The Association of Trauma Center Transport and Long‐term Functional Outcomes in Head‐injured Older Adults Transported by Emergency Medical Services

2020 ◽  
Vol 27 (3) ◽  
pp. 207-216
Author(s):  
Daniel K. Nishijima ◽  
Samuel D. Gaona ◽  
Mark Faul ◽  
Daniel J. Tancredi ◽  
Trent Waechter ◽  
...  
Keyword(s):  
Older Adults ◽  
Emergency Medical Services ◽  
Trauma Center ◽  
Functional Outcomes ◽  
Medical Services ◽  
Emergency Medical ◽  
Head Injured

Long-term outcomes among injured older adults transported by emergency medical services

Injury ◽  
2019 ◽  
Vol 50 (6) ◽  
pp. 1175-1185 ◽  
Author(s):  
Craig D. Newgard ◽  
Amber Lin ◽  
N. David Yanez ◽  
Eileen Bulger ◽  
Susan Malveau ◽  
...  
Keyword(s):  
Older Adults ◽  
Emergency Medical Services ◽  
Medical Services ◽  
Long Term Outcomes ◽  
Emergency Medical

scholarly journals Prehospital time and mortality in polytrauma patients: a retrospective analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
E. Berkeveld ◽  
Z. Popal ◽  
P. Schober ◽  
W. P. Zuidema ◽  
F. W. Bloemers ◽  
...  
Keyword(s):  
Patient Outcome ◽  
Emergency Medical Services ◽  
Trauma Center ◽  
Total Mortality ◽  
Medical Services ◽  
Severely Injured ◽  
Emergency Medical ◽  
Polytrauma Patients ◽  
Level I ◽  
Prehospital Time

Abstract Background The time from injury to treatment is considered as one of the major determinants for patient outcome after trauma. Previous studies already attempted to investigate the correlation between prehospital time and trauma patient outcome. However, the outcome for severely injured patients is not clear yet, as little data is available from prehospital systems with both Emergency Medical Services (EMS) and physician staffed Helicopter Emergency Medical Services (HEMS). Therefore, the aim was to investigate the association between prehospital time and mortality in polytrauma patients in a Dutch level I trauma center. Methods A retrospective study was performed using data derived from the Dutch trauma registry of the National Network for Acute Care from Amsterdam UMC location VUmc over a 2-year period. Severely injured polytrauma patients (Injury Severity Score (ISS) ≥ 16), who were treated on-scene by EMS or both EMS and HEMS and transported to our level I trauma center, were included. Patient characteristics, prehospital time, comorbidity, mechanism of injury, type of injury, HEMS assistance, prehospital Glasgow Coma Score and ISS were analyzed using logistic regression analysis. The outcome measure was in-hospital mortality. Results In total, 342 polytrauma patients were included in the analysis. The total mortality rate was 25.7% (n = 88). Similar mean prehospital times were found between the surviving and non-surviving patient groups, 45.3 min (SD 14.4) and 44.9 min (SD 13.2) respectively (p = 0.819). The confounder-adjusted analysis revealed no significant association between prehospital time and mortality (p = 0.156). Conclusion This analysis found no association between prehospital time and mortality in polytrauma patients. Future research is recommended to explore factors of influence on prehospital time and mortality.

scholarly journals The Role of Emergency Medical Services in Geriatrics: Bridging the Gap between Primary and Acute Care

CJEM ◽  
2015 ◽  
Vol 18 (1) ◽  
pp. 54-61 ◽  
Author(s):  
Judah Goldstein ◽  
Jennifer McVey ◽  
Stacy Ackroyd-Stolarz
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Emergency Medical Services ◽  
Acute Care ◽  
Functional Independence ◽  
Adverse Outcomes ◽  
Medical Services ◽  
Care Needs ◽  
Frail Older Adults ◽  
Emergency Medical

AbstractCaring for older adults is a major function of emergency medical services (EMS). Traditional EMS systems were designed to treat single acute conditions; this approach contrasts with best practices for the care of frail older adults. Care might be improved by the early identification of those who are frail and at highest risk for adverse outcomes. Paramedics are well positioned to play an important role via a more thorough evaluation of frailty (or vulnerability). These findings may inform both pre-hospital and subsequent emergency department (ED) based decisions. Innovative programs involving EMS, the ED, and primary care could reduce the workload on EDs while improving patient access to care, and ultimately patient outcomes. Some frail older adults will benefit from the resources and specialized knowledge provided by the ED, while others may be better helped in alternative ways, usually in coordination with primary care. Discerning between these groups is a challenge worthy of further inquiry. In either case, care should be timely, with a focus on identifying emergent or acute care needs, frailty evaluation, mobility assessments, identifying appropriate goals for treatment, promoting functional independence, and striving to have the patient return to their usual place of residence if this can be done safely. Paramedics are uniquely positioned to play a larger role in the care of our aging population. Improving paramedic education as it pertains to geriatrics is a critical next step.

Long-Term Mortality of Emergency Medical Services Patients

2017 ◽  
Vol 70 (3) ◽  
pp. 366-373.e3 ◽  
Author(s):  
Morten T. Bøtker ◽  
Christian J. Terkelsen ◽  
Jan N. Sørensen ◽  
Søren B. Jepsen ◽  
Søren P. Johnsen ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Medical Services ◽  
Emergency Medical ◽  
Long Term Mortality

scholarly journals An Emergency Medical Services Program to Promote the Health of Older Adults

2006 ◽  
Vol 54 (6) ◽  
pp. 956-962 ◽  
Author(s):  
Manish N. Shah ◽  
Lindsay Clarkson ◽  
E. Brooke Lerner ◽  
Rollin J. Fairbanks ◽  
Robert McCann ◽  
...  
Keyword(s):  
Older Adults ◽  
Emergency Medical Services ◽  
Medical Services ◽  
Emergency Medical

scholarly journals Study on patient satisfaction among patients with trauma admitted to trauma centre and emergency medical services ward

2019 ◽  
Vol 6 (4) ◽  
pp. 1219
Author(s):  
Mrutyunjay I. Uppin ◽  
Kapildev K. Hannurkar ◽  
Archana M. Uppin
Keyword(s):  
Patient Satisfaction ◽  
Emergency Medical Services ◽  
Trauma Center ◽  
Road Traffic ◽  
Trauma Centre ◽  
Medical Services ◽  
Research Centre ◽  
Trauma Patients ◽  
Quality Health Care ◽  
Emergency Medical

Background: Patient satisfaction is an important key factor for determining the quality health care and services offered by the emergency departments in the hospital. The objectives of the study were to assess the satisfaction of the trauma patients attending the trauma center with the services provided by the KLES Dr. Prabhakar Kore Hospital and Research Centre, Belagavi, Karnataka.Methods: Fifty trauma patients admitted and treated in trauma center and emergency medical services ward (TCEMS) at KLES Dr. Prabhakar Kore Hospital and Research Centre, Belagavi, over a period of 3 months (from November 2014 till January 2015) were interviewed. After obtaining an informed consent, the required data was collected using a pre-designed and pre-tested questionnaire.Results: Out of the 50 patients interviewed, 86% were males and 14% were females. Out of them 74% were road traffic accident victims. 67.5% of these victims were between the age group of 21 and 50 yrs. The overall satisfaction was good with all the services provided at the center. 80% were satisfied with the care provided by the doctors, 80% with communication by doctors, more than 75% with accessory services, more than 65% with the wait times at various levels and more than 85% satisfaction with amenities in the ward.Conclusions: In conclusion our study revealed that the availability of consultant in triage area, improvements in communication, quick service at the Casualty Pharmacy, reducing the perceived waiting times at various levels and improvement in the ambience of the unit would further enhance the patient satisfaction with TCEMS.

scholarly journals Construction of a dynamic arrival time coverage map for emergency medical services

2018 ◽  
Vol 10 (1) ◽  
pp. 167-173 ◽  
Author(s):  
Adam Piórkowski
Keyword(s):  
Emergency Medical Services ◽  
Arrival Time ◽  
Medical Services ◽  
The Road ◽  
Emergency Medical ◽  
Long Term Trends ◽  
Static Version ◽  
On The Road ◽  
Dynamic Version

Abstract This article presents a design of coverage maps for emergency journeys made by emergency medical services. The system was designed for the Malopolskie Voivodeship Office in Cracow, Poland. The proposed solution displays maps of the ambulance coverage of areas and ambulance’s potential journey times. There are two versions of the map: static and dynamic. The static version is used to appropriately allocate ambulances to cover an area with the ability to reach locations in less than 15 or 20 minutes; the dynamic version allows monitoring of ambulance fleets under normal conditions or in the event of a crisis. The article also presents the results of archival data related to the movement of ambulances on the roads of Malopolskie Voivodship. Particular attention was paid to the relation between the speed of vehicles and the traffic on the road, the day of the week or month, and long-term trends. The collected observations made it possible to assume a general model of ambulance movement in the voivodeship to calculate arrival time coverage maps.

scholarly journals MANAGING DEATH IN THE FIELD: HOW EMERGENCY MEDICAL SERVICES TEAMS PROVIDE END-OF-LIFE CARE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S499-S499
Author(s):  
Deborah P Waldrop ◽  
Jacqueline M McGinley ◽  
Brian M Clemency
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Emergency Medical Services ◽  
End Of Life ◽  
End Of Life Care ◽  
Medical Services ◽  
Life Care ◽  
Serious Illness ◽  
Emergency Medical ◽  
Seriously Ill

Abstract Emergency medical services (EMS) providers respond more frequently to calls for older adults with serious illness than for people in other age groups. Recent legislation that makes it possible to document healthcare decisions has facilitated an era of choice in end-of-life care. EMS teams make time-sensitive decisions about care, resuscitation and hospital transport that influence how and where a seriously ill older adult will die and how his/her family will experience the death. Yet, EMS providers’ perspectives on urgent decision-making and how they work with families are unknown. The purpose of this study was to explore the decision-making process that occurs how EMS teams respond when someone is dying from a serious illness (vs. an injury). In-depth in-person interviews were conducted with 50 EMS providers (24 emergency medical technicians [EMTs] and 26 Paramedics) from four ambulance services. Participants’ ages ranged from 21-57 (M=37.9) and 70% were male. Qualitative data was coded using Atlas.ti software. Three themes illuminated participants’ experiences with end-of-life calls: (1) How legally binding documents (e.g. Do Not Resuscitate [DNR] orders, Medical Orders for Life Sustaining Treatment [MOLST]) inform care; (2) Decision-making about foregoing or halting resuscitation (e.g. no hospitalization, death at home); and (3) Family care, support and education. The results suggest that EMS providers have critically important roles in upholding the wishes of seriously ill older adults and helping caregiving families through the end-of-life transition. Implications: Discussions about the meaning of legally binding documents (e.g. DNR, MOLST) and EMS calls are important in advance care planning.

scholarly journals Emergency medical service, nursing, and physician providers’ perspectives on delirium identification and management

Dementia ◽  
2016 ◽  
Vol 16 (3) ◽  
pp. 329-343 ◽  
Author(s):  
Michael A LaMantia ◽  
Frank C Messina ◽  
Shola Jhanji ◽  
Arif Nazir ◽  
Mungai Maina ◽  
...  
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Emergency Medical Services ◽  
Mental Status ◽  
Medical Services ◽  
Diagnostic Strategy ◽  
Emergency Physicians ◽  
Emergency Nurses ◽  
Study Objective ◽  
Emergency Medical

Purpose of the study The study objective was to understand providers’ perceptions regarding identifying and treating older adults with delirium, a common complication of acute illness in persons with dementia, in the pre-hospital and emergency department environments. Design and methods The authors conducted structured focus group interviews with separate groups of emergency medical services staff, emergency nurses, and emergency physicians. Recordings of each session were transcribed, coded, and analyzed for themes with representative supporting quotations identified. Results Providers shared that the busy emergency department environment was the largest challenge to delirium recognition and treatment. When describing delirium, participants frequently detailed hyperactive features of delirium, rather than hypoactive features. Participants shared that they employed no clear diagnostic strategy for identifying the condition and that they used heterogeneous approaches to treat the condition. To improve care for older adults with delirium, emergency nurses identified the need for more training around the management of the condition. Emergency medical services providers identified the need for more support in managing agitated patients when in transport to the hospital and more guidance from emergency physicians on what information to collect from the patient’s home environment. Emergency physicians felt that delirium care would be improved if they could have baseline mental status data on their patients and if they had access to a simple, accurate diagnostic tool for the condition. Implications Emergency medical services providers, emergency nurses, and emergency physicians frequently encounter delirious patients, but do not employ clear diagnostic strategies for identifying the condition and have varying levels of comfort in managing the condition. Clear steps should be taken to improve delirium care in the emergency department including the development of mechanisms to communicate patients’ baseline mental status, the adoption of a systematized approach to recognizing delirium, and the institution of a standardized method to treat the condition when identified.

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