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

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.

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Emergency Medical Services Out-of-Hospital Scene and Transport Times and Their Association With Mortality in Trauma Patients Presenting to an Urban Level I Trauma Center

Annals of Emergency Medicine ◽

10.1016/j.annemergmed.2012.08.026 ◽

2013 ◽

Vol 61 (2) ◽

pp. 167-174 ◽

Cited By ~ 73

Author(s):

C. Eric McCoy ◽

Michael Menchine ◽

Sehra Sampson ◽

Craig Anderson ◽

Christopher Kahn

Keyword(s):

Emergency Medical Services ◽

Trauma Center ◽

Medical Services ◽

Trauma Patients ◽

Emergency Medical ◽

Urban Level ◽

Level I

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Evaluating the effect of driving distance to the nearest higher level trauma centre on undertriage: a cohort study

Emergency Medicine Journal ◽

10.1136/emermed-2021-211635 ◽

2021 ◽

pp. emermed-2021-211635

Author(s):

Job F Waalwijk ◽

Robin D Lokerman ◽

Rogier van der Sluijs ◽

Audrey A A Fiddelers ◽

Luke P H Leenen ◽

...

Keyword(s):

Injury Severity Score ◽

Emergency Medical Services ◽

Resource Use ◽

Severity Score ◽

Injury Severity ◽

Trauma Centre ◽

Medical Services ◽

Trauma Patients ◽

Emergency Medical ◽

Critical Resource

BackgroundIt is of great importance that emergency medical services professionals transport trauma patients in need of specialised care to higher level trauma centres to achieve optimal patient outcomes. Possibly, undertriage is more likely to occur in patients with a longer distance to the nearest higher level trauma centre. This study aims to determine the association between driving distance and undertriage.MethodThis prospective cohort study was conducted from January 2015 to December 2017. All trauma patients in need of specialised care that were transported to a trauma centre by emergency medical services professionals from eight ambulance regions in the Netherlands were included. Patients with critical resource use or an Injury Severity Score ≥16 were defined as in need of specialised care. Driving distance was calculated between the scene of injury and the nearest higher level trauma centre. Undertriage was defined as transporting a patient in need of specialised care to a lower level trauma centre. Generalised linear models adjusting for confounders were constructed to determine the association between driving distance to the nearest higher level trauma centre per 1 and 10 km and undertriage. A sensitivity analysis was conducted with a generalised linear model including inverse probability weights.Results6101 patients, of which 4404 patients with critical resource use and 3760 patients with an Injury Severity Score ≥16, were included. The adjusted generalised linear model demonstrated a significant association between a 1 km (OR 1.04; 95% CI 1.04 to 1.05) and 10 kilometre (OR 1.50; 95% CI 1.42 to 1.58) increase in driving distance and undertriage in patients with critical resource use. Also in patients with an Injury Severity Score ≥16, a significant association between driving distance (1 km (OR 1.06; 95% CI 1.06 to 1.07), 10 km (OR 1.83; 95% CI 1.71 to 1.95)) and undertriage was observed.ConclusionPatients in need of specialised care are less likely to be transported to the appropriate trauma centre with increasing driving distance. Our results suggest that emergency medical services professionals incorporate driving distance into their decision making regarding transport destinations, although distance is not included in the triage protocol.

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P095: Who, what, where: a critical assessment of helicopter emergency medical services transport and transfer times on patient outcomes at two level 1 trauma centres

CJEM ◽

10.1017/cem.2016.271 ◽

2016 ◽

Vol 18 (S1) ◽

pp. S110-S110

Author(s):

B. Nolan ◽

A. Ackery ◽

H. Tien ◽

B. Sawadsky ◽

S. Rizoli ◽

...

Keyword(s):

Mortality Rate ◽

Emergency Medical Services ◽

Trauma Centre ◽

Medical Services ◽

Trauma Patients ◽

Helicopter Emergency Medical Services ◽

Trauma Centres ◽

Emergency Medical ◽

Level 1 ◽

Mode Of Transport

Introduction: Helicopter emergency medical services (HEMS) have become an engrained component of trauma systems to expedite transportation to a trauma centre. Ornge is a provincially run, paramedic-staffed HEMS that is responsible for all air ambulance service within Ontario, Canada. They provide transportation for trauma patients through one of three ways: scene call, modified scene call or interfacility transfer. In this study we report the characteristics of patients transported by each of these methods to two level 1 trauma centres and assess for any impact on morbidity or mortality. Methods: A local trauma registry was used to identify all patients transported to our two trauma centres by HEMS over a 36-month period. Data surrounding patient demographic, arrival characteristics, transport times and in-hospital course were abstracted from the registry. Statistical analysis will be used to compare methods of transport and characterize any association between mode of transport and mortality. Results: From January 1st, 2012 to December 31st, 2014 HEMS transferred a total of 911 patients to our trauma centers with an overall mortality rate of 11%. Of these patients 139 were scene calls with a mortality rate of 8%, 333 were modified scene calls with a mortality rate of 14% and 439 were interfacility transfers with a mortality rate of 10%. Conclusion: Identifying any association between the type of HEMS transport and morbidity and mortality, we may be able to predict those that need more urgent transfer to a trauma centre and find ways to decrease our overall pre-trauma center time.

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Assessment of helicopter versus ground emergency medical services in reducing mortality rate and the length of stay in adult trauma patients between 2002 and 2014 recorded in King Abdulaziz Medical City trauma registry

Saudi Journal of Emergency Medicine ◽

10.24911/sjemed/72-1576150683 ◽

2020 ◽

pp. 15-19

Author(s):

Shahad Aldelaijan ◽

Mona Alsanae ◽

Maysan almegbel ◽

Nouf Alsadoun ◽

Shahad Altoyan ◽

...

Keyword(s):

Mortality Rate ◽

Length Of Stay ◽

Emergency Medical Services ◽

Trauma Registry ◽

Medical Services ◽

Trauma Patients ◽

Emergency Medical ◽

Medical City

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Prehospital time and mortality in polytrauma patients: a retrospective analysis

BMC Emergency Medicine ◽

10.1186/s12873-021-00476-6 ◽

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.

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Diagnostic value of emergency medical services provider judgement in the identification of head injuries among trauma patients

European Journal of Neurology ◽

10.1111/ene.13804 ◽

2018 ◽

Vol 26 (2) ◽

pp. 274-280

Author(s):

E. A. J. van Rein ◽

D. Jochems ◽

R. D. Lokerman ◽

R. van der Sluijs ◽

R. M. Houwert ◽

...

Keyword(s):

Emergency Medical Services ◽

Head Injuries ◽

Diagnostic Value ◽

Medical Services ◽

Trauma Patients ◽

Emergency Medical

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Strengthening the Capacity of Emergency Medical Services in Low and Middle Income Countries using Dispatcher-Coordinated Taxis

Transportation Research Record Journal of the Transportation Research Board ◽

10.1177/0361198120929024 ◽

2020 ◽

Vol 2674 (9) ◽

pp. 338-345

Author(s):

Vipul Mishra ◽

Richa Ahuja ◽

N. Nezamuddin ◽

Geetam Tiwari ◽

Kavi Bhalla

Keyword(s):

Response Time ◽

Emergency Medical Services ◽

Road Traffic ◽

International Standards ◽

Medical Services ◽

Road Traffic Crash ◽

Middle Income ◽

Middle Income Countries ◽

Emergency Medical ◽

Low And Middle Income

International standards recommend provision of one ambulance for every 50,000 people to fulfill demand for transporting patients to definitive care facilities in low and middle income countries (LMICs). Governments’ consistent attempt to build capacity of emergency medical services (EMS) in LMICs has been financially demanding. This study is an attempt to assess the feasibility of capacity building of existing EMS in Delhi, India by using taxis as an alternative mode of transport for emergency transportation of road traffic crash victims to enable improvement in response time for road traffic crashes where time criticality is deemed important. Performance of the proposed system is evaluated based on response time, coverage and distance. The system models the performance and quantifies the taxi–ambulance configuration for achieving EMS performance within international standards.

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Clinical handover from emergency medical services to the trauma team: A gap analysis

CJEM ◽

10.1017/cem.2019.438 ◽

2020 ◽

Vol 22 (S2) ◽

pp. S21-S29

Author(s):

Arshia P. Javidan ◽

Avery B. Nathens ◽

Homer Tien ◽

Luis T. da Luz

Keyword(s):

Emergency Medical Services ◽

Gap Analysis ◽

Trauma Team ◽

Trauma Centre ◽

Medical Services ◽

Active Listening ◽

Team Leaders ◽

Process Measures ◽

Team Members ◽

Emergency Medical

ABSTRACTObjectivesThere has been limited evaluation of handover from emergency medical services (EMS) to the trauma team. We sought to characterize these handover practices to identify areas of improvement and determine if handover standardization might be beneficial for trauma team performance.MethodsData were prospectively collected over a nine-week period by a trained observer at a Canadian level one trauma centre. A randomized scheduled was used to capture a representative breadth of handovers. Data collected included outcome measures such as duration of handover, structure of the handover, and information shared, process measures such as questions and interruptions from the trauma team, and perceptions of the handover from nurses, trauma team leaders and EMS according to a bidirectional Likert scale.Results79 formal verbal handovers were observed. Information was often missing regarding airway (present 22%), breathing (54%), medications (59%), and allergies (54%). Handover structure lacked consistency beyond the order of identification and mechanism of injury. Of all questions asked, 35% were questioning previously given information. The majority of handovers (61%) involved parallel conversations between team members while EMS was speaking. There was a statistically significant disparity between the self-evaluation of EMS handovers and the perceived quality determined by nurses and trauma team leaders.ConclusionsWe have identified the need to standardize handover due to poor information content, a lack of structure and active listening, information repetition, and discordant expectations between team members. These data will guide the development of a co-constructed framework integrating the perspectives of all team members.

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