Immobilization and evacuation of accident victims by first responders in Delhi, India: a survey

Background: Despite many improvements, pre-hospital care is known to be inconsistent and inefficient across India. This contributes to high mortality and morbidity of accident and medical emergency victims. Pre-hospital care may be provided by bystanders, but they are known to hesitate due to multiple reasons. The first aiders (ambulance staff or police personnel) who are responsible for providing appropriate initial care are not adequately trained to manage all aspects of emergency situations including extrication, cardiopulmonary resuscitation, management of bleeding, and protection of the spine evacuation and transfer. The current study was conducted to gauge the knowledge of first aid among bystanders and first aiders in Delhi national capital region.Methods: Two separate surveys with closed-ended questions were formulated for the bystanders and first aiders in english and hindi. A sample of 511 bystanders and 309 first aiders (108 ambulance and 201 police personnel) completed the survey between February 2019 and April 2019. Data was analysed descriptively. Comparison were made across demographic variables for the bystanders. For first aiders, comparisons were made between ambulance staff and police personnel, and between emergency medical technicians and drivers.Results: The average total scores for the bystanders were 38.5±14.2%. Slight differences across age and educational qualifications were found. The average total score for the first aiders was 34.3±12.3%. Ambulance personnel scored significantly better than police personnel in evacuation (70.3±26.6% versus 42.6±26.5%) and CPR subdomains (37.6±19.4% versus 21.9±14.7%). The emergency medical technicians scored better than the driver in their total and first aid subdomain scores.Conclusions: The knowledge amongst first responders including bystanders and first aiders was low and efforts to educate and train them would improve the much-needed quality of pre-hospital care.

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Disaster Triage by Advanced Emergency Medical Technicians

Journal of the World Association for Emergency and Disaster Medicine ◽

10.1017/s1049023x00028971 ◽

1987 ◽

Vol 3 (2) ◽

pp. 6-8

Author(s):

Constance J. Doyle ◽

Richard E. Birney

Keyword(s):

Medical Care ◽

Rural Areas ◽

First Responders ◽

Environmental Hazards ◽

Field Conditions ◽

Emergency Medical Technicians ◽

Trauma Patients ◽

Paramedical Personnel ◽

Emergency Medical

Many disaster plans are based on the presence of a physician at the scene to perform triage. This requirement originated when there were no trained paramedical personnel in the field and may actually delay care in rural areas where a physician may not be readily available or may be the only physician at the hospital.It is our hypothesis that properly trained Advanced Emergency Medical Technicians (AEMT's) may serve as triage officers for rural disasters with little difference, and perhaps improvement, in the outcomes of medical care. AEMT's are among the first responders to arrive at scenes of accidents and often triage from three to five trauma patients in multiple victim accidents on the highway. They are on duty, available and strategically located both day and night. The AEMT's are familiar with working under field conditions, i.e. at night by headlight, in rain, snow, and darkness, and know extrication procedures. They are aware of environmental hazards. They have radio and telemetry communication with a physician when needed.

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Measles, Mumps, Rubella, and Varicella Immunization Status of First Responders—A Policy Proposal

AAOHN Journal ◽

10.1177/216507990905700505 ◽

2009 ◽

Vol 57 (5) ◽

pp. 187-189

Author(s):

Dana Drew Nord ◽

Frances Childre

Keyword(s):

Occupational Health ◽

First Responders ◽

Emergency Medical Technicians ◽

Policy Proposal ◽

Immunization Status ◽

Emergency Medical ◽

Health Nursing ◽

Occupational Health Nursing

The responsibility of occupational health nursing often extends to the communities that workers serve. This is especially true for first responders (i.e., firefighters, paramedics, and emergency medical technicians) and their measles, mumps, rubella, and varicella status.

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MORDERN APPROACHES TO THE COMPLETE AND ORGANIC EQUIPMEN OF SHIPS AND BOATS OF NAVY OF THE RUSSIAN FEDERATION

Marine Medicine ◽

10.22328/2413-5747-2019-5-1-71-75 ◽

2019 ◽

Vol 5 (1) ◽

pp. 71-75

Author(s):

V. A. Grachev ◽

P. В. Panov ◽

Yu. V. Krasnova ◽

E. V. Umnikov ◽

E. Yu. Kazakova

Keyword(s):

Medical Care ◽

Medical Equipment ◽

First Aid ◽

Medical Emergency ◽

Critical Parameters ◽

Surface Ship ◽

Emergency Medical ◽

Initial Stage ◽

Equipment Modernization ◽

The Russian Federation

Ensuring timely emergency medical service and implementation of actions for first-aid treatment the most significant making organization seamen health protection. The first-aid kits, a bag of the doctor and the paramedic developed for ground forces and which are available on supply not fully conform to requirements imposed to complete organic equipment of the ships and boats of Navy. Medical equipment modernization and introduction of new and innovative complete and organic equipment for first-aid treatment is a need of real time. Improvement of this type equipment characteristic allows to increase efciency of the provided medical care at the initial stage and to provide maintenance of the Navy ship forces, by decrease in incidence of the personnel. The main directions of development of medical equipment of providing first and emergency medical care, designed for the provision ships and boats of Navy. Critical parameters that must be considered in the process of modernization available and developing new kits of medical equipment. A short characteristic of the ship first-aid kits and medical emergency and urgent aid bags offered for the development, taking into account the specifics of the daily and combat activities of the personnel of the underwater and surface ship of the Navy.

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Police Involvement in Pediatric Prehospital Care

PEDIATRICS ◽

10.1542/peds.87.5.636 ◽

1991 ◽

Vol 87 (5) ◽

pp. 636-641

Author(s):

Lisa M. Sinclair ◽

M. Douglas Baker

Keyword(s):

Cardiopulmonary Resuscitation ◽

Emergency Medical Services ◽

Prehospital Care ◽

The United States ◽

First Aid ◽

Medical Services ◽

Police Chiefs ◽

Emergency Medical ◽

Police Personnel ◽

Care System

One hundred fourteen emergency medical services agencies and 76 police chiefs throughout the United States were prospectively surveyed to ascertain the current utilization of police personnel within the prehospital care system. More than three fourths (77%) of the surveys mailed were completed. Respondents indicated the following: (1) a majority (92%) of police personnel were trained in cardiopulmonary resuscitation and basic first aid, (2) only half (57%) of police were trained in moving or transporting patients, and (3) few (36%) police were provided ongoing training in emergency pediatric medical skills. In spite of this, police were reportedly present at calls activating emergency medical services systems between 24% and 69% of the time, and the majority of these were trauma related. Police chiefs surveyed indicated that their officers played a large role in medical management prior to arrival of emergency medical services personnel; 87% would initiate cardiopulmonary resuscitation and 93% would begin basic first aid. Sixty-one percent of police chiefs indicated that officers would occasionally "scoop and run" with a critically ill child rather than await emergency medical services arrival. The data indicate that, right or wrong, police personnel are actively involved in their prehospital care system at present. In many instances, their help may be needed. Further thought should be given toward defining an exact emergency medical services role for police personnel and toward providing adequate initial and ongoing basic medical training for these individuals.

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Abstract 315: Three-Year Survey in Ishikawa Prefecture of Nontraumatic Aneurysm and Dissection of the Aorta Not Followed by Out-of-Hospital Cardiac Arrest in Patients Who Were Transported by Emergency Medical Technicians

Circulation ◽

10.1161/circ.130.suppl_2.315 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Hideo Inaba ◽

Taiki Nishi ◽

Takahisa Kamikura ◽

Hiroki Matsubara ◽

Akira Yamashita ◽

...

Keyword(s):

Survival Rate ◽

Aortic Aneurysm ◽

Signs And Symptoms ◽

Acute Onset ◽

Medical Emergency ◽

Emergency Medical Technicians ◽

Fire Departments ◽

Emergency Medical ◽

Co Morbidity ◽

Aneurysm Dissection

Aim: To investigate the signs, symptoms and incidences of aortic aneurysm/dissection (A/D) that did and did not cause OHCA and were transported by EMTs. Materials and Methods: Fire departments prospectively collected the data for cases with non-traumatic aortic A/D that were transported by EMS during the period of 2011 to 2013. The data included the backgrounds, signs and symptoms of the patients at the scene, backgrounds of the bystanders and 1-month survival. Results: As shown in Fig. 1, of 219 cases transported by Emergency Medical Technicians (EMTs) on their suspicion of aortic A/D, 140 cases were diagnosed with aortic A/D. Of 72,185 cases with endogenous medical emergency, 176 cases transported without EMT’s suspicion of aortic A/D were finally diagnosed with aortic aneurysm/dissection. In total, 316 cases had the aortic A/D. Thus, sensitivity of our regional EMS for non-traumatic aortic AD was 44% (140/316) while positive predictive value was 64% (140/219). The backgrounds of patients are as follows: male gender (51%), median value (25-75%) of age [73 (62-83)], high co-morbidity (88%). The major signs and symptoms obtained by EMTs were characterized by acute onset but mostly non-specific: chest pain (45%), back pain (40%), abdominal pain (14%). Moving severe pain was rarely caught (6%). These symptoms happened without a hard exercise (99%), and detected mainly by family members (41%) and patients themselves (34%). Bilateral blood pressure difference was rarely detected (5%). One-month survival rate was higher in cases transported to major emergency medical hospitals offering a major vascular surgery than those to other hospitals. None of other factors were associated with the survival. Conclusions: The Incidence of aortic A/D in all medical emergencies was extremely low. The survival rate may depend on the level of transported hospital. Clear criteria for “aortic transportation bypass” is required in EMS system.

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Patient Selection for Advanced Prehospital Care in a Two-Level Emergency Medical System

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00038528 ◽

1989 ◽

Vol 4 (1) ◽

pp. 36-38 ◽

Cited By ~ 1

Author(s):

David Applebaum

Keyword(s):

Life Support ◽

Prehospital Care ◽

Advanced Life Support ◽

First Aid ◽

Emergency Medical Technicians ◽

Emergency Medical ◽

Dispatch System ◽

The Impact ◽

Selection Of Patients ◽

Selection Of

In Jerusalem, the Emergency Medical Service is the sole prehospital provider for a population of 450,000 residents. Ambulances are dispatched from a centrally located first-aid center. Separate basic and advanced life support (MICU) ambulances are provided. Basic life support units are staffed by Emergency Medical Technicians (EMTs) trained to provide first aid and cardiopulmonary resuscitation (CPR). These units are dispatched to service persons in whom advanced life support (ALS) services are not likely to be required. The MICU is staffed by paramedical personnel plus a qualified physician. In order to maximize the efficiency of the service an attempt was made to use the MICU only for patients who may benefit from ALS interventions.Selection of patients for whom the ALS unit may be required is accomplished by switchboard operators. These personnel routinely dispatch the MICU for definite emergencies such as unconsciousness or absence of breathing. All other cases have been reported first to an on-call physician who ultimately decides whether or not to dispatch the MICU. This method of determining priority for dispatch is called the Consultation-Dispatch System (CDS). This method of determining priority seemed inefficient, so an alternative system was implemented that did not require prior physician consultation. This brief report details the impact of this change on system operation and MICU activity.

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