scholarly journals Understanding the burden and mitigating risks in the utilisation of the Emergency Medical Services in the management of community mental health emergencies

2021 ◽  
Author(s):  
Ian Howard ◽  
Nicholas Castle ◽  
Loua Al Shaikh ◽  
Robert Owen
Keyword(s):  
Mental Health ◽  
Emergency Medical Services ◽  
Average Rate ◽  
Risk Identification ◽  
Medical Services ◽  
Action Plans ◽  
Transportation Of Patients ◽  
Cross Sectional ◽  
Patient Cohort ◽  
Emergency Medical

Introduction Mental health disorders are highly prevalent globally with access to appropriate care oftentimes problematic. The Emergency Medical Services (EMS) have been suggested as a potential solution to improve access, however, it is unclear whether these services provide the most appropriate response with respect to the needs of patients experiencing a mental health emergency. Methods A multi-method study was conducted to assess the current burden and potential risks associated with the transportation of patients experiencing a mental health emergency by EMS. Part 1 utilised a cross-sectional study of routinely collected clinical data for the period January 2018 to December 2019. Part 2 employed a systematic risk identification methodology focused on identifying the hazards associated with the transportation of this patient cohort, to identify key action plans towards mitigating their occurrence. Results Patients experiencing a mental health emergency were transported at an average rate of 11.96 per 1000 transports. Approximately 7% were administered prehospital sedation, with Ketamine administered as the most common sedative. Altogether, 50 potential hazards were identified involving the transportation of patients experiencing a mental health emergency. The Patient Assessment subprocess contained the most potential hazards/failure points (n=13). Risks categorized as occasional (n=33) and moderate (n=16) made up the majority. Conclusion The burden of mental health emergencies on EMS is considerable, with the potential for several significant risks. Despite this, there was unequal focus on the development of care pathways and clinical guidance for this patient cohort compared with the more "traditional" case types serviced by EMS. Consequently, we identified several strategic-level action plans to mitigate these hazards and improve the delivery of care for these patients in the community.

Mental health patterns during COVID-19 in emergency medical services (EMS)

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Sílvia Monteiro Fonseca ◽  
Sara Faria ◽  
Sónia Cunha ◽  
Márcio Silva ◽  
M. Joaquina Ramos ◽  
...  
Keyword(s):  
Mental Health ◽  
Emergency Medical Services ◽  
Well Being ◽  
Medical Services ◽  
Security Measures ◽  
Obsessive Compulsive ◽  
Cross Sectional ◽  
Content Type ◽  
Emergency Medical ◽  
Health Patterns

PurposeThis study aims to explore patterns of Emergency Medical Services (EMS) personnel's mental health, regarding their levels of anxiety, depression, stress, COVID-19 anxiety, obsessive-compulsive symptoms and well-being; and to explore variables that contribute to these patterns, among sociodemographic/professional and COVID-19 experience variables.Design/methodology/approachParticipants were 214 EMS personnel, who answered the Patient-Health Questionnaire, Perceived Stress Scale, COVID-19 Anxiety Scale, Obsessive-Compulsive Inventory, Well-Being Questionnaire and COVID-19 related questions.FindingsEMS personnel showed an adequate psychological adjustment during COVID-19. Two clusters/patterns were found: the poorly (34%) and the well (66%) psychologically-adjusted. Personnel's age, COVID-19 fear and workplace security measures' adequacy contributed to which pattern they were more likely to belong to.Research limitations/implicationsDespite being cross-sectional and not controlling for pre-COVID-19 data, this study adds to the COVID-19 literature. Findings call for the need to explore: other COVID-19 fears; how personnel perceive workplace security measures; COVID-19 valid instruments; pre-COVID-19 data; and mental health patterns with different rescuers.Practical implicationsFindings explored EMS personnel's patterns of mental health during the COVID-19, as well as its covariates. Results allow to better prepare emergency management, which can develop prevention strategies focused on older professionals, COVID-19 related fears and how personnel assess security measures.Originality/valueThis study contributes to the scarce literature focused on COVID-19 mental health patterns instead of focussing on isolated mental health variables, as well as what contributes to these patterns. Moreover, it is one of the few studies that focused on EMS personnel rather than hospital staff.

National study of emergency medical services core competencies in Saudi Arabia

2020 ◽  
Vol 9 (3) ◽  
pp. 245-255
Author(s):  
Talal AlShammari ◽  
Paul Jennings ◽  
Brett Williams
Keyword(s):  
Saudi Arabia ◽  
Emergency Medical Services ◽  
Core Competencies ◽  
Healthcare Providers ◽  
Core Competency ◽  
Medical Services ◽  
National Study ◽  
Cross Sectional ◽  
Content Type ◽  
Emergency Medical

PurposeEmergency medical services (EMS) educational standards in Saudi Arabia have developed at an unprecedented rate, and the rapid pace of development has resulted in a considerable disparity of educational approaches. Therefore, an empirically based core competency framework should be developed. The aim was to utilize exploratory factor analysis (EFA) in the reduction and generation of a theoretical Saudi competency model.Design/methodology/approachA purposive sample was utilized in a national quantitative cross-sectional study design of Saudi Red Crescent Authority (SRCA) healthcare workers. The instrument comprised 41 core competency items rated on a Likert scale. EFA alpha factoring with oblique promax rotation was applied to the 41 items.FindingsA total of 450 EMS healthcare providers participated in the study, of whom 422 (93.8 per cent) were male and 28 (6.2 per cent) female. Of the participants, 230 (60 per cent) were aged 29–39 years and 244 (54.2 per cent) had 5–9 years of experience. An EFA of instrument items generated five factors: professionalism, preparedness, communication, clinical and personal with an eigenvalue > 1, representing 67.5 per cent of total variance. Only variables that had a loading value >0.40 were utilized in the factor solution.Originality/valueThe EFA model Saudi ParamEdic Competency Scale (SPECS) has been identified, with 27 core competency items and five overarching factors. The model has considerable similarities to other medical competency frameworks. However, some aspects are specifically unique to the Saudi EMS context. The SPECS model provides an academic blueprint that can be used by paramedic educational programs to ensure empirical alignment with the needs of the industry and community.

Differences in Cardiovascular Health Metrics in Emergency Medical Technicians Compared to Paramedics: A Cross-Sectional Study of Emergency Medical Services Professionals

2019 ◽  
Vol 34 (03) ◽  
pp. 288-296 ◽  
Author(s):  
Rebecca E. Cash ◽  
Remle P. Crowe ◽  
Julie K. Bower ◽  
Randi E. Foraker ◽  
Ashish R. Panchal
Keyword(s):  
Emergency Medical Services ◽  
Cardiovascular Health ◽  
High Stress ◽  
Emergency Medical Technicians ◽  
Medical Services ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Lower Odds ◽  
Emergency Medical ◽  
Employment Characteristics

AbstractBackground:Emergency Medical Services (EMS) professionals face high physical demands in high-stress settings; however, the prevalence of cardiovascular health (CVH) risk factors in this health care workforce has not been explored. The primary objective of this study was to compare the distribution of CVH and its individual components between a sample of emergency medical technicians (EMTs) and paramedics. The secondary objective was to identify associations between demographic and employment characteristics with ideal CVH in EMS professionals.Methods:A cross-sectional survey based on the American Heart Association’s (AHA; Dallas, Texas USA) Life’s Simple 7 (LS7) was administered to nationally-certified EMTs and paramedics. The LS7 components were scored according to previously described cut points (ideal = 2; intermediate = 1; poor = 0). A composite CVH score (0-10) was calculated from the component scores, excluding cholesterol and blood glucose due to missing data. Multivariable logistic regression was used to estimate odds ratios (OR; 95% CI) for demographic and employment characteristics associated with optimal CVH (≥7 points).Results:There were 24,708 respondents that were currently practicing and included. More EMTs achieved optimal CVH (n = 4,889; 48.8%) compared to paramedics (n = 4,338; 40.6%). Factors associated with higher odds of optimal CVH included: higher education level (eg, college graduate or more: OR = 2.26; 95% CI, 1.97-2.59); higher personal income (OR = 1.26; 95% CI, 1.17-1.37); and working in an urban versus rural area (OR = 1.31; 95% CI, 1.23-1.40). Paramedic certification level (OR = 0.84; 95% CI, 0.78-0.91), older age (eg, 50 years or older: OR = 0.65; 95% CI, 0.58-0.73), male sex (OR = 0.54; 95% CI, 0.50-0.56), working for a non-fire-based agency (eg, private service: OR = 0.68; 95% CI, 0.62-0.74), and providing medical transport service (OR = 0.81; 95% CI, 0.69-0.94) were associated with lower odds of optimal CVH.Conclusions:Several EMS-related characteristics were associated with lower odds of optimal CVH. Future studies should focus on better understanding the CVH and metabolic risk profiles for EMS professionals and their association with incident cardiovascular disease (CVD), major cardiac events, and occupational mortality.Cash RE, Crowe RP, Bower JK, Foraker RE, Panchal AR. Differences in cardiovascular health metrics in emergency medical technicians compared to paramedics: a crosssectional study of Emergency Medical Services professionals.Prehosp Disaster Med.2019;34(3):288–296.

Survey of Iowa Emergency Medical Services on the Effects of the 1993 Floods

1997 ◽  
Vol 12 (3) ◽  
pp. 37-41 ◽  
Author(s):  
Stanley E. Chartoff ◽  
Joann M. Gren
Keyword(s):  
Emergency Medical Services ◽  
Missouri River ◽  
Medical Services ◽  
Cross Sectional ◽  
Emergency Medical ◽  
First Response ◽  
Service Areas ◽  
The Government ◽  
Survey Questionnaires

AbstractIntroduction:From June through August 1993, extensive flooding in the Mississippi and Missouri River basins resulted in 50 deaths and 12 billion dollars [U.S.] in damages in nine Midwestern states. In Iowa (1990 population 2,777,000), the government declared all 99 counties Federal Disaster Areas. This study examines how this event impacted local emergency medical services (EMS).Methods:All 797 registered prehospital ambulance, rescue, and first-response companies in Iowa received survey questionnaires. Two follow-up mailings were provided for non-responders.Results:A total of 468 EMS companies (59%) returned completed questionnaires. The geographic distribution ofresponders and non-responders was similar. Of the companies responding, 132 (28%) reported an impact on their operations from the flood disaster. The most frequently reported operational changes included the use of non-traditional vehicles, providing aid to regions outside usual service areas, and involvement in non-medical rescue operations.Conclusion:A major flood provides unique challenges for emergency medical services. Cross-sectional surveys can identify areas of improvement for prehospital systems located in flood-prone areas. Results from this study provide a basis for constructing a more refined instrument to study future flood disasters.

scholarly journals Standard Precautions Among Emergency Medical Services in Urban and Rural Areas

2019 ◽  
Vol 68 (2) ◽  
pp. 73-80
Author(s):  
Riyadh A. Alhazmi ◽  
R. David Parker ◽  
Sijin Wen
Keyword(s):  
West Virginia ◽  
Emergency Medical Services ◽  
Rural Areas ◽  
Urban Areas ◽  
Medical Services ◽  
Cross Sectional Survey ◽  
Standard Precautions ◽  
Cross Sectional ◽  
Emergency Medical ◽  
Rural And Urban

Backround: Emergency medical services (EMS) workers are at risk of exposure to bloodborne pathogens and frequently exposed to blood and bodily fluids through percutaneous injuries. This study aimed to assess the consistency with which standard precautions (SPs) among rural and urban EMS providers were used. Methods: This study consisted of a cross-sectional survey conducted with a sample of certified EMS providers in West Virginia in which we ascertained details about sociodemographic characteristics, and the frequency of consistent SP. An email invitation was sent to a comprehensive list of agencies obtained from the Office of West Virginia EMS. Findings: A total of 248 out of 522 (47%) EMS providers completed the survey. The majority of the EMS providers (76%) consistently complied with SPs; however, more than one third (38%) of urban EMS providers indicated inconsistent use compared with 19% of rural EMS providers ( p = .002). Most EMS providers reported low prevention practices to exposure of blood and body fluids in both areas. Conclusion/Application to Practice: The results emphasize the need to enhanced safe work practices among EMS providers in both rural and urban areas through education and increasing self-awareness. Occupational health professional in municipalities that serve these workers are instrumental in ensuring these workers are trained and evaluated for their compliance with SPs while in the field.

In-Field Extremity Amputation: Prevalence and Protocols in Emergency Medical Services

1996 ◽  
Vol 11 (1) ◽  
pp. 63-66 ◽  
Author(s):  
Kathryn E. Kampen ◽  
Jon R. Krohmer ◽  
Jeffrey S. Jones ◽  
J.M. Dougherty ◽  
Robert K. Bonness
Keyword(s):  
North America ◽  
Emergency Medical Services ◽  
Motor Vehicle ◽  
Epidemiological Survey ◽  
Medical Services ◽  
Cross Sectional ◽  
Vehicle Accidents ◽  
Emergency Medical ◽  
Trauma Surgeons ◽  
And Training

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.

scholarly journals Analysis of the equity of emergency medical services: a cross-sectional survey in Chongqing city

The Lancet ◽  
2015 ◽  
Vol 386 ◽  
pp. S45
Author(s):  
Yalan Liu ◽  
Yi Jiang ◽  
Shenglan Tang ◽  
Qian Long ◽  
Jingfu Qiu ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Medical Services ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Emergency Medical ◽  
Chongqing City
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