scholarly journals IMPACT OF AGING POPULATIONS ON MUNICIPAL EMERGENCY MEDICAL SERVICES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S956-S956
Author(s):  
Nidya Velasco Roldan ◽  
Caitlin E Coyle ◽  
Michael Ward ◽  
Jan Mutchler
Keyword(s):  
Emergency Medical Services ◽  
Assisted Living ◽  
Local Governments ◽  
Emergency Services ◽  
Medical Services ◽  
Assisted Living Facilities ◽  
Older Population ◽  
Emergency Medical ◽  
Age Related ◽  
Aging Populations

Abstract The services that residents require from their local governments vary depending on the demographics of their populations. While municipalities have long sought to consider how changes in the young population may impact their school system needs, few systematic considerations have been developed relating to how aging populations may impact municipal service provision. This study aims to address this issue by focusing on demands on emergency services at the municipal level. Using data from the Massachusetts Ambulance Trip Record Information System (MATRIS) we explore the association between emergency medical services (EMS) demand and population age-structure. The data shows an overrepresentation of older people among EMS users. People age 65 and older represent 16% of Massachusetts’ population but account for 31% of the transported emergent calls —e.g., 911 calls— and 60% of the scheduled transports. Results from the OLS regression analysis suggest that communities with larger shares of older residents have significantly higher numbers of EMS calls. The type of community and other age-related community features such as the percentage of older residents living alone and the percentage of older population dually eligible for Medicare and Medicaid are also significantly associated with the number of EMS calls. Contrary to our expectations, other resources available in the community such nursing homes or assisted living facilities were not significantly associated with number of EMS calls. Our research indicates that if growth in the older population occurs as projected, the demand placed on the EMS system by older populations will grow considerably in coming decades.

Vaccination of the Elderly in Assisted Living by the Israeli Emergency Medical Services

2021 ◽  
Vol 111 (7) ◽  
pp. 1223-1226
Author(s):  
Eli Jaffe ◽  
Keren Dopelt ◽  
Nadav Davidovitch ◽  
Yuval Bitan
Keyword(s):  
Public Health ◽  
Emergency Medical Services ◽  
Assisted Living ◽  
The Elderly ◽  
Vulnerable Population ◽  
Entire Population ◽  
Medical Services ◽  
Assisted Living Facilities ◽  
Emergency Medical ◽  
Two Parameters

Emergency Medical Services (EMS) in Israel was called on to vaccinate the most vulnerable population—the elderly in assisted living facilities and their caregivers. Two parameters led the operation: (1) maximum use of the scarce COVID-19 vaccine, and (2) minimizing the time it took to reach this entire population. We present the process of vaccinating 126 245 people in two weeks at 756 locations countrywide, focusing on the planning and logistics of this operation. Resilience, flexible logistics, and dedicated personnel provided an efficient public health operation.

scholarly journals Public access defibrillation: utilisation and missed opportunities

2019 ◽  
Vol 16 ◽  
Author(s):  
Chris Cunningham ◽  
Jared R Lowe ◽  
Arthur Johnson ◽  
William Carter ◽  
William M Whited ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Assisted Living ◽  
Public Awareness ◽  
Public Access ◽  
Medical Services ◽  
Assisted Living Facilities ◽  
Missed Opportunities ◽  
Emergency Medical ◽  
Private Homes ◽  
Missed Opportunity

IntroductionAutomated external defibrillators (AEDs) for public use are becoming increasingly prevalent, but little is known about utilisation. The purpose of this study was to compare the locations of out-of-hospital cardiac arrests (OHCAs) to the locations of AEDs to determine whether missed opportunities exist.MethodsA retrospective study was performed of all OHCAs in which resuscitation was attempted between 1 January 2005 and 31 December 2010 in Orange County, North Carolina, United States of America, a mixed suburban/rural emergency medical services (EMS) system. Emergency medical services records were used to determine public AED utilisation and OHCA location. The locations were plotted on a map using ArcGIS. Businesses, public buildings and facilities located within a 100 metre radius of each OHCA were surveyed to determine AED availability. Data were analysed using standard descriptive statistics.ResultsDuring the study period, 307 OHCAs occurred at 282 locations. Of these, 219 (71%) occurred in private homes, 26 (9%) in nursing or assisted living facilities, and 62 (20%) in public locations. An AED location was within 100 metres of an OHCA location in 22 cases. Five cases were excluded due to the arrest being witnessed by EMS, and late or unknown AED installation time. Of the remaining 17 OHCAs, seven (41%) had a nearby AED that was not used, constituting a missed opportunity for deployment.ConclusionIn nearly half of OHCAs that have a nearby public AED, the AED was not utilised. This suggests that public awareness and accessibility of AED locations should be improved.

Correlation of age and rurality with low-urgency use of emergency medical services (LUEMS): A geographic analysis

CJEM ◽  
2017 ◽  
Vol 20 (6) ◽  
pp. 874-881 ◽  
Author(s):  
Mikiko Terashima ◽  
Alix J.E. Carter
Keyword(s):  
Emergency Medical Services ◽  
Public Transportation ◽  
Rural Areas ◽  
Tertiary Care ◽  
Incidence Rates ◽  
Medical Services ◽  
Older Population ◽  
Age Cohorts ◽  
Geographic Analysis ◽  
Emergency Medical

ABSTRACTObjectivesStudies suggest that addressing the needs of the older population in rural areas may substantially reduce their low-urgency use of emergency medical services (LUEMS). It may ultimately also help improve the efficiency in our health system. There is, however, a dearth of evidence substantiating geographic patterns in LUEMS by different age cohorts. This exploratory study was aimed to clarify the understanding of emergency medical services (EMS) use in Nova Scotia through a geographic analysis.MethodsRecords with Canadian Triage and Acuity Scale of 4 and 5 were considered as LUEMS. We assessed the distribution of LUEMS incidence rates (proportion of LUEMS out of all EMS uses) by age and rurality, using descriptive statistics and Geographic Information Systems mapping.ResultsNearly half of all EMS transports were individuals of 65+ years of age; 35% of those were LUEMS. The rates increased along with the level of rurality, and the older cohort had the highest incidence rates in non-metro communities. High rates were seen primarily in some rural communities farthest away from the capital/tertiary care centre.ConclusionHigh LUEMS incidence rates are rural phenomena but not specific to the older population. However, the absolute number of LUEMS by the older cohort is significant, and elder-specific interventions in rural regions could still lead to effective cost savings. Further investigation of other factors, such as distance to the emergency department, availability of public transportation, and socioeconomic conditions of EMS users, is needed.

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 Collaboration for preliminary design of a mobile health solution for ambulance dispatch in Rwanda

2020 ◽  
Vol 3 (2) ◽  
pp. 1-5
Author(s):  
Ashley Rosenberg ◽  
◽  
Rob Rickard ◽  
Fraterne Zephyrin Uwinshuti ◽  
Gabin Mbanjumucyo ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Emergency Services ◽  
Prehospital Care ◽  
Capital City ◽  
Medical Services ◽  
Middle Income ◽  
Golden Hour ◽  
Middle Income Countries ◽  
Emergency Medical ◽  
Prehospital Emergency

The first 60 minutes after a trauma are described as “the golden hour.” For each minute of prehospital time, the risk of dying increases by 5% (Sampalis et al., 1999). Since 90% of the global burden of injuries occur in low- and middle-income countries and lead to 5.8 million deaths annually, addressing rapid access to emergency services is critical in these settings (Nielsen et al., 2012). In most low- and middle-income countries (LMICs), there are no formal trauma systems, and many lack organized prehospital care (Nielsen et al., 2012). Emergency medical dispatch and communication systems are a foundational component of emergency medical services (World Health Organization, 2005). Yet there are no established recommendations of creating these systems inLMICs.Rwanda, a country of over 12 million people, is a rapidly developing leader in East Africa. The Ministry of Health of Rwanda established the Service d’Aide Medicale Urgente (SAMU) in 2007, recognizing the need for public emergency medical services. SAMU’s national dispatch center receives roughly 3,000 calls per month through a national 912 hotline. It organizes regional transportation with 260 total ambulances located at hospitals throughout the country and provides prehospital emergency services in the capital city of Kigali with a fleet of 12 ambulances. In the city, each ambulance has a driver, nurse and anesthetist dispatched for every call. Emergency department nursing and anesthetist staff are dispatched from hospitals around the country to respond to regional emergencies. No formal prehospital cadre of the workforce exists although the SAMU staffhave extensive field experience in prehospital care. SAMU has several challenges to rapid prehospital emergency care including lack of addresses beyond the capital city, unclear location data in densely populated areas, complex communication processes with little information about health facility capacity, and no established electronic dispatch system. The average response time for SAMU ambulances was 59 minutes in 2018, but 39% of calls were not completed within the golden hour.

scholarly journals Introduction and contemporary condition of helicopter emergency medical services in Korea

2020 ◽  
Vol 63 (4) ◽  
pp. 193-198
Author(s):  
Jin-Seong Cho ◽  
Hyuk Jun Yang
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Emergency Medical Services ◽  
Local Governments ◽  
Cost Effective ◽  
Severe Trauma ◽  
Economic Research ◽  
Medical Services ◽  
Air Ambulances ◽  
Emergency Medical

As most medical facilities in Korea have been concentrated in large cities, the need to improve emergency medical services in islands and mountainous areas has emerged. Consequently, the Ministry of Health and Welfare and local governments have introduced emergency medical helicopters (known as helicopter ambulances or air ambulances) with doctors in medically vulnerable areas. Having been introduced in two regions in 2011, air ambulances are operational in seven regions as of the end of 2019. The flight time is from sunrise to sunset, except in Gyeonggi province, which is open all day. Although the criteria for transport vary depending on whether an ambulance is available for operation, it is basically intended for emergency critical diseases, such as severe trauma, stroke, and acute myocardial infarction. From September 23, 2011 to December 31, 2018, a total of 10,367 transfer requests were received, which included 534 (5.2%) interruptions, 2,657 (25.6%) rejects, and 7,176 (69.2%) transfers. A total of 7,209 patients were transferred during this period, which included 1,693 (23.5%) patients of severe trauma, 1,149 (15.9%) patients of stroke, 802 (11.1%) patients of acute myocardial infarction, and 3,565 (49.5%) patients suffering from other emergency diseases. Some economic research on air ambulances in Korea has been reported to be cost-effective, but additional research should be performed. In the future, it is necessary to widen the area of operation of air ambulances and find alternative means of transporting patients during unfavorable conditions such as night or bad weather.

scholarly journals Implementation and development of guidelines in the emergency services in Kosovo – PARIHS framework

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
R Hodza-Beganovic ◽  
H Carlsson ◽  
H Lidberg ◽  
V Blaku ◽  
P Berggren
Keyword(s):  
Emergency Medical Services ◽  
Emergency Services ◽  
Treatment Guidelines ◽  
Medical Services ◽  
Local Context ◽  
Implementation Outcomes ◽  
Emergency Medical ◽  
External Facilitator ◽  
Core Components ◽  
Parihs Framework

Abstract Background The aim of this project is to create understanding on the determinant factors enhancing adherence to treatment guidelines for the emergency medical services in Kosovo (EMSK). Focus is on barriers, and enablers while introducing the guidelines. It is aiming to create clearance and understanding of how and why the implementation outcomes are achieved. The factors influencing implementation will be mapped in three main domains. The domains are part of the determinant framework Promoting Action on Research Implementation in Health Services (PARIHS). Each of the domains is further divided into sub-constructs. Methods The process of implementing treatment guidelines into the emergency medical services in Kosovo was observed and documented by 4 researchers, using a participatory research design. The PARIHS framework that consists of three core components: evidence, context, and facilitation was applied to make clarity on what works better and why, in order to achieve the outcomes of the implemented guidelines. Results The preliminary results have shown that the three constructs have an important role in the process of implementation. The domain evidence determined the way the evidence based practice is conceived in this particular setting. The domain context concerns the organization and teamwork shaped challenges and possibilities for adherence to the guidelines. The role of an external facilitator was of specific importance. Conclusions The PARIHS framework serves in both practical and theoretical planning of an intervention. In the present project it provides clarity on planning of the process, while also offer understanding of the elements that contribute to the sustainability of the intervention. Finally the lessons from the approach can be replicated in similar context. Key messages Implementation projects can be more successful suing a framework to direct the effort. Such interventions should be premised with clarity on the evidence, the local context, and facilitation factors. 

scholarly journals Testing quality indicators and proposing benchmarks for physician-staffed emergency medical services: a prospective Nordic multicentre study

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e030626 ◽  
Author(s):  
Helge Haugland ◽  
Anna Olkinuora ◽  
Leif Rognås ◽  
David Ohlen ◽  
Andreas Krüger
Keyword(s):  
Adverse Events ◽  
Emergency Medical Services ◽  
Quality Indicators ◽  
Emergency Services ◽  
Quality Measurement ◽  
Medical Services ◽  
Total Quality ◽  
Emergency Medical ◽  
Sentinel Events ◽  
Quality Measurements

ObjectivesA consensus study from 2017 developed 15 response-specific quality indicators (QIs) for physician-staffed emergency medical services (P-EMS). The aim of this study was to test these QIs for important characteristics in a real clinical setting. These characteristics were feasibility, rankability, variability, actionability and documentation. We further aimed to propose benchmarks for future quality measurements in P-EMS.DesignIn this prospective observational study, physician-staffed helicopter emergency services registered data for the 15 QIs. The feasibility of the QIs was assessed based on the comments of the recording physicians. The other four QI characteristics were assessed by the authors. Benchmarks were proposed based on the quartiles in the dataset.SettingNordic physician-staffed helicopter emergency medical services.Participants16 physician-staffed helicopter emergency services in Finland, Sweden, Denmark and Norway.ResultsThe dataset consists of 5638 requests to the participating P-EMSs. There were 2814 requests resulting in completed responses with patient contact. All QIs were feasible to obtain. The variability of 14 out of 15 QIs was adequate. Rankability was adequate for all QIs. Actionability was assessed as being adequate for 10 QIs. Documentation was adequate for 14 QIs. Benchmarks for all QIs were proposed.ConclusionsAll 15 QIs seem possible to use in everyday quality measurement and improvement. However, it seems reasonable to not analyse the QI ‘Adverse Events’ with a strictly quantitative approach because of a low rate of adverse events. Rather, this QI should be used to identify adverse events so that they can be analysed as sentinel events. The actionability of the QIs ‘Able to respond immediately when alarmed’, ‘Time to arrival of P-EMS’, ‘Time to preferred destination’, ‘Provision of advanced treatment’ and ‘Significant logistical contribution’ was assessed as being poor. Benchmarks for the QIs and a total quality score are proposed for future quality measurements.

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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