Organization of prehospital medical care for patients with cerebral stroke

AbstractIntroduction:Little is known about the risk perceptions and attitudes of healthcare personnel, especially of emergency prehospital medical care personnel, regarding the possibility of an outbreak or epidemic event.Problem:This study was designed to investigate pre-event knowledge and attitudes of a national sample of the emergency prehospital medical care providers in relation to a potential human influenza pandemic, and to determine predictors of these attitudes.Methods:Surveys were distributed to a random, cross-sectional sample of 20% of the Australian emergency prehospital medical care workforce (n = 2,929), stratified by the nine services operating in Australia, as well as by gender and location. The surveys included: (1) demographic information; (2) knowledge of influenza; and (3) attitudes and perceptions related to working during influenza pandemic conditions. Multiple logistic regression models were constructed to identify predictors of pandemic-related risk perceptions.Results:Among the 725 Australian emergency prehospital medical care personnel who responded, 89% were very anxious about working during pandemic conditions, and 85% perceived a high personal risk associated with working in such conditions. In general, respondents demonstrated poor knowledge in relation to avian influenza, influenza generally, and infection transmission methods. Less than 5% of respondents perceived that they had adequate education/training about avian influenza. Logistic regression analyses indicate that, in managing the attitudes and risk perceptions of emergency prehospital medical care staff, particular attention should be directed toward the paid, male workforce (as opposed to volunteers), and on personnel whose relationship partners do not work in the health industry.Conclusions:These results highlight the potentially crucial role of education and training in pandemic preparedness. Organizations that provide emergency prehospital medical care must address this apparent lack of knowledge regarding infection transmission, and procedures for protection and decontamination. Careful management of the perceptions of emergency prehospital medical care personnel during a pandemic is likely to be critical in achieving an effective response to a widespread outbreak of infectious disease.

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A new model for providing prehospital medical care in large stadiums

Annals of Emergency Medicine ◽

10.1016/s0196-0644(88)80563-8 ◽

1988 ◽

Vol 17 (8) ◽

pp. 825-828 ◽

Cited By ~ 41

Author(s):

Daniel W Spaite ◽

Elizabeth A Criss ◽

Terence D Valenzuela ◽

Harvey W Meislin ◽

Roger Smith ◽

...

Keyword(s):

Medical Care ◽

New Model ◽

Prehospital Medical Care

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Anticipated Behaviors of Emergency Prehospital Medical Care Providers during an Influenza Pandemic

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00007603 ◽

2010 ◽

Vol 25 (1) ◽

pp. 20-25 ◽

Cited By ~ 15

Author(s):

Vivienne C. Tippett ◽

Kerrianne Watt ◽

Steven G. Raven ◽

Heath A. Kelly ◽

Michael Coory ◽

...

Keyword(s):

Medical Care ◽

Pandemic Influenza ◽

Health Workers ◽

Influenza Pandemic ◽

Infectious Agents ◽

Care Providers ◽

Knowledge And Attitudes ◽

Adequate Knowledge ◽

Willingness To Change ◽

Prehospital Medical Care

AbstractIntroduction:Emergency prehospital medical care providers are frontline health workers during emergencies. However, little is known about their attitudes, perceptions, and likely behaviors during emergency conditions. Understanding these attitudes and behaviors is crucial to mitigating the psychological and operational effects of biohazard events such as pandemic influenza, and will support the business continuity of essential prehospital services.Problem:This study was designed to investigate the association between knowledge and attitudes regarding avian influenza on likely behavioral responses of Australian emergency prehospital medical care providers in pandemic conditions.Methods:Using a reply-paid postal questionnaire, the knowledge and attitudes of a national, stratified, random sample of the Australian emergency prehospital medical care workforce in relation to pandemic influenza were investigated. In addition to knowledge and attitudes, there were five measures of anticipated behavior during pandemic conditions: (1) preparedness to wear personal protective equipment (PPE); (2) preparedness to change role; (3) willingness to work; and likely refusal to work with colleagues who were exposed to (4) known and (5) suspected influenza. Multiple logistic regression models were constructed to determine the independent predictors of each of the anticipated behaviors, while controlling for other relevant variables.Results:Almost half (43%) of the 725 emergency prehospital medical care personnel who responded to the survey indicated that they would be unwilling to work during pandemic conditions; one-quarter indicated that they would not be prepared to work in PPE; and one-third would refuse to work with a colleague exposed to a known case of pandemic human influenza.Willingness to work during a pandemic (OR = 1.41; 95% CI = 1.0−1.9), and willingness to change roles (OR = 1.44; 95% CI = 1.04−2.0) significantly increased with adequate knowledge about infectious agents generally. Generally, refusal to work with exposed (OR = 0.48; 95% CI = 0.3−0.7) or potentially exposed (OR = 0.43; 95% CI = 0.3−0.6) colleagues significantly decreased with adequate knowledge about infectious agents. Confidence in the employer's capacity to respond appropriately to a pandemic significantly increased employee willingness to work (OR = 2.83; 95% CI = 1.9−4.1); willingness to change roles during a pandemic (OR = 1.52; 95% CI = 1.1−2.1); preparedness to wear PPE (OR = 1.68; 95% CI = 1.1−2.5); and significantly decreased the likelihood of refusing to work with colleagues exposed to (suspected) influenza (OR = 0.59; 95% CI = 0.4−0.9).Conclusions:These findings indicate that education and training alone will not adequately prepare the emergency prehospital medical workforce for a pandemic. It is crucial to address the concerns of ambulance personnel and the perceived concerns of their relationship with partners in order to maintain an effective prehospital emergency medical care service during pandemic conditions.

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DEVELOPMENT OF PCI-CAPABLE HOSPITALS NECESSITY CALCULATION ALGORITHM

Health Care of the Russian Federation ◽

10.18821/0044-197x-2019-63-1-29-34 ◽

2019 ◽

Vol 63 (1) ◽

pp. 29-34

Author(s):

Olesya V. Sagaydak ◽

E. V. Oshchepkova

Keyword(s):

Medical Care ◽

Calculation Algorithm ◽

The Real ◽

Coronary Syndrome ◽

Group 4 ◽

Group 3 ◽

Prehospital Medical Care ◽

Group 5 ◽

Group 2 ◽

Group 1

Introduction. Today there is no method to assess whether number of PCI-capable centers in Russia corresponds to the real needs. The aim of the study was to develop a PCI-capable hospitals necessity calculation algorithm. Material and methods. We used population densities, maximum/optimal distances (areas) to which delivery of patients with acute coronary syndrome by sanitary transport is possible and maximum/optimal areas where patients can be transported by ambulance transport. Then we calculated the density threshold values: Group 1: 53 persons/km2 or more; Group 2: 53-27 people/km2; Group 3: 27-18 people/km2; Group 4: 18-8 people/km2; Group 5: 8 persons/km2 and less. Results. Formulas were proposed for calculating the need for PCI-centers. For group 1: population/60000 people, for group 2: area/11,310 km2, group 3: area/31,416 km2, group 4 with functioning of sanitary aviation: area/70,686 km2 (additional strengthening of the prehospital medical care); in the absence of functioning sanitary aviation: area/31,416 km2 (also additional strengthening of the pre-hospital stage of medical care); for group 5: population/600,000 in large cities (in addition, the use of sanitary aviation, increased prehospital medical care, the organization of primary vascular departments). Discussion. The existing amount of percutaneous interventions in Russia is not enough to meet the real needs for this treatment. At the same time, simple multiplying of PCI-centers is not expedient. Conclusion. According to the developed algorithm, in Russia it is necessary to organize 239 PCI-centers 24/7. In regions with a high population density it is possible to combine several cathlabs in one center.

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Disaster and Mass Casualty Incident Responses by Doctor Car

Prehospital and Disaster Medicine ◽

10.1017/s1049023x19002590 ◽

2019 ◽

Vol 34 (s1) ◽

pp. s121-s121

Author(s):

Masamune Kuno ◽

Kensuke Suzuki ◽

Kyoko Unemoto ◽

Takashi Tagami ◽

Fumihiko Nakayama ◽

...

Keyword(s):

Medical Care ◽

Prehospital Care ◽

Mass Casualty Incident ◽

Mass Casualty ◽

Medical Team ◽

First Case ◽

The Disabled ◽

Care Systems ◽

Prehospital Medical Care ◽

Under Construction

Introduction:Ambulances with physicians, known as Doctor Car, and Tokyo DMAT are the two prehospital care systems responsible for medical team dispatch in the Tokyo area. While there are 25 designated hospitals for DMAT, Doctor Car is only available at four hospitals. Our hospital incorporates both systems. While the prehospital care system must be utilized at the time of disaster, Doctor Car was dispatched 418 times in 2017, and the use of DMAT is less than ten times per year.Aim:To review the past disaster responses of our hospital.Methods:The study reviews three cases where our hospital responded to mass casualty incidents and disasters with either Doctor Car or DMAT. The first case was the treatment of crush syndrome caused by a collapsed parking slope. It took more than 24 hours for the rescue, in which the team treated patients during transport and at the hospital. The second case was our response to a mass stabbing incident committed at a facility for the disabled. In collaboration with the onsite rescue team, we conducted triage, hemostasis, transfusion, etc. The third case was caused by a fire in a building under construction. We provided treatments like triage and tracheal intubation on the spot.Results:Because paramedics are allowed to conduct only a limited amount of treatments, dispatch of the medical team to the site is effective.Discussion:For a medical team to be effective at the dispatched site, the team must be accustomed not only to the specific need of medical care during disasters but also prehospital medical care, which may include the abilities to ensure safety during transport and on-site and adapt to the prehospital environment. Doctor Car is a useful way to realize such abilities.

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