophia Dyer
Keyword(s):  
Law Enforcement ◽  
Medical Care ◽  
Emergency Medical Services ◽  
Training Program ◽  
Comfort Level ◽  
Medical Services ◽  
Active Shooter ◽  
Response Training ◽  
Emergency Medical ◽  
Before And After

AbstractIntroductionEmergency Medical Services (EMS) routinely stage in a secure area in response to active shooter incidents until the scene is declared safe by law enforcement. Due to the time-sensitive nature of injuries at these incidents, some EMS systems have adopted response tactics utilizing law enforcement protection to expedite life-saving medical care.ObjectiveDescribe EMS provider perceptions of preparedness, adequacy of training, and general attitudes toward active shooter incident response after completing a tactical awareness training program.MethodsAn unmatched, anonymous, closed-format survey utilizing a five-point Likert scale was distributed to participating EMS providers before and after a focused training session on joint EMS/police active shooter rescue team response. Descriptive statistics were used to compare survey results. Secondary analysis of responses based on prior military or tactical medicine training was performed using a chi-squared analysis.ResultsTwo hundred fifty-six providers participated with 88% (225/256) pretraining and 88% (224/256) post-training surveys completed. Post-training, provider agreement that they felt adequately prepared to respond to an active shooter incident changed from 41% (92/225) to 89% (199/224), while agreement they felt adequately trained to provide medical care during an active shooter incident changed from 36% (82/225) to 87% (194/224). Post-training provider agreement that they should never enter a building with an active shooter changed from 73% (165/225) to 61% (137/224). Among the pretraining surveys, significantly more providers without prior military or tactical experience agreed they should never enter a building with an active shooter until the scene was declared safe (78% vs 50%, P = .002), while significantly more providers with prior experience felt both adequately trained to provide medical care in an active shooter environment (56% vs 31%, P = .007) and comfortable working jointly with law enforcement within a building if a shooter were still inside (76% vs 56%, P = .014). There was no difference in response to these questions in the post-training survey.ConclusionsAttitudes and perceptions regarding EMS active shooter incident response appear to change among providers after participation in a focused active shooter response training program. Further studies are needed to determine if these changes are significant and whether early EMS response during an active shooter incident improves patient outcomes.JonesJ, KueR, MitchellP, EblanG, DyerKS. Emergency Medical Services response to active shooter incidents: provider comfort level and attitudes before and after participation in a focused response training program. Prehosp Disaster Med. 2014;29(4):1-7.

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.

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