scholarly journals Digital Infrastructure as a Component of Emergency Medical Services Transformation

2020 ◽  
Vol 47 (4) ◽  
pp. 138-146
Author(s):  
Svitlana MALONOHA

The importance of digital infrastructure for the transformation of emergency medical services as one of the priority areas of public policy and public authorities are considered. Some approaches to the definition of digital infrastructure are studied. This study made it possible to identify the components of the digital infrastructure of emergency medical services and outline its role in the health care ecosystem. The approach to the application of the modular architecture of the digital infrastructure of emergency medical services as a conceptual basis for the integration of information systems of different departments into a single emergency system is considered. Exist two groups of mechanisms that influence the formation of the digital infrastructure of emergency medical services and indicate the causal links that explain how their use can lead to the transformation of emergency medical services. The range of tasks that are solve due to the digital infrastructure aimed at improving the efficiency, accuracy of diagnosis and provision of emergency medical services is outlined. New opportunities are opening up to improve the quality of emergency medical services provision in a human-centered health care system based on a digital infrastructure, the central elements of which are the exchange of information contained in electronic records and patient health cards and mobile digital devices, diagnostics and information transfer. The list of problems on the way of emergency medical services transformation is formulated and some recommendations for their solution are offered, the formulation of which is based on the analysis of existing practices and own long-term experience at the emergency medical services system.

PEDIATRICS ◽  
1995 ◽  
Vol 96 (3) ◽  
pp. 526-537
Author(s):  

Emergency care for life-threatening pediatric illness and injury requires specialized resources including equipment, drugs, trained personnel, and facilities. The American Medical Association Commission on Emergency Medical Services has provided guidelines for the categorization of hospital pediatric emergency facilities that have been endorsed by the American Academy of Pediatrics (AAP).1 This document was used as the basis for these revised guidelines, which define: 1. The desirable characteristics of a system of Emergency Medical Services for Children (EMSC) that may help achieve a reduction in mortality and morbidity, including long-term disability. 2. The role of health care facilities in identifying and organizing the resources necessary to provide the best possible pediatric emergency care within a region. 3. An integrated system of facilities that provides timely access and appropriate levels of care for all critically ill or injured children. 4. The responsibility of the health cane facility for support of medical control of pre-hospital activities and the pediatric emergency care and education of pre-hospital providers, nurses, and physicians. 5. The role of pediatric centers in providing outreach education and consultation to community facilities. 6. The role of health cane facilities for maintaining communication with the medical home of the patient. Children have their emergency care needs met in a variety of settings, from small community hospitals to large medical centers. Resources available to these health care sites vary, and they may not always have the necessary equipment, supplies, and trained personnel required to meet the special needs of pediatric patients during emergency situations.


2021 ◽  
Vol 136 (1_suppl) ◽  
pp. 62S-71S
Author(s):  
Josie J. Sivaraman ◽  
Scott K. Proescholdbell ◽  
David Ezzell ◽  
Meghan E. Shanahan

Objectives Tracking nonfatal overdoses in the escalating opioid overdose epidemic is important but challenging. The objective of this study was to create an innovative case definition of opioid overdose in North Carolina emergency medical services (EMS) data, with flexible methodology for application to other states’ data. Methods This study used de-identified North Carolina EMS encounter data from 2010-2015 for patients aged >12 years to develop a case definition of opioid overdose using an expert knowledge, rule-based algorithm reflecting whether key variables identified drug use/poisoning or overdose or whether the patient received naloxone. We text mined EMS narratives and applied a machine-learning classification tree model to the text to predict cases of opioid overdose. We trained models on the basis of whether the chief concern identified opioid overdose. Results Using a random sample from the data, we found the positive predictive value of this case definition to be 90.0%, as compared with 82.7% using a previously published case definition. Using our case definition, the number of unresponsive opioid overdoses increased from 3412 in 2010 to 7194 in 2015. The corresponding monthly rate increased by a factor of 1.7 from January 2010 (3.0 per 1000 encounters; n = 261 encounters) to December 2015 (5.1 per 1000 encounters; n = 622 encounters). Among EMS responses for unresponsive opioid overdose, the prevalence of naloxone use was 83%. Conclusions This study demonstrates the potential for using machine learning in combination with a more traditional substantive knowledge algorithm-based approach to create a case definition for opioid overdose in EMS data.


CJEM ◽  
2016 ◽  
Vol 19 (3) ◽  
pp. 220-229
Author(s):  
Jan L. Jensen ◽  
Andrew H. Travers

AbstractNationally, emphasis on the importance of evidence-based practice (EBP) in emergency medicine and emergency medical services (EMS) has continuously increased. However, meaningful incorporation of effective and sustainable EBP into clinical and administrative decision-making remains a challenge. We propose a vision for EBP in EMS: Canadian EMS clinicians and leaders will understand and use the best available evidence for clinical and administrative decision-making, to improve patient health outcomes, the capability and quality of EMS systems of care, and safety of patients and EMS professionals. This vision can be implemented with the use of a structure, process, system, and outcome taxonomy to identify current barriers to true EBP, to recognize the opportunities that exist, and propose corresponding recommended strategies for local EMS agencies and at the national level. Framing local and national discussions with this approach will be useful for developing a cohesive and collaborative Canadian EBP strategy.


2021 ◽  
Vol 104 (Suppl. 1) ◽  
pp. S35-S39

Background: Ultrasound guided peripheral intravenous access (USGPIV) has derived benefits for the Emergency and Pre-hospital Management. However, no studies have yet been conducted that have focused upon Emergency Medical Services (EMS) personnel in Thailand. Objective: To introduce USGPIV cannulation to the health care providers of Emergency Medical Services and to examine the success rates of the first attempts at PIV cannulation. Materials and Methods: This prospective observational study was conducted with 49 EMS providers in August 2020. All respondents had been participants in a USGPIV workshop. Afterwards, the participants’ skills were evaluated in a Pre-hospital simulation model, which was conducted in a moving ambulance. The data, which was recorded, noted the number of attempts required to successfully obtain USGPIV access, as well as the participants’ opinions about using ultrasound in this procedure. Results: Among the 49 participants, the first attempt success rate was found to be at 57.14%. The participants’ genders, their years of work experience, their experience of performing PIV with real patients, and the categories of the Emergency Medical Services health care providers were determined not to be factors that had contributed to the success rate of the first attempts at USGPIV. Our study demonstrated a “High” level of satisfaction with regard to performing USGPIV with this ultrasound device (4 out of 5). However, the participants noted that some elements of the environment in the ambulance may have affected the success rate of performing this procedure. Conclusion: In this study, the success rate of the first attempts was found to be lower than in other studies. However, in regard to this simulation, implementing this procedure represents the first step towards assisting Thai EMS personnel to perform ultrasound procedures. Keywords: Ultrasound, Peripheral IV cannulation, Emergency medicine, Emergency medical services, Emergency medical personnel


1992 ◽  
Vol 7 (4) ◽  
pp. 323-323

The first Pan-European Conference on Emergency Medical Services (PECEMS) was convened in Budapest, Hungary, 30 August through 3 September 1992, under the sponsorship of numerous international and national organizations with participants representing more than 40 countries.Evidence placed before the conference identified serious deficiencies in the delivery of emergency health care in the overwhelming majority of participating countries.


2019 ◽  
Vol 45 (1) ◽  
pp. 12-17 ◽  
Author(s):  
Laura Linares-González ◽  
José Sáez Rodríguez ◽  
Cristina M. Beltrán-Aroca ◽  
Eloy Girela-López

1999 ◽  
Vol 27 (4) ◽  
pp. 297-315 ◽  
Author(s):  
Charles P. Sabatino

This article details the results of a national survey conducted in 1999 of statewide laws and protocols providing for the creation and recognition of donot- resuscitate (DNR) orders effective in nonhospital settings. Applicable primarily to emergency medical services (EMS) personnel, most of these laws and protocols have been in existence for less than ten years, and there is little current comparative information on them. Such policies are commonly called out-of-hospital or prehospital DNR orders, although one state-Virginia-recently amended its DNR law to establish a durable DNR order applicable to all health care providers and all settings. I will refer to the laws and policies examined here interchangeably as out-of hospital DNR protocols or EMS-DNR protocols. The survey produced a descriptive snapshot of such laws and protocols in effect on a statewide basis as of March 1999.


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