scholarly journals Validity and risk factor analysis for helicopter emergency medical services in Japan: a pilot study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Noriaki Yamada ◽  
Yuichiro Kitagawa ◽  
Takahiro Yoshida ◽  
Sho Nachi ◽  
Hideshi Okada ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pilot Study ◽  
Hospital Admission ◽  
Prehospital Care ◽  
Emergency Medical Technician ◽  
Emergency Intervention ◽  
Emergency Calls ◽  
Emergency Medical ◽  
Life Threatening ◽  
Medical Emergencies

Abstract Background Some emergency departments use triage scales, such as the Canadian Triage and Acuity Scale and Japan Urgent Stroke Triage Score, to detect life-threatening situations. However, these protocols have not been used for aeromedical services. Therefore, we investigated the factors predicting these life-threatening situations in aeromedical services as a pilot study for establishing the protocol. Method We retrospectively evaluated helicopter emergency medical service cases from 1 April 2015 to 31 March 2020 at Gifu University Hospital using the mission records. We only evaluated cases dealing with suggested internal medicine issues. We excluded cases influenced by external factors such as trauma or cases that included hospital-to-hospital transportation, focusing only on prehospital care. We evaluated the validity of the medical emergencies based on the needs for emergency interventions and hospital admission and of the suggested diagnoses and associated risk factors. Result A total of 451 cases were suitable for inclusion in the study. In the analysis for all emergency calls, 235 (52.11%) cases needed emergency intervention and 300 (64.4%) required hospital admission. The suggested diagnosis was valid for 261 (57.87%) cases. After the first assessment by emergency medical technicians, 75 cases were removed. Analysis after this first assessment found that 52.31% cases required emergency intervention, 70.26% needed admission, and the suggested diagnosis was valid for 69.41% of cases. In the analysis of emergency calls, the multivariate analysis of some key variables identified age, playing sports, and gasping as risk factors for emergency intervention. Hospital admission risk factors included being age only. The suggested diagnosis was valid only for sports situations. In the analysis after the first assessment by an emergency medical technician, risk factors for emergency intervention included being age being male, playing sports, and gasping, and those for hospital admission was being age, being male, and experiencing stroke symptoms and/or disturbance of consciousness. The suggested diagnosis was valid only for sports situations. Conclusion Some ‘second’ keywords/phrases predict medical emergencies. Therefore, the dispatch commander should gather these keyword/phrases to assess.

scholarly journals Validity and risk factor analysis for helicopter emergency medical services (HEMS): The emergency call dispatch of Japanese air ambulances (Doctor-HeliTM️)

2021 ◽  
Author(s):  
Noriaki YAMADA ◽  
Yuichiro KITAGAWA ◽  
Takahiro YOSHIDA ◽  
Sho NACHI ◽  
Hideshi OKADA ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Admission ◽  
Prehospital Care ◽  
University Hospital ◽  
Air Ambulances ◽  
Emergency Intervention ◽  
Emergency Calls ◽  
Emergency Medical ◽  
Disturbance Of Consciousness ◽  
Medical Emergencies

Abstract Background:Some emergency departments use triage scales, such as the Canadian Triage and Acuity Scale and the JUST, to detect the status of life-threatening situations. However, these triage systems have not been used for aeromedical services in Japan. Therefore, we investigated these profiles and conducted a pilot study.Method:We retrospectively evaluated the helicopter emergency medical service cases from 1 April 2015 to 31 March 2020 at Gifu University Hospital using our mission record. In this study, we only evaluated cases that dealt with internal medicine. We excluded cases that were influenced by external factors such as trauma or cases that included hospital-to-hospital transportation, focusing only on prehospital care. We evaluated the validity of medical emergencies such as emergency interventions and the necessity of hospital admission. In addition, we evaluated the validity of the suggested diagnoses and the associated risk factors.Result:A total of 451 cases were suitable for inclusion in the study. In the analysis for all emergency calls, 235 (52.11%) needed emergency intervention and 300 (64.4%) required hospital admission. The suggested diagnosis was valid for 261 (57.87%) cases. After the first assessment by emergency medical technicians (EMTs), 75 cases were removed from the analysis.Therefore, the results of the analysis for all emergency calls requiring emergency intervention were: 52.31%, need admission: 70.26%, and the suggested diagnosis was valid for 69.41% of cases. Results of a multivariate analysis of some key variables identified risk factors for emergency intervention, namely, age, under sports, and gasping. Hospital admission risk factors are being years old only. The suggested diagnosis was only valid in under sports situations.In the first analysis, the risk factors for emergency intervention are years old, being male, under sports, and gasping, and for hospital admission they are years old, being male, detecting stroke symptoms, and disturbance of consciousness. The suggested diagnosis was only valid in under sports situations.Conclusion:There are some “second” keywords/phrases that predict medical emergencies. Therefore, the dispatch commander should gather these keyword/phrases to assess.

Pre-Hospital Care Quality Program

1985 ◽  
Vol 1 (S1) ◽  
pp. 48-51
Author(s):  
Emil Pascarelli ◽  
Anthony Ciorciari
Keyword(s):  
Cognitive Abilities ◽  
Prehospital Care ◽  
Public Awareness ◽  
Care Quality ◽  
Emergency Medical Technician ◽  
Mass Public ◽  
Emergency Medical ◽  
Quality Program ◽  
The Usa ◽  
Clinical Changes

Paramedic units have awakened a new concept in prehospital care in the USA. New emergency medical services (EMS) administrations, better educated personnel, and mass public awareness through media events have all contributed to the change.Operational changes designed to tighten control of the emergency medical technician (EMT) and paramedic came about through deployment of ambulances and categorization and designation of emergency hospitals. Clinical changes have given the EMS responder, particularly the paramedic, a great deal of freedom in the care given to patients. The paramedic, who uses subjective criteria, can administer care ranging from Standard First Aid to advanced cardiology. Subjective control should be rigid for the EMT or paramedic, when cognitive abilities include only knowledge, comprehension and application, but not for those who have had a chance to exercise analytic and synthetic skills in pre-hospital training programs.

The Institute of Medicine Report on Emergency Medical Services for Chi: Thoughts for Emergency Medical Technicians, Paramedics, and Emergency Physicians

PEDIATRICS ◽  
1995 ◽  
Vol 96 (1) ◽  
pp. 199-205
Author(s):  
Richard T. Cook
Keyword(s):  
Emergency Medical Services ◽  
Prehospital Care ◽  
Fellowship Training ◽  
Pediatric Emergency ◽  
Emergency Medical Technician ◽  
Medical Services ◽  
Institute Of Medicine ◽  
Emergency Physicians ◽  
Care Givers ◽  
Emergency Medical

The emergency medical technician, the paramedic, and the emergency physician, as well as emergency physicians who have additional expertise in emergency medical service (EMS) prehospital care or pediatric emergency medicine (through experience or formal fellowship training), will all find the Institute of Medicine's report, Emergency Medical Services for Chi (EMS-C), to be an invaluable background resource as well as a guide for EMS system and EMS-C-related planning. With both breadth and depth, it reviews many of the issues in EMS-C today from many perspectives and provides practical information to enable these care givers to understand better the "big picture" of EMS-C as well as to assist them in continuing to make a difference in the day-to-day emergency care for children. It is well referenced, engenders respect for all members of the team within the broad continuum of EMS-C, and provides encouragement to them to work together to identify and address issues and solve problems to improve the quality of care for our nation's children.

Emergency Medical Services in India: The Present and Future

2014 ◽  
Vol 29 (3) ◽  
pp. 307-310 ◽  
Author(s):  
Mohit Sharma ◽  
Ethan S. Brandler
Keyword(s):  
Emergency Medical Services ◽  
Emergency Services ◽  
Prehospital Care ◽  
Emergency Medical Technician ◽  
Medical Services ◽  
Prehospital Emergency Care ◽  
Publication Type ◽  
Emergency Medical ◽  
Trauma Service ◽  
Care System

AbstractIndia is the second most populous country in the world. Currently, India does not have a centralized body which provides guidelines for training and operation of Emergency Medical Services (EMS). Emergency Medical Services are fragmented and not accessible throughout the country. Most people do not know the number to call in case of an emergency; services such as Dial 108/102/1298 Ambulances, Centralized Accident and Trauma Service (CATS), and private ambulance models exist with wide variability in their dispatch and transport capabilities. Variability also exists in EMS education standards with the recent establishment of courses like Emergency Medical Technician-Basic/Advanced, Paramedic, Prehospital Trauma Technician, Diploma Trauma Technician, and Postgraduate Diploma in EMS. This report highlights recommendations that have been put forth to help optimize the Indian prehospital emergency care system, including regionalization of EMS, better training opportunities, budgetary provisions, and improving awareness among the general community. The importance of public and private partnerships in implementing an organized prehospital care system in India discussed in the report may be a reasonable solution for improved EMS in other developing countries.SharmaM, BrandlerES. Emergency Medical Services in India: the present and future. Prehosp Disaster Med. 2014;29(3):1-4.

Medical Emergencies and Administration of Medication in School

PEDIATRICS ◽  
1978 ◽  
Vol 61 (1) ◽  
pp. 115-116
Author(s):  
Keyword(s):  
School Health ◽  
Emergency Medical Technician ◽  
Red Cross ◽  
Life And Death ◽  
School Population ◽  
American Academy Of Pediatrics ◽  
Emergency Medical ◽  
Policies And Procedures ◽  
Medical Emergencies ◽  
Medical Technician

Although the occurrence of medical emergencies that are life-and-death matters is quite rare in the school population, certain medical illnesses and injuries do occur while children are in school and require immediate assessment. Since it is unrealistic to expect a school nurse or physician to be immediately available for this assessment, school administrations should develop a set of written policies and procedures to handle these emergencies until such time as a nurse or physician can be contacted or be physically present. Two or more regular members of the school staff, depending on school size, should be designated as the responsible persons to handle the assessment, and one member should be available at all times to give whatever first aid is needed. These persons should be trained in a standard Red Cross course, including cardiopulmonary resuscitation, or have training as an emergency medical technician. This training should be updated as often as necessary to keep them competent in this area. An emergency medical kit should be available in each school and checked regularly by the responsible staff persons who are trained in this area. A detailed account of medical emergencies in school, including a list of equipment necessary for an emergency medical kit and how to classify medical emergencies and their treatment, is contained in chapter 18 of the school health manual of the American Academy of Pediatrics.1 The emergencies related to participation in athletics should be handled by a member of the athletic staff. Chapter 15 of the school health manual details procedures for management of athletic injuries.1

Integration of Emergency Medical Services and Special Weapons and Tactics (SWAT) Teams: The Emergence of the Tactically Trained Medic

1992 ◽  
Vol 7 (3) ◽  
pp. 285-288 ◽  
Author(s):  
David Q. McArdle ◽  
David Rasumoff ◽  
John Kolman
Keyword(s):  
Prehospital Care ◽  
Penetrating Trauma ◽  
The United States ◽  
Emergency Medical Technician ◽  
Care Providers ◽  
Law Enforcement Agencies ◽  
Small Unit ◽  
Emergency Medical ◽  
Swat Team ◽  
Special Environment

AbstractThe emphasis of training for paramedics that function in the civilian sector in the United States has focused on the management of blunt trauma. The personal risks they face generally are the result of accidents or public health threats. The management of penetrating trauma under the threat of intentional personal harm is a different matter.Law enforcement agencies have responded to the threat of apprehending heavily armed felons by forming special units highly trained in military-style, small-unit tactics. To provide care in this special environment, and support a special weapons and tactics (SWAT) team in fulfilling its mission, there is a requirment for a unique body of knowledge and special skills. (Prehospital care providers with at least emergency medical technician [EMT] skills and SWAT training will be referred to as tactical medics.)

Occupational Stress among Japanese Emergency Medical Technicians: Hyogo Prefecture

2005 ◽  
Vol 20 (2) ◽  
pp. 115-121 ◽  
Author(s):  
Naoki Okada ◽  
Noboru Ishii ◽  
Minori Nakata ◽  
Shinichi Nakayama
Keyword(s):  
Occupational Stress ◽  
Mental Stress ◽  
Prehospital Care ◽  
Physical Stress ◽  
Emergency Medical Technician ◽  
Emergency Medical Technicians ◽  
Lower Back ◽  
Emergency Medical ◽  
Hyogo Prefecture ◽  
Medical Technician

AbstractIntroduction:As prehospital care became emphasized in emergency medical services in Japan, qualification as a “paramedic” was established in 1991 as a requirement for national qualification as a emergency medical technician (EMT).With recent increases in emergency transportation, the responsibilities of paramedics have become more complex and demand a higher level of competency; however, no method of evaluating occupational stress among Japanese EMTs currently exists.Methods:A questionnaire survey of the working conditions and health of 2,017 EMTs in Hyogo Prefecture was conducted. To analyze stress levels among these EMTs, the survey was divided into two categories: (1) physical stress; and (2) mental stress.Results:The number of responses was 1,551 (76.9%) and the average age of the respondents was 35.4 years. The lower back, neck, and shoulders were most frequently subjected to physical stress, which was related to the daily operations as an EMT. Mental stress was reported more frequently by those who were older or qualified paramedics.Discussion:The high frequency of lower back pain suggests the need for improvement in the work environment and periodic education.Conclusions:Although job satisfaction among paramedics was high, they were exposed to greater mental stress. Therefore, systematic management of stress must be developed and established.

Incidence and Outcomes after Out-of-Hospital Medical Emergencies in Gambia: A Case for the Integration of Prehospital Care and Emergency Medical Services in Primary Health Care

2018 ◽  
Vol 33 (6) ◽  
pp. 650-657
Author(s):  
Sunkaru Touray ◽  
Baboucarr Sanyang ◽  
Gregory Zandrow ◽  
Isatou Touray
Keyword(s):  
Health Care ◽  
Emergency Medical Services ◽  
Emergency Care ◽  
Prehospital Care ◽  
The Gambia ◽  
Medical Emergency ◽  
Medical Services ◽  
Primary Health ◽  
Emergency Medical ◽  
Medical Emergencies

AbstractBackgroundThe Gambia is going through a rapid epidemiologic transition with a dual disease burden of infections and non-communicable diseases occurring at the same time. Acute, time-sensitive, medical emergencies such as trauma, obstetric emergencies, respiratory failure, and stroke are leading causes of morbidity and mortality among adults in the country.ProblemData on medical emergency care and outcomes are lacking in The Gambia. Data on self-reported medical emergencies among adults in a selection of Gambian communities are presented in this report.MethodsA total of 320 individuals were surveyed from 34 communities in the greater Banjul area of The Gambia using a survey instrument estimating the incidence of acute medical emergencies in an adult population. Self-reported travel time to a health facility during medical emergencies and patterns of health-seeking behavior with regard to type of facility visited and barriers to accessing emergency care, including cost and medical insurance coverage, are presented in this report.ResultsOf the 320 individuals surveyed, 262 agreed to participate resulting in a response rate of 82%. Fifty-two percent of respondents reported an acute medical emergency in the preceding year that required urgent evaluation at a health facility. The most common facility visited during such emergencies was a health center. Eighty-seven percent of respondents reported a travel time of less than one hour during medical emergencies. Out-of-pocket cost of medications accounted for the highest expenditure during emergencies. There was a low awareness and willingness to subscribe to health insurance among individuals surveyed.Conclusion: There is a high incidence of acute medical emergencies among adults in The Gambia which are associated with adverse outcomes due to a combination of poor health literacy, high out-of-pocket expenditures on medications, and poor access to timely prehospital emergency care. There is an urgent need to develop prehospital acute care and Emergency Medical Services (EMS) in the primary health sector as part of a strategy to reduce mortality and morbidity in the country.TourayS, SanyangB, ZandrowG, TourayI. Incidence and outcomes after out-of-hospital medical emergencies in Gambia: a case for the integration of prehospital care and Emergency Medical Services in primary health care. Prehosp Disaster Med. 2018;33(6):650–657.

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