scholarly journals (P2-22) Proposed Model for Cellular Medical Record in Emergency Medicine

2011 ◽  
Vol 26 (S1) ◽  
pp. s142-s142
Author(s):  
N. Friedman ◽  
A. Goldberg
Keyword(s):  
Emergency Medicine ◽  
Medical Record ◽  
Emergency Services ◽  
Health Condition ◽  
Clinical Parameters ◽  
Emergency Situations ◽  
Life Saving ◽  
Proposed Model ◽  
Communication Methods ◽  
Conceptual Revolution

IntroductionIn a hypothetical situation, an emergency services team is launched to treat a man who collapsed in the street. The team finds John Doe's mobile phone, and within seconds retrieves the required clinical parameters from his Mobile Medical Record (MMR), thus, providing a life-saving treatment suited to his personal health condition. This study seeks to determine if the necessary clinical parameters, required at emergency situations have ever been examined in order to best match both emergency situations and cellular technology.ObjectiveTo characterize the clinical parameters that make up an MMR in the context of saving lives, and to propose a model for an MMR in emergency medicine.MethodsThe essential emergency medicine clinical parameters in the context of life-saving treatments were characterized through interviews with prehospital and hospital experts in emergency medicine. The results were analyzed with the help of a cellular multimedia expert in order to best incorporate the clinical parameters into cellular phones as MMRs.ConclusionEmergency medicine teams chose individual and specific clinical parameters in a certain order of appearance from the general medical record that should assembly, in their opinion, an emergency medicine MMR. A MMR was chosen by the emergency medicine treatment teams as one of their preferred communication methods. The MMR model, if applied correctly, will provide the emergency medicine treatment teams an available, reliable, homogeneous database of real time clinical parameters adapted to life-saving conditions. The MMR model represents a conceptual revolution of taking the medical record from the caregiver and transferring it to the patient, which can be constantly at hand at any given time or place in their mobile phones.

(P2-30) Development of Disaster and Emergency Medicine in Nepal

2011 ◽  
Vol 26 (S1) ◽  
pp. s145-s145
Author(s):  
R.K. Maharjan
Keyword(s):  
Emergency Medicine ◽  
Disaster Response ◽  
Emergency Services ◽  
Service Providers ◽  
Research Training ◽  
University Teaching ◽  
International Institute ◽  
Institute Of Medicine ◽  
Emergency Situations ◽  
National Stadium

Nepal, a landlocked country between China and India, is developing disaster and emergency medicine. In 2007, the Nepal Disaster and Emergency Medicine (NADEM) Center was formed with the aim of developing this specialty in Nepal. The first hospital was built in July 1889. It wasn't until 1988 that a Disaster Response Team was organized following a stampede incident in the national stadium in Kathmandu. The country often experiences disaster and emergency situations due to geographic and natural hazards and political tensions.In 1984, the Institute of Medicine, Tribhuvan University Teaching Hospital created emergency services with general practitioners (GPs) directing and providing services. Since then, almost all emergency services of different hospitals are run by GPs with house officers, nurses, and paramedics. There still is a lack of training and proper management, and limited equipment and infrastructure to provide needed disaster and emergency services to the people. The NADEM Center is developing coordination objectives between different emergency service providers to organize ways of service providing. This will be done through NADEM's continuing medical education and publication of Journal of Nepal Disaster and Emergency Medicine (J-NADEM) and NewsHealth; coordination among emergency medical services (prehospital), in-hospital services, and disaster and critical care medicine; and planning and implementation of different research, training, workshops, seminars, and conferences in disaster and emergency medicine with cooperation from the world. The NADEM Center will develop International Institute of Disaster and Emergency Medicine.

IMPLEMENTATIONS EMERGENCY RESPONSE SYSTEM IN CASE OF ACCIDENTS AND EMERGENCY SITUATIONS (ERA-GLONASS) FOR CARS AND TRUCKS IN UZBEKISTAN

2020 ◽  
Author(s):  
Akmal Rustamov
Keyword(s):  
Emergency Response ◽  
Call Center ◽  
Emergency Services ◽  
Main Idea ◽  
Emergency Situation ◽  
High Mountain ◽  
Additional Information ◽  
Emergency Situations ◽  
Emergency Response System ◽  
Response System

The paper addresses the problem of increasing transportation safety due to usage of new possibilities provided by modern technologies. The proposed approach extends such systems as ERA-GLONASS and eCall via service network composition enabling not only transmitting additional information but also information fusion for defining required emergency means as well as planning for a whole emergency response operation. The main idea of the approach is to model the cyber physical human system components by sets of services representing them. The services are provided with the capability of self- contextualization to autonomously adapt their behaviors to the context of the car-driver system. The approach is illustrated via an accident emergency situation response scenario. “ERA-GLONASS” is the Russian state emergency response system for accidents, aimed at improving road safety and reducing the death rate from accidents by reducing the time for warning emergency services. In fact, this is a partially copied European e Call system with some differences in the data being transmitted and partly backward compatible with the European parent. The principle of the system is quite simple and logical: in the event of an accident, the module built into the car in fully automatic mode and without human intervention determines the severity of the accident, determines the vehicle’s location via GLONASS or GPS, establishes connection with the system infrastructure and in accordance with the protocol, transfers the necessary data on the accident (a certain distress signal). Having received the distress signal, the employee of the call center of the system operator should call the on-board device and find out what happened. If no one answers, send the received data to Sistema-112 and send it to the exact coordinates of the team of rescuers and doctors, and the last one to arrive at the place is given 20 minutes. And all this, I repeat, without the participation of a person: even if people caught in an accident will not be able to independently call emergency services, the data on the accident will still be transferred. In this work intended to add some information about applying system project in Uzbek Roads especially mountain regions like “Kamchik” pass. The Kamchik Pass is a high mountain pass at an elevation of 2.306 m above the sea level, located in the Qurama Mountains in eastern Uzbekistan and its length is about 88km.The road to reach the pass is asphalted, but there are rough sections where the asphalt has disappeared. It’s called A373. The old road over the pass was by passed by a tunnel built in 1999. On the horizon, the snow-capped peaks of the Fan Mountains come into view. The pass is located in the Fergana Valley between the Tashkent and Namangan Regions.

Race, insurance status and treating facility type associated with completeness of medical record in patients with breast cancer.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 143-143
Author(s):  
Marita Yaghi ◽  
Nadeem Bilani ◽  
Iktej Jabbal ◽  
Leah Elson ◽  
Maroun Bou Zerdan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Missing Data ◽  
Medical Record ◽  
Real World ◽  
Private Insurance ◽  
Insurance Status ◽  
Clinical Parameters ◽  
Facility Type ◽  
Missing Variables ◽  
White Patients

143 Background: The National Cancer Database (NCDB) is a large registry that collates real-world medical record data from millions of patients in the United States. A previous published study using the NCDB found that gaps in the medical record were associated with worse overall survival outcomes. We investigated cases of breast cancer in this registry to understand which factors were predictive of records with missing data. Methods: We screened for missing data in 54 clinical parameters documented by the NCDB pertaining to the diagnosis, workup, management and survival of patients with breast cancer diagnosed between 2004 and 2017. We performed univariate statistics to describe gaps in the dataset, followed by multivariate logistic regression modeling to identify factors associated lack of completeness of the medical record – defined as the presence of > 3 missing variables. Results: A total of n = 2,981,732 patients were included in this analysis. The median number of missing variables per record was 3 (5.6% of clinical parameters surveyed). 52.1% of records had ≤ 3 variables missing, while 47.9% had > 3 variables missing. Predictors of a record with missing data in > 3 variables were: age, race, insurance status and facility type . Regarding race, we found that records of Asian patients were less likely to have missing data as compared to records of White patients (OR 0.75, 95% CI: 0.74-0.76, p < 0.001). Conversely, there was no difference in completeness of the medical record between Black and White patients (OR 0.99, 95% CI: 0.99-1.01, p = 0.890). Patients with private insurance (OR 0.77, 95% CI 0.76-0.79, p < 0.001), or Medicaid (OR 0.65, 95% CI 0.64-0.67, p < 0.001) or Medicare (OR 0.66, 95% CI 0.64-0.67, p < 0.001) were also less likely to have missing data compared to uninsured patients, with patients on private insurance being the least likely to have incomplete records. Finally, patient records from academic programs (OR 0.91, 95% CI 0.90-0.92, p < 0.001) were less likely to contain > 3 missing variables compared to records from patients treated at community cancer programs. Conclusions: Despite high fidelity of NCDB data, social determinants of health including insurance status and treating facility type, were associated with differences in the completeness of the medical record. Improvements in documentation and data quality are necessary to optimize use of real-world data in cancer registries. Further research is needed to determine how these differences could be independently associated with inferior outcomes.

Abstract 151: Barriers and Opportunities for a Drone-Delivered AED Network in Durham, North Carolina

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_4) ◽  
Author(s):  
Monique A Starks ◽  
Jessica Sperling ◽  
Amy Cardenas ◽  
Audrey L Blewer ◽  
Edward Sharpe ◽  
...  
Keyword(s):  
Qualitative Methodology ◽  
Emergency Services ◽  
Response Times ◽  
Business Community ◽  
Aviation Industry ◽  
Automated External Defibrillators ◽  
Life Saving ◽  
Private And Public ◽  
Barriers And Opportunities ◽  
Stakeholder Attitudes

Background: The general public is unfamiliar with the concept of medical drones delivering life-saving technologies. Our research sought to define stakeholder attitudes towards development of drone-based emergency care for out-of-hospital cardiac arrest. Methods: Using qualitative methodology, we explored key stakeholder attitudes about using a drone to deliver automated external defibrillators (AED), challenges and facilitators to early establishment of a drone AED network, implementation considerations, and factors related to long-term sustainability. We identified 22 key individuals as potential respondents based on professional position; 16 respondents participated in data collection. Research participants included leaders in government, healthcare, emergency services, business, community, and the aviation industry (regulation and drone operation). Interview data were recorded and transcribed; data were analyzed using NVivo. A coding schema was developed based on constructs identified in previous literature and inductive consideration of this study’s data, including both thematic and descriptive coding. Results: We found broad support for a drone-delivered AED network. Such a network was perceived as valuable for reduced response times and for enhanced access to hard-to-reach areas. Identified challenges included operationalizing an autonomous drone AED network, privacy and safety concerns, current legal and regulatory requirements, financial liabilities, public buy-in and concern for public actually using an AED, and the need for research on treatment and cost- effectiveness of a drone network. Facilitators of development for a drone AED network included solidifying key partnerships (including integration into current EMS or fire services), identifying viable funding from private and public entities, and learning from existing drone models (e.g. commercial package or medical supply delivery). Conclusion: This study found general and conceptual support for the development of a drone network for AED delivery across key informants from an array of related fields. Such information should be considered in developing a regional drone AED network.

Prehospital Treatment with Dobutamine

1993 ◽  
Vol 8 (3) ◽  
pp. 247-249
Author(s):  
Bjarne Oberg ◽  
Mogens Bredgaard Sorensen
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Infusion Pump ◽  
Mean Value ◽  
Prehospital Treatment ◽  
Emergency Situations ◽  
Life Saving ◽  
Circulatory Insufficiency ◽  
Mobile Intensive Care Unit ◽  
Blood Pressures

AbstractPurpose:To assess the effectiveness of the use of dobutamine hydrochloride in out-of hospital emergency situations.Population:Patients with severe circulatory insufficiency caused by acute illness or injury encountered by the Mobile Intensive Care Unit of Copenhagen (population 467,000) during a 15-month study period.Methods:A newly developed dobutamine solution was administered by infusion pump to patients in whom normal emergency treatment failed to restore an acceptable circulatory state.Results:A total of 40 patients were treated with 4–48 μg dobutamine/kg/minute. The treatment was judged to be primary life-saving in 15 patients, the condition was improved in 16 patients, and nine patients died. Systolic blood pressures (in those who survived) rose from a mean value of 45 mmHg (range 0–80 mmHg) to 105 mmHg (range 65–180 mmHg). No tachycardia or arrhythmias were noted.Conclusion:This newly developed dobutamine solution is very useful in prehospital treatment of patients with circulatory failure and is recommend for use by mobile intensive care unit teams.

scholarly journals Impact of Prioritization on the Outpatient Queuing System in the Emergency Department with Limited Medical Resources

Symmetry ◽  
2019 ◽  
Vol 11 (6) ◽  
pp. 796 ◽  
Author(s):  
Ao Zhang ◽  
Xiaomin Zhu ◽  
Qian Lu ◽  
Runtong Zhang
Keyword(s):  
Emergency Department ◽  
Emergency Services ◽  
Service System ◽  
Queuing System ◽  
Hospital Service ◽  
Key Factors ◽  
Queuing Model ◽  
Medical Resources ◽  
Proposed Model

The emergency department has an irreplaceable role in the hospital service system because of the characteristics of its emergency services. In this paper, a new patient queuing model with priority weight is proposed to optimize the management of emergency department services. Compared with classical queuing rules, the proposed model takes into consideration the key factors of service and the first-come-first-served queuing rule in emergency services. According to some related queuing indicators, the optimization of emergency services is discussed. Finally, a case study and some compared analysis are conducted to illustrate the practicability of the proposed model.

Defining emergency telehealth

2019 ◽  
pp. 1357633X1989165
Author(s):  
Neal Sikka ◽  
Hartmut Gross ◽  
Aditi U Joshi ◽  
Edward Shaheen ◽  
Michael J Baker ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Emergency Services ◽  
Care Delivery ◽  
Quality Care ◽  
Cost Effective ◽  
Public Health Care ◽  
Emergency Physicians ◽  
Working Definition ◽  
Effective Manner ◽  
Definition Of

The American College of Emergency Physicians Emergency Telehealth Section was charged with development of a working definition of emergency telehealth that aligns with the College’s definition of emergency medicine. A modified Delphi method was used by the section membership who represented telehealth providers in both private and public health-care delivery systems, academia and industry, rural and urban settings. Presented in this manuscript is the final definition of emergency telehealth developed with an additional six clarifying statements to address the context of the definition. Emergency telehealth is a core domain of emergency medicine and is inclusive of remotely providing all types of care for acute conditions of any kind requiring expeditious care irrespective of any prior relationship. The development of this definition is important to the global community of emergency physicians and all patients seeking acute care to ensure that appropriately trained clinicians are providing the highest quality of emergency services via the telehealth modality. We recommend implementing emergency telehealth in a manner that ensures appropriate qualifications of providers, appropriate/parity reimbursement for telehealth services and, most importantly, the delivery of quality care to patients in a safe, efficient, timely and cost-effective manner.

scholarly journals A narrative review on the management of Acute Heart Failure in Emergency Medicine Department

2020 ◽  
Vol 30 (1) ◽  
pp. 171-178
Author(s):  
Amin Saberinia ◽  
Ali Vafaei ◽  
Parvin Kashani
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Emergency Medicine ◽  
Acute Heart Failure ◽  
Severe Heart Failure ◽  
Positive Pressure ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Emergency Situations ◽  
Contemporary Management

The main urgent symptom presented to anemergency departmentis acute heart failure (AHF). In that considerable risksof morbidity and mortality, it isimportant to plan precision medicine to achieve the most suitable outcomes. The object of this review is to provide a summary of contemporary management proceduresof emergency medicine in a department of acute heart failure. Heart failure could be presented with a broad range of symptoms, in particular a sudden worsening of those of Chronic Obstructive Pulmonary Disease. The treatment should focus on acute and chronic underlying disorders with instructions focusing on haemodynamics and blood pressure status. Treatment of patients suffering with worsening symptoms of AHF mainly focuses on intravenous diuretics. In emergency situations, patients suffering with AHF with low blood pressure must receive emergency consultation and a primary fluid bolus therapy (range 250–500 mL) followed by inotropic therapy with or without antihypotensive agents. For treatment of severe heart failure and cardiogenic shock in patients treated with noradrenalin, when blood pressure support is required, a direct-acting inotropic agent, dobutamine, could be applied effectively. When non-invasive positive pressure ventilation is needed, suppliers must track for any possibility of sudden worsening, i.e., for acute de compensated heart failure. When cardiac output is high the disorder could be treated with vasopressor.

scholarly journals A Critical Appraisal of Emergency Medicine Specialty Training and Resignation among Residents in Emergency Medicine in Turkey

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Murat Cetin ◽  
Sercan Bicakci ◽  
Mustafa Emin Canakci ◽  
Mevlut Okan Aydin ◽  
Basak Bayram
Keyword(s):  
Emergency Medicine ◽  
Work Environment ◽  
Online Survey ◽  
Critical Appraisal ◽  
Emergency Services ◽  
Training Programs ◽  
Personal Characteristics ◽  
Specialty Training ◽  
Scientific Journals ◽  
Burn Out

Background and Aim. The nonsatisfaction among emergency medicine specialty trainees is an underrated issue in Turkey. Several previous studies have evaluated the burn-out and its consequences among physicians, but there is no study conducted with specialty trainees. The aim of this study is to evaluate the reasons for resignation among emergency medicine specialty residents in Turkey. Method. A total of 41 participants, who resigned from emergency medicine residency, were contacted by phone and invited to complete an online survey that included 25 questions about personal characteristics and departmental information. Results. Most frequent reasons of resignation were violence/security concerns (63.4%), busy work environment (53.7%), and mobbing (26.8%). Participants who reported that they have resigned due to inadequate training were mostly over 30 years old (p=0.02), continued more than 6 months to EMST (p<0.001), reported that there was no regular rotation program (p=0.003) or access to full-text scientific journals (p=0.045) in their department. All participants thought that there were deficits in the training programs, and none of them declared regret for resigning. Twenty-eight participants (68.2%) continued their specialty training at a different discipline after resignation. Conclusion. Major barriers against a high-quality and sustainable emergency medicine residency are violence in emergency services, mobbing in academic or administrative bodies, and inaccessibility to scientific resources. These obstacles can only be removed by cooperation of multiple institutions in Turkey.

A maximal covering facility location model for emergency services within an M (t)/M/m/m queuing system

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Iman Bahrami ◽  
Roya M. Ahari ◽  
Milad Asadpour
Keyword(s):  
Facility Location ◽  
Emergency Services ◽  
Queuing System ◽  
Location Model ◽  
Computational Time ◽  
Nsga Ii ◽  
Content Type ◽  
Maximal Covering ◽  
Proposed Model

Purpose In emergency services, maximizing population coverage with the lowest cost at the peak of the demand is important. In addition, due to the nature of services in emergency centers, including hospitals, the number of servers and beds is actually considered as the capacity of the system. Hence, the purpose of this paper is to propose a multi-objective maximal covering facility location model for emergency service centers within an M (t)/M/m/m queuing system considering different levels of service and periodic demand rate. Design/methodology/approach The process of serving patients is modeled according to queuing theory and mathematical programming. To cope with multi-objectiveness of the proposed model, an augmented ε-constraint method has been used within GAMS software. Since the computational time ascends exponentially as the problem size increases, the GAMS software is not able to solve large-scale problems. Thus, a NSGA-II algorithm has been proposed to solve this category of problems and results have been compared with GAMS through random generated sample problems. In addition, the applicability of the proposed model in real situations has been examined within a case study in Iran. Findings Results obtained from the random generated sample problems illustrated while both the GAMS software and NSGA-II almost share the same quality of solution, the CPU execution time of the proposed NSGA-II algorithm is lower than GAMS significantly. Furthermore, the results of solving the model for case study approve that the model is able to determine the location of the required facilities and allocate demand areas to them appropriately. Originality/value In the most of previous works on emergency services, maximal coverage with the minimum cost were the main objectives. Hereby, it seems that minimizing the number of waiting patients for receiving services have been neglected. To the best of the authors’ knowledge, it is the first time that a maximal covering problem is formulated within an M (t)/M/m/m queuing system. This novel formulation will lead to more satisfaction for injured people by minimizing the average number of injured people who are waiting in the queue for receiving services.

Sign in / Sign up

Export Citation Format

Share Document