Motor Vehicle Accidents and Emergency Medical Services on Indian Reservations

1988 ◽  
Vol 153 (9) ◽  
pp. 453-456 ◽  
Author(s):  
John Porvaznik ◽  
Gordon H. Jensen
1996 ◽  
Vol 11 (1) ◽  
pp. 63-66 ◽  
Author(s):  
Kathryn E. Kampen ◽  
Jon R. Krohmer ◽  
Jeffrey S. Jones ◽  
J.M. Dougherty ◽  
Robert K. Bonness

AbstractObjective:To determine current experience, attitudes, and training concerning the performance of in-field extremity amputations in North America.Design:Cross-sectional, epidemiological survey.Participants:Emergency medical services (EMS) directors from the 200 largest metropolitan areas in North America and attendees at the 1992 Mid-Year National Association of EMS Physicians Meeting.Interventions:The survey consisted of five questions focusing on demographic and operational data, the frequency of occurrence of the performance of in-field amputations, personnel responsible for performing the procedure, existing written protocols for the procedure, and the scope of training provided.Results:A total of 143 surveys was completed. Eighteen respondents (13%) reported a total of 26 in-field extremity amputations in the past five years. The most common cause for the injuries requiring amputations was motor-vehicle accidents. In the majority of cases (53.2%), trauma surgeons were responsible for performing the amputation, followed by emergency physicians (36.4%). Of respondents, 96% stated that there was no training available through their EMS agencies related to the performance of in-field extremity amputations. Only two EMS systems had an existing protocol regarding in-field amputations.Conclusions:The results suggest a need for established protocols to make the procedure easily accessible when needed, especially in large metropolitan EMS systems. This information should be emphasized during EMS training and reinforced through continuing education.


2018 ◽  
Vol 33 (2) ◽  
pp. 165-170
Author(s):  
Aaron B. Klassen ◽  
S. Brent Core ◽  
Christine M. Lohse ◽  
Matthew D. Sztajnkrycer

AbstractStudy ObjectivesLaw enforcement is increasingly viewed as a key component in the out-of-hospital chain of survival, with expanded roles in cardiac arrest, narcotic overdose, and traumatic bleeding. Little is known about the nature of care provided by law enforcement prior to the arrival of Emergency Medical Services (EMS) assets. The purpose of the current study was to perform a descriptive analysis of events reported to a national EMS database.MethodsThis study was a descriptive analysis of the 2014 National Emergency Medical Services Information System (NEMSIS) public release research data set, containing EMS emergency response data from 41 states. Code E09_02 1200 specifically identifies care provided by law enforcement prior to EMS arrival.ResultsA total of 25,835,729 unique events were reported. Of events in which pre-arrival care was documented, 2.0% received prior aid by law enforcement. Patients receiving law enforcement care prior to EMS arrival were more likely to be younger (52.8 [SD=23.3] years versus 58.7 [SD=23.3] years), male (54.8% versus 46.7%), and white (80.3% versus 77.5%). Basic Life Support (BLS) EMS response was twice as likely in patients receiving prior aid by law enforcement. Multiple-casualty incidents were five times more likely with prior aid by law enforcement. Compared with prior aid by other services, law enforcement pre-arrival care was more likely with motor vehicle accidents, firearm assaults, knife assaults, blunt assaults, and drug overdoses, and less likely at falls and childbirths. Cardiac arrest was significantly more common in patients receiving prior aid by law enforcement (16.5% versus 2.6%). Tourniquet application and naloxone administration were more common in the law enforcement prior aid group.ConclusionWhere noted, law enforcement pre-arrival care occurs in 2.0% of EMS patient encounters. The majority of cases involve cardiac arrest, motor vehicle accidents, and assaults. Better understanding of the nature of law enforcement care is required in order to identify potential barriers to care and to develop appropriate training and policy recommendations.KlassenAB, CoreSB, LohseCM, SztajnkrycerMD. A descriptive analysis of care provided by law enforcement prior to EMS arrival in the United States. Prehosp Disaster Med. 2018;33(2):165–170.


1993 ◽  
Vol 22 (4) ◽  
pp. 651-656 ◽  
Author(s):  
Richard C Hunt ◽  
Robert L Brown ◽  
Kathleen A Cline ◽  
Jon R Krohmer ◽  
John B McCabe ◽  
...  

Author(s):  
Patcharee Prommoon ◽  
Thanom Phibalsak ◽  
Janya Netwachirakul ◽  
Mayuree Mekthat ◽  
Walailuk Jitpiboon ◽  
...  

Objective: This study aimed to report the situation of injuries and emergency medical services in southern Thailand.Material and Methods: Data from the Injury Surveillance system of a Level 1 Trauma Center Hospital in lower southern Thailand during 2012-2016 were extracted. Trends in epidemiological characteristics of both traffic and non-traffic injuries and emergency medical services were described. Logistic regression was used for the analysis.Results: The number of patients admitted to emergency departments due to traffic and non-traffic injuries was stable over the five-year period (n=102, 840). Traffic injuries involving motorcycles and falls were the two leading causes of injury. Most were adults aged 19-60 years (62.5%). The most common risky behaviors were driving a motor vehicle without wearing a seatbelt (81.9%) and riding a motorcycle without wearing a helmet (71.7%). Alcohol and drug use were relatively low but significantly increased the odds of sustaining a severe/critical injury. Significant predictors of severe/ critical non-traffic injury included drowning [odds ratio (OR)=29.7, 95% confidence interval (CI)=11.9-74.7], self-harm/ suicide (OR=12.6, 95% CI=9.2-17.3), and bites/stings from poisonous animals (OR=8.1, 95% CI=6.1-10.8). The use of Emergency Medical Services (EMS) was low but increased over time. The main challenge was delivering appropriate EMS for different levels of injury. The percentage of health care staff who performed advanced life support appropriately for critically injured patients ranged from 95.5% to 100.0% while for severely injured patients, ranged from 93.9% to 100.0%.Conclusion: Traffic and non-traffic injuries were high and the use of EMS was still low in southern Thailand.


2012 ◽  
Vol 7 (2) ◽  
pp. 137-144 ◽  
Author(s):  
Lt. Elise Cooper, MD, MPH ◽  
James R. Langabeer II, PhD ◽  
Diaa Alqusairi, MS ◽  
David Persse, MD, EMT-P, FACEP

Introduction: Little is known about the capacity and activity of emergency medical services (EMS) during large-scale disasters. This article provides a case study of the role of EMS in one large urban city during a major hurricane.Methods: The authors analyzed changes in call volume data from the City of Houston Fire Department’s EMS during Hurricane Ike. Descriptive and statistical analyses are used to explain surges and statistical differences in volumes.Results: Demand for EMS care can increase approximately 40 percent during surges in the disaster cycle, placing extreme burdens on system capacity and workload. The largest increase in demand came from respiratory problems, falls, and chest pains, with the largest decrease in calls from motor vehicle accidents.Conclusions: A strategy for managing surges in prehospital care from major disasters is a requirement for modern EMS.


2009 ◽  
Vol 197 (1) ◽  
pp. 30-34 ◽  
Author(s):  
Richard P. Gonzalez ◽  
Glenn R. Cummings ◽  
Herbert A. Phelan ◽  
Madhuri S. Mulekar ◽  
Charles B. Rodning

2012 ◽  
Vol 10 (1) ◽  
pp. 29-32 ◽  
Author(s):  
Israel Figueiredo Junior ◽  
Mauricio Vidal de Carvalho ◽  
Glaucia Macedo de Lima

OBJECTIVE: To outline a profile of pediatric trauma victims and verify the likelihood of trauma in children on a high traffic roadway. METHODS: A descriptive cohort study of the records of emergency medical service activations on the Rio-Niterói Bridge, a high traffic roadway in Rio de Janeiro, Brazil. Descriptive statistics were expressed as absolute and relative frequencies. The estimated risk of trauma in children aged < 12 years was calculated by means of odds ratios, with a 95% confidence interval. RESULTS: Trauma accounted for 514 of 1,244 activations (41.31%) of the Rio-Niterói Bridge emergency medical service between March 2002 and March 2003. Response to incidents involving children aged < 12 years accounted for 52 of these (4.18%). Half of victims were between the ages of 6 and 12 years (n = 26), and 55.76% were male (n = 29). Of the 52 victims, 37 (71.15%) were involved in motor vehicle accidents (OR: 3.70; 95%CI: 1.94-7.13; p < 0.0001). Of these, 28 were vehicle-vehicle collisions (75.67%). The most common sites of injury were the extremities (n = 12; 32.43%), face (n = 10; 27.02%), and head (n = 9; 24.32%). Pre-hospital procedures were performed on 23 of the 37 patients (62.16%), and 44.23% (n = 23/52) required hospital transportation. There were no deaths during the study period. CONCLUSIONS: In this study, children were at significantly higher odds of being treated for trauma while on a highway with heavy traffic flow. The most common sites of injury in this sample were the lower extremities and the head, face, and neck complex.


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