Comparison of Emergency Medical Services and Trauma Care Systems Among Pan-Asian Countries: An International, Multicenter, Population-Based Survey

2016 ◽  
Vol 21 (2) ◽  
pp. 242-251 ◽  
Author(s):  
Kyong Min Sun ◽  
Kyoung Jun Song ◽  
Sang Do Shin ◽  
Hideharu Tanaka ◽  
Goh E. Shaun ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Trauma Care ◽  
Population Based ◽  
Medical Services ◽  
Asian Countries ◽  
Emergency Medical ◽  
Care Systems ◽  
International Multicenter ◽  
Population Based Survey

Trauma System Development and Future Directions

1993 ◽  
Vol 8 (2) ◽  
pp. 111-114 ◽  
Author(s):  
Judith B. Braslow ◽  
Joan A. Snyder
Keyword(s):  
Public Health ◽  
Emergency Medical Services ◽  
Trauma Care ◽  
System Development ◽  
Trauma System ◽  
The United States ◽  
Advisory Council ◽  
Medical Services ◽  
Emergency Medical ◽  
Care Systems

AbstractTraumatic injury, both unintentional and intentional, is a serious public health problem. Trauma care systems play a significant role in reducing mortality, morbidity, and disability due to injuries. However, barriers to the provision of prompt and appropriate emergency medical services still exist in many areas of the United States. Title XII of the Public Health Service Act provides for programs in support of trauma care planning and system development by states and localities. This legislation includes provisions for: 1) grants to state agencies to modify the trauma care component of the state Emergency Medical Services (EMS) plan; 2) grants to improve the quality and availability of trauma care in rural areas; 3) development of a Model Trauma Care System Plan for states to use as a guide in trauma system development; and 4) the establishment of a National Advisory Council on Trauma Care Systems.

03 The prehospital 12 lead electrocardiogram is associated with improved outcomes in patients with acute coronary syndromes presenting to emergency medical services: a nationwide linked cohort study

2021 ◽  
Vol 38 (9) ◽  
pp. A2.1-A2
Author(s):  
Tom Quinn ◽  
Timothy Driscoll ◽  
Lucia Gavalova ◽  
Mary Halter ◽  
Chris P Gale ◽  
...  
Keyword(s):  
Cohort Study ◽  
Emergency Medical Services ◽  
Population Based ◽  
Medical Services ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Emergency Medical ◽  
St Segment ◽  
Coronary Syndromes ◽  
Audit Project

BackgroundUse of the Pre-Hospital 12-lead Electrocardiogram (PHECG) is recommended in patients presenting to emergency medical services (EMS) with suspected acute coronary syndrome (ACS).ObjectivesTo investigate differences in mortality between those who did/did not receive PHECG.MethodsPopulation-based, linked cohort study using Myocardial Ischaemia National Audit Project (MINAP) data from 2010-2017.ResultsOf 330,713 patients, 263,420 (79.6%) had PHECG, 67,293 (20.3%) did not. 30-day mortality was 7.8% overall, 7.1% with PHECG vs 10.9% without PHECG (adjusted Odds Ratio [aOR] 0.772, 95% confidence interval [CI] 0.748-0.795, p<0.001). 1 year mortality was 16.1% overall, 14.2% with PHECG vs 23.2% without (aOR 0.692, 95% CI 0.676-0.708, p<0.001). 144,254 patients had ST segment elevation myocardial infarction (STEMI); 130,240 (90.2%) had PHECG, 30 day mortality 8.8% overall, 8.0% with PHECG vs 15.9% without (aOR 0.588, 95% CI 0.557-0.622, p<0.001), 1 year mortality 13.1% overall, 12.1% with PHECG vs 22.8% without (aOR 0.585, 95% CI 0.557-0.614, p<0.001). 186,459 patients had non-STEMI; 133,180 (71.4%) had PHECG. 30-day mortality 7.1% overall, 6.1% with PHECG vs 9.6% without (aOR 0.677, 95%CI 0.652-0.704, p<0.001), 1 year mortality 18.3% overall, 16.3% with PHECG vs 23.3% without (aOR 0.694, 95% CI 0.676-0.713, p<0.001). 110,571 STEMI patients received primary PCI, 103,741 (93.8%) had PHECG. 30 day mortality 5.4% overall, 5.3% with PHECG vs 7.0% without (aOR 0.739, 95% CI 0.667-0.829, p<0.001). 1 year mortality 8.5% overall, 8.4% with PHECG vs 9.8% without (aOR 0.833, 95% CI 0.762-0.911, p<0.001). 26,127 (18.1%) STEMI patients received no reperfusion; 19,873 (76%) had PHECG. Mortality at 30 days 22.1% overall, 21.3% with PHECG vs 24.7% without (aOR 0.911, 95% CI 0.847-0.980, p=0.013), 1 year mortality 32.2% overall, 30.9% with PHECG, 36.4% without (aOR 0.865, 95% CI 0.810-0.925, p<0.001).ConclusionPHECG was associated with lower mortality at 30 days and 1 year in both STEMI and non-STEMI patients.

Rationale, development and implementation of the ReACanROC registry for out-of-hospital cardiac arrests in France and Canada

2021 ◽  
pp. emermed-2020-211073
Author(s):  
Matthieu Heidet ◽  
Hervé Hubert ◽  
Brian E Grunau ◽  
Sheldon Cheskes ◽  
Valentine Baert ◽  
...  
Keyword(s):  
North America ◽  
Emergency Medical Services ◽  
Care Delivery ◽  
Steering Committee ◽  
Population Based ◽  
Research Network ◽  
Medical Services ◽  
Emergency Medical ◽  
Utstein Style ◽  
Wide Population

France and Canada prehospital systems and care delivery in out-of-hospital cardiac arrests (OHCAs) show substantial differences. This article aims to describe the rationale, design, implementation and expected research implications of the international, population-based, France-Canada registry for OHCAs, namely ReACanROC, which is built from the merging of two nation-wide, population-based, Utstein-style prospectively implemented registries for OHCAs attended to by emergency medical services. Under the supervision of an international steering committee and research network, the ReACanROC dataset will be used to run in-depth analyses on the differences in organisational, practical and geographic predictors of survival after OHCA between France and Canada. ReACanROC is the first Europe-North America registry ever created to meet this goal. To date, it covers close to 80 million people over the two countries, and includes approximately 200 000 cases over a 10-year period.

Population-Based Study of Hypoglycemia in Patients with Type 1 Diabetes Mellitus Requiring Emergency Medical Services

2012 ◽  
Vol 18 (6) ◽  
pp. 834-841 ◽  
Author(s):  
Ajay Parsaik ◽  
Rickey Carter ◽  
Lucas Myers ◽  
Jennifer Geske ◽  
Steven Smith ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Emergency Medical Services ◽  
Population Based ◽  
Medical Services ◽  
Population Based Study ◽  
Emergency Medical

Impact of Improved Emergency Medical Services and Emergency Trauma Care on the Reduction in Mortality from Trauma

1985 ◽  
Vol 25 (7) ◽  
pp. 575-579 ◽  
Author(s):  
JOSEPH P. ORNATO ◽  
EDWARD J. CRAREN ◽  
NORMAN M. NELSON ◽  
KENNETH F. KIMBALL
Keyword(s):  
Emergency Medical Services ◽  
Trauma Care ◽  
Medical Services ◽  
Emergency Medical

A population-based investigation of public access defibrillation: Role of emergency medical services care

Resuscitation ◽  
2010 ◽  
Vol 81 (2) ◽  
pp. 163-167 ◽  
Author(s):  
Thomas D. Rea ◽  
Michele Olsufka ◽  
Brock Bemis ◽  
Lindsay White ◽  
Lihua Yin ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Population Based ◽  
Public Access ◽  
Medical Services ◽  
Public Access Defibrillation ◽  
Emergency Medical

scholarly journals Dispatch accuracy of physician-staffed emergency medical services in trauma care in south-east Norway: a retrospective observational study

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Martin Samdal ◽  
Kjetil Thorsen ◽  
Ola Græsli ◽  
Mårten Sandberg ◽  
Marius Rehn
Keyword(s):  
Emergency Medical Services ◽  
Trauma Care ◽  
Injury Severity ◽  
Road Traffic ◽  
Medical Services ◽  
Data Systems ◽  
Hospital Data ◽  
Accurate Identification ◽  
Emergency Medical ◽  
Patient Pathways

Abstract Background Selection of incidents and accurate identification of patients that require assistance from physician-staffed emergency medical services (P-EMS) remain essential. We aimed to evaluate P-EMS availability, the underlying criteria for dispatch, and the corresponding dispatch accuracy of trauma care in south-east Norway in 2015, to identify areas for improvement. Methods Pre-hospital data from emergency medical coordination centres and P-EMS medical databases were linked with data from the Norwegian Trauma Registry (NTR). Based on a set of conditions (injury severity, interventions performed, level of consciousness, incident category), trauma incidents were defined as complex, warranting P-EMS assistance, or non-complex. Incident complexity and P-EMS involvement were the main determinants when assessing the triage accuracy. Undertriage was adjusted for P-EMS availability and response and transport times. Results Among 19,028 trauma incidents, P-EMS were involved in 2506 (13.2%). The range of overtriage was 74–80% and the range of undertriage was 20–32%. P-EMS readiness in the event of complex incidents ranged from 58 to 70%. The most frequent dispatch criterion was “Police/fire brigade request immediate response” recorded in 4321 (22.7%) of the incidents. Criteria from the groups “Accidents” and “Road traffic accidents” were recorded in 10,875 (57.2%) incidents, and criteria from the groups “Transport reservations” and “Unidentified problem” in 6025 (31,7%) incidents. Among 4916 patient pathways in the NTR, 681 (13.9%) could not be matched with pre-hospital data records. Conclusions Both P-EMS availability and dispatch accuracy remain suboptimal in trauma care in south-east Norway. Dispatch criteria are too vague to facilitate accurate P-EMS dispatch, and pre-hospital data is inconsistent and insufficient to provide basic data for scientific research. Future dispatch criteria should focus on the care aspect of P-EMS. Better tools for both dispatch and incident handling for the emergency medical coordination centres are essential. In general, coordination, standardisation, and integration of existing data systems should enhance the quality of trauma care and increase patient safety.

Gunshot Injuries in Children Served by Emergency Services

2017 ◽  
pp. 127-137
Author(s):  
Craig D. Newgard ◽  
Nathan Kuppermann ◽  
James F. Holmes ◽  
Jason S. Haukoos ◽  
Brian Wetzel ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Injury Severity ◽  
Emergency Services ◽  
Population Based ◽  
Adverse Outcomes ◽  
Medical Services ◽  
Major Surgery ◽  
Gunshot Injuries ◽  
Emergency Medical ◽  
Injury Mechanisms

OBJECTIVE To describe the incidence, injury severity, resource use, mortality, and costs for children with gunshot injuries, compared with other injury mechanisms. METHODS This was a population-based, retrospective cohort study (January 1, 2006–December 31, 2008) including all injured children age ≤19 years with a 9-1-1 response from 47 emergency medical services agencies transporting to 93 hospitals in 5 regions of the western United States. Outcomes included population-adjusted incidence, injury severity score ≥16, major surgery, blood transfusion, mortality, and average per-patient acute care costs. RESULTS A total of 49 983 injured children had a 9-1-1 emergency medical services response, including 505 (1.0%) with gunshot injuries (83.2% age 15–19 years, 84.5% male). The population-adjusted annual incidence of gunshot injuries was 7.5 cases/100 000 children, which varied 16-fold between regions. Compared with children who had other mechanisms of injury, those injured by gunshot had the highest proportion of serious injuries (23%, 95% confidence interval [CI] 17.6–28.4), major surgery (32%, 95% CI 26.1–38.5), in-hospital mortality (8.0%, 95% CI 4.7–11.4), and costs ($28 510 per patient, 95% CI 22 193–34 827). CONCLUSIONS Despite being less common than other injury mechanisms, gunshot injuries cause a disproportionate burden of adverse outcomes in children, particularly among older adolescent males. Public health, injury prevention, and health policy solutions are needed to reduce gunshot injuries in children.

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