scholarly journals The development of emergency medical services benefit score: a European Delphi study

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Anssi Heino ◽  
Lasse Raatiniemi ◽  
Timo Iirola ◽  
Merja Meriläinen ◽  
Janne Liisanantti ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Delphi Study ◽  
Scoring System ◽  
Prehospital Care ◽  
University Hospital ◽  
Medical Services ◽  
Original Form ◽  
Clinical Use ◽  
Emergency Medical ◽  
Delphi Round

Abstract Background The helicopter emergency services (HEMS) Benefit Score (HBS) is a nine-level scoring system developed to evaluate the benefits of HEMS missions. The HBS has been in clinical use for two decades in its original form. Advances in prehospital care, however, have produced demand for a revision of the HBS. Therefore, we developed the emergency medical services (EMS) Benefit Score (EBS) based on the former HBS. As reflected by its name, the aim of the EBS is to measure the benefits produced by the whole EMS systems to patients. Methods This is a four-round, web-based, international Delphi consensus study with a consensus definition made by experts from seven countries. Participants reviewed items of the revised HBS on a 5-point Likert scale. A content validity index (CVI) was calculated, and agreement was defined as a 70% CVI. Study included experts from seven European countries. Of these, 18 were prehospital expert panellists and 11 were in-hospital commentary board members. Results The first Delphi round resulted in 1248 intervention examples divided into ten diagnostic categories. After removing overlapping examples, 413 interventions were included in the second Delphi round, which resulted in 38 examples divided into HBS categories 3–8. In the third Delphi round, these resulted in 37 prehospital interventions, examples of which were given revised version of the score. In the fourth and final Delphi round, the expert panel was given an opportunity to accept or comment on the revised scoring system. Conclusions The former HBS was revised by a Delphi methodology and EBS developed to represent its structural purpose better. The EBS includes 37 exemplar prehospital interventions to guide its clinical use. Trial registration The study permission was requested and granted by Turku University Hospital (decision number TP2/010/18).

Triage Ability of Emergency Medical Services Providers and Patient Disposition: A Prospective Study

1999 ◽  
Vol 14 (3) ◽  
pp. 67-72 ◽  
Author(s):  
John R. Richards ◽  
Stephen J. Ferrall
Keyword(s):  
Chest Pain ◽  
Emergency Medical Services ◽  
Patient Characteristics ◽  
University Hospital ◽  
Medical Services ◽  
Shortness Of Breath ◽  
Study Objective ◽  
Patient Disposition ◽  
Emergency Medical ◽  
Respiratory Complaints

AbstractStudy objective:To determine the ability of emergency medical services (EMS) providers to subjectively triage patients with respect to hospital admission and to determine patient characteristics associated with increased likelihood of admission.Methods:A prospective, cross-sectional study of a consecutive sample of patients arriving by ambulance during the month of February 1997 at an urban, university hospital, Emergency Department. Emergency medical services providers completed a questionnaire asking them to predict admission to the hospital and requested patient demographic information. Predictions were compared to actual patient disposition.Results:A total of 887 patients were included in the study, and 315 were admitted to the hospital (36%). With respect to admission, emergency medical services providers had an accuracy rate of 79%, with a sensitivity of 72% and specificity of 83% (kappa = 0.56). Blunt traumatic injury and altered mental status were the most common medical reasons for admission. Variables significantly associated with high admission rates were patients with age > 50 years, chest pain or cardiac complaints, shortness of breath or respiratory complaints, Medicare insurance, and Hispanic ethnicity. The emergency medical services providers most accurately predicted admission for patients presenting with labor (kappa = 1.0), shortness of breath / respiratory complaints (kappa = 0.84), and chest pain (kappa = 0.77).Conclusion:Emergency medical services providers can predict final patient disposition with reasonable accuracy, especially for patients presenting with labor, shortness of breath, or chest pain. Certain patient characteristics are associated with a higher rate of actual admission.

scholarly journals Reporting Helicopter Emergency Medical Services in Major Incidents: A Delphi Study

2016 ◽  
Vol 35 (6) ◽  
pp. 348-351 ◽  
Author(s):  
Sabina Fattah ◽  
Anne Siri Johnsen ◽  
Stephen J.M. Sollid ◽  
Torben Wisborg ◽  
Marius Rehn ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Delphi Study ◽  
Medical Services ◽  
Helicopter Emergency Medical Services ◽  
Emergency Medical ◽  
Major Incidents

Prehospital Care for Victims of Submersion

PEDIATRICS ◽  
1990 ◽  
Vol 86 (4) ◽  
pp. 625-626
Author(s):  
MARTHA BUSHORE
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Emergency Medical Services ◽  
Growth And Development ◽  
Prehospital Care ◽  
Rapid Response ◽  
Urban Setting ◽  
Medical Services ◽  
Emergency Medical ◽  
Study Results

In this issue of Pediatrics is a study1 that represents a milestone in the growth and development of Emergency Medical Services for Children systems. Linda Quan and co-workers provide us with a study of victims of submersion who were less than 20 years of age and who received care during a 10-years interval in an Emergency Medical Services unit and required hospitalization or died. Because the majority of these submersions occurred in the urban setting of King Country with the rapid response of Emergency Medical Services units and reliable recording of cardiopulmonary resuscitation (CPR) data, the study results are impressively complete.

Pediatric Prehospital Care in Urban and Rural Areas

PEDIATRICS ◽  
1991 ◽  
Vol 88 (4) ◽  
pp. 681-690 ◽  
Author(s):  
James S. Seidel ◽  
Deborah Parkman Henderson ◽  
Patrick Ward ◽  
Barbara Wray Wayland ◽  
Beverly Ness
Keyword(s):  
Emergency Medical Services ◽  
Rural Areas ◽  
Urban Areas ◽  
Pediatric Patients ◽  
Life Support ◽  
Prehospital Care ◽  
Advanced Life Support ◽  
Medical Services ◽  
Care Providers ◽  
Emergency Medical

There are limited data concerning pediatric prehospital care, although pediatric prehospital calls constitute 10% of emergency medical services activity. Data from 10 493 prehospital care reports in 11 counties of California (four emergency medical services systems in rural and urban areas) were collected and analyzed. Comparison of urban and rural data found few significant differences in parameters analyzed. Use of the emergency medical services system by pediatric patients increased with age, but 12.5% of all calls were for children younger than 2 years. Calls for medical problems were most common for patients younger than 5 years of age; trauma was a more common complaint in rural areas (64%, P = .0001). Frequency of vital sign assessment differed by region, as did hospital contact (P < .0001). Complete assessment of young pediatric patients, with a full set of vital signs and neurologic assessment, was rarely performed. Advanced life support providers were often on the scene, but advanced life support treatments and procedures were infrequently used. This study suggests the need for additional data on which to base emergency medical services system design and some directions for education of prehospital care providers.

Optimizing Routine and Disaster Prehospital Care Through Improved Emergency Medical Services Oversight

2020 ◽  
pp. 1-13
Author(s):  
Mahshid Abir ◽  
Jane Forman ◽  
Rekar K. Taymour ◽  
Christina Brent ◽  
Brahmajee K. Nallamothu ◽  
...  
Keyword(s):  
Rural Communities ◽  
Emergency Medical Services ◽  
Disaster Response ◽  
Prehospital Care ◽  
Rapid Assessment ◽  
Medical Services ◽  
Primary Data ◽  
Current Evidence ◽  
Emergency Medical ◽  
Facilitators And Barriers

ABSTRACT Objective: To identify modifiers of emergency medical services (EMS) oversight quality, including facilitators and barriers, and inform best practices and policy related to EMS oversight and system performance. Methods: We used a qualitative design, including 4 focus groups and 10 in-depth, 1-on-1 interviews. Primary data were collected from EMS stakeholders in Michigan from June to July 2016. Qualitative data were analyzed using the rapid assessment technique. Results: Emergent themes included organizational structure, oversight and stakeholder leadership, interorganizational communication and relationships, competition or collaboration among MCA stakeholders, quality improvement practices, resources, and needs specific to rural communities. Conclusions: EMS is a critical component of disaster response. This study revealed salient themes and modifiers, including facilitators and barriers, of EMS oversight quality. These findings were evaluated in the context of current evidence and informed state policy to improve the quality of EMS oversight and prehospital care for both routine and disaster settings. Some were particular to geographic regions and communities, whereas others were generalizable.

Improving Pediatric Education for Emergency Medical Services Providers: A Qualitative Study

2016 ◽  
Vol 32 (1) ◽  
pp. 20-26 ◽  
Author(s):  
Seth A. Brown ◽  
Theresa C. Hayden ◽  
Kimberly A. Randell ◽  
Lara Rappaport ◽  
Michelle D. Stevenson ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Focus Groups ◽  
Emergency Medical Services ◽  
Prehospital Care ◽  
Educational Interventions ◽  
Medical Services ◽  
Theory Approach ◽  
Publication Type ◽  
Pediatric Education ◽  
Emergency Medical

AbstractObjectivesPrevious studies have illustrated pediatric knowledge deficits among Emergency Medical Services (EMS) providers. The purpose of this study was to identify perspectives of a diverse group of EMS providers regarding pediatric prehospital care educational deficits and proposed methods of training improvements.MethodsPurposive sampling was used to recruit EMS providers in diverse settings for study participation. Two separate focus groups of EMS providers (administrative and non-administrative personnel) were held in three locations (urban, suburban, and rural). A professional moderator facilitated focus group discussion using a guide developed by the study team. A grounded theory approach was used to analyze data.ResultsForty-two participants provided data. Four major themes were identified: (1) suboptimal previous pediatric training and training gaps in continuing pediatric education; (2) opportunities for improved interactions with emergency department (ED) staff, including case-based feedback on patient care; (3) barriers to optimal pediatric prehospital care; and (4) proposed pediatric training improvements.ConclusionFocus groups identified four themes surrounding preparation of EMS personnel for providing care to pediatric patients. These themes can guide future educational interventions for EMS to improve pediatric prehospital care.BrownSA, HaydenTC, RandellKA, RappaportL, StevensonMD, KimIK. Improving pediatric education for Emergency Medical Services providers: a qualitative study. Prehosp Disaster Med. 2017;32(1):20–26.

scholarly journals A Descriptive Study of Prehospital Care Provided by Emergency Medical Services (Ems) During Pediatric Transport in Ottawa

2003 ◽  
Vol 8 (suppl_B) ◽  
pp. 31B-31B
Author(s):  
JC Richard ◽  
MH Osmond ◽  
L Nesbitt ◽  
IG Stiell
Keyword(s):  
Emergency Medical Services ◽  
Prehospital Care ◽  
Descriptive Study ◽  
Medical Services ◽  
Emergency Medical

scholarly journals Frequency and severity of prehospital obstetric events encountered by emergency medical services in the United States

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rebecca E. Cash ◽  
Robert A. Swor ◽  
Margaret Samuels-Kalow ◽  
David Eisenbrey ◽  
Anjali J. Kaimal ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Prehospital Care ◽  
The United States ◽  
Medical Services ◽  
Patient Acuity ◽  
Cohen’S Kappa ◽  
Specific Patient ◽  
Cohen's Kappa ◽  
Emergency Medical ◽  
High Acuity

Abstract Background Prehospital obstetric events encountered by emergency medical services (EMS) can be high-risk patient presentations for which suboptimal care can cause substantial morbidity and mortality. The frequency of prehospital obstetric events is unclear because existing descriptions have reported obstetric and gynecological conditions together, without delineating specific patient presentations. Our objective was to identify the types, frequency, and acuity of prehospital obstetric events treated by EMS personnel in the US. Methods We conducted a cross-sectional analysis of EMS patient care records in the 2018 National EMS Information System dataset (n=22,532,890). We focused on EMS activations (i.e., calls for service) for an emergency scene response for patients aged 12-50 years with evidence of an obstetric event. Type of obstetric event was determined by examining patient symptoms, the treating EMS provider’s impression (i.e., field diagnosis), and procedures performed. High patient acuity was ascertained by EMS documentation of patient status and application of the modified early obstetric warning system (MEOWS) criteria, with concordance assessed using Cohen’s kappa. Descriptive statistics were calculated to describe the primary symptoms, impressions, and frequency of each type of obstetric event among these activations. Results A total of 107,771 (0.6%) of EMS emergency activations were identified as involving an obstetric event. The most common presentation was early or threatened labor (15%). Abdominal complaints, including pain and other digestive/abdomen signs and symptoms, was the most common primary symptom (29%) and primary impression (18%). We identified 3,489 (3%) out-of-hospital deliveries, of which 1,504 were preterm. Overall, EMS providers documented 34% of patients as being high acuity, similar to the MEOWS criteria (35%); however, there were high rates of missing data for EMS documented acuity (19%), poor concordance between the two measures (Cohen’s kappa=0.12), and acuity differences for specific conditions (e.g., high acuity of non-cephalic presentations, 77% in EMS documentation versus 53% identified by MEOWS). Conclusion Prehospital obstetric events were infrequently encountered by EMS personnel, and about one-third were high acuity. Additional work to understand the epidemiology and clinical care of these patients by EMS would help to optimize prehospital care and outcomes.

scholarly journals Managing CBRN Mass Casualty Incidents at Hospitals - Find a Simple Solution for a Complex Problem: a Pilot Study

2021 ◽  
Author(s):  
Maximilian Kippnich ◽  
Nora Schorscher ◽  
Helmut Sattler ◽  
Uwe Kippnich ◽  
Patrick Meybohm ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Full Scale ◽  
The Body ◽  
University Hospital ◽  
Medical Services ◽  
Temperature Management ◽  
Simulated Patients ◽  
Special Forces ◽  
Technical Requirements ◽  
Emergency Medical

Abstract Background Chemical, Biological or Radio-nuclear (CBRN) incidents are a major challenge for emergency medical services and the involved hospitals. The challenge becomes even greater, if decontamination needs to be performed nearby or even within the hospital campus. To be prepared for such scenarios, the University Hospital Wuerzburg has developed a comprehensive and alternative CBRN response plan. Bullet points of the strategy are decontamination by Special Forces of the fire brigade and CBRN-experts of the Emergency Medical Services and the adaption to the hospitals spatial conditions. The focus of the presented study was to proof the practicability of the concept, the duration of the decontamination process and the temperature management during a full-scale exercise.Methods On demand the decontamination unit can be put into operation within the roofed basement access zone in front of the emergency department. The entire decontamination area can be deployed 24/7 by the hospitals technical staff. Fire and rescue services in adequate personal protective equipment are responsible for the decontamination process itself. The study was designed as full-scale exercise, which was documented by a camera team. The body temperature of the decontaminated Persons and the environment temerature was measured.Results The entire process proofed to be successful. The decontamination area was ready for operation within 30 minutes. The decontamination of the four simulated patients took 5,5 ± 0,6 minutes (mean ± SD) including handovers and undressing. 30 people have participated in the full-scale exercise. At the end of the decontamination process the temperature of the undressed upper body of the training patients was 27,25 ± 1 °C (81,05 ± 2 °F) (mean ± SD), the water in the shower was about 35°C (95°F).Conclusion The presented concept is comprehensive and simple for a best possible c care during CBRN incidents at hospitals. It ensures wet decontamination by Special Forces, while the technical requirements are created by the hospital.

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