Effectiveness of use of local hemostatic agents for external bleeding by visiting ambulance teams

The alternative use of local hemostatic agents based on chitosan is the gentlest method of stopping bleeding, with minimal damaging effect on tissues, in comparison with the imposition of a hemostatic tourniquet or a pressure bandage.Goal. To evaluate the effectiveness of temporary stopping of external bleeding with the help of local hemostatic agents based on chitosan in powder and bandage forms and to determine the expediency of their use by visiting ambulance teams.Materials and methods. Specialists of the field teams of Ambulance and Medical Emergency Care Station n. a. A. S. Puchkov (Moscow, Russia) used local hemostatic agents based on chitosan in the form of a powder, a bandage in comparison with traditional hemostatic agents (a hemostatic tourniquet to stop arterial bleeding and a pressure bandage). The criteria for hemostasis were the absence of wetting of the pressure bandage and the absence of the need for a hemostatic tourniquet.Results. 103 patients were included in the main group, and 106 patients with arterial and venous bleeding from wounds of various localization were included in the control group. The age of patients in the compared groups ranged from 18 to 94 years. When using hemostatic powder and bandage, primary hemostasis was achieved in 99 patients in 96.1 % of cases, compared with the control group in 76 patients in 67.9 % of cases.Conclusions. Simplicity and ease of use, the speed of stopping bleeding and achieving results, as well as the absence of the need for special skills among specialists in the use of hemostatic agents, improved the quality of emergency medical care for patients with bleeding and allowed them to be recommended as a dressing for emergency medical care.

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Knowledge and Attitudes of the Out-Of-Hospital Emergency Care Consumers in Santo Domingo, Dominican Republic

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00006038 ◽

2008 ◽

Vol 23 (4) ◽

pp. 373-376 ◽

Cited By ~ 1

Author(s):

Amado Alejandro Báez ◽

Ediza Giraldez ◽

Peter L. Lane ◽

Charles Pozner ◽

Juan Rodriguez ◽

...

Keyword(s):

Dominican Republic ◽

Medical Care ◽

Prehospital Care ◽

Statistical Significance ◽

Medical Emergency ◽

Categorical Variables ◽

Continuous Variables ◽

Emergency Medical Care ◽

Santo Domingo ◽

Emergency Medical

AbstractIntroduction:Prehospital emergency services are a vital public service, and consumer access to the system is an important factor in their use. The Dominican Republic recently experienced “the epidemiological transition” leading to increased morbidity and mortality secondary to traumatic and cardiac conditions—thus, increasing the need for prompt and adequate delivery of emergency medical care.Methods:A survey was administered to 90 subjects from diverse backgrounds, all living in Santo Domingo. Survey items included questions on emergency medical services (EMS) systems knowledge (i.e., access numbers), confidence in the system, first-aid education and prior experience with the EMS system. Chi-square was used to measure statistical significance for categorical variables and Student's t-test for continuous variables (JMP 2.0 software was used for statistical processing).Results:A total of 90 subjects were surveyed. The average age of respondents was 36 ± 12 years SD. More than one-fifth (22.2%) of respondents did not know the established universal emergency number (9-1-1), and 37.8% responded that they would access a different telephone number in case of a medical emergency.Conclusions:Important deficiencies and access-to-care concerns were interpreted from the results. An adequate understanding of the current state of prehospital care could lead to creation of policies by system administrators to further improve the delivery of emergency medical care. This study will assist system administrators in future design and policy issues.

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Moscow ambulance station. From origin to modern times

Medical alphabet ◽

10.33667/2078-5631-2019-2-31(406)-5-10 ◽

2019 ◽

Vol 2 (31) ◽

pp. 5-10

Author(s):

N. F. Plavunov ◽

V. A. Kadyshev ◽

A. M. Sidorov ◽

A. N. Rozhenetskiy ◽

L. F. Verkhoturova

Keyword(s):

Medical Care ◽

Emergency Care ◽

100Th Anniversary ◽

Medical Emergency ◽

Time Of Arrival ◽

Emergency Medical Care ◽

Medical Sciences ◽

Modern Times ◽

Emergency Medical ◽

Analysis Of Performance

This article is dedicated to the 100th anniversary of the establishment of the Ambulance and Medical Emergency Care Station n. a. A. S. Puchkov in Moscow. Alexander Sergeyevich Puchkov, Doctor of Medical Sciences, Honored Doctor of the RSFSR, steadily led her from 1923 to 1952. The data presented in the articles of Mr. Puchkov served as the basis for comparing indicators about the station’s activities during its formation and the modern ambulance and emergency medical services in Moscow. Some features, characteristics and conditions for the provision of emergency and emergency medical care in Moscow in the year 1926 are shown. So, for example, the number of brigades increased by 68.7 times (from 15 in 1926 to 1,031 in 2018). The average time of arrival of the brigade for an accident both in 1926 and in 2018 is 10–12 minutes long. The share of calls by ambulance teams to children under 15 years of age has also increased significantly. The analysis of performance over the years has made it possible to trace the development of the ambulance station from the time of its creation to the present day. The fundamental principles laid down by Alexander S. Puchkov remain in the ambulance work at the present time. Doctors and paramedics of ambulance and emergency medical care teams continue to promptly provide medical care to all those in need, guided by many provisions that were developed and implemented over 90 years ago.

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Improving emergency medical care for psychiatric inpatients

European Psychiatry ◽

10.1016/s0924-9338(11)73426-5 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 1722-1722

Author(s):

C. Gordon ◽

F. Cheema ◽

J. Graham

Keyword(s):

Medical Care ◽

Qualitative Interviews ◽

Primary Objective ◽

Medical Emergency ◽

Psychiatric Ward ◽

Emergency Medical Care ◽

Modest Improvement ◽

Emergency Medical ◽

Psychiatric Staff ◽

The Impact

IntroductionAt the European Psychiatric Association's International Congress 2010, we reported on psychiatric staff confidence regarding emergency medical care in our poster: “How Well Prepared is a Psychiatric Ward for Dealing with a Medical Emergency?”. This work highlighted areas for improvement, including staff confidence and familiarity with equipment. Consequently, several aspects of practice were enhanced, including addressing training shortfalls alongside adopting a uniform layout for emergency trolleys. In order to identify improvement, the process was re-audited with a new qualitative component to gather staff opinion.ObjectivesOur primary objective was to examine whether our interventions had improved staff confidence with regard emergency medical care. Our secondary objectives included exploring staff attitudes toward delivery of such care and to identify further areas for improvement.AimsOur primary aim was to evaluate the impact of our interventions on delivery of emergency medical careMethodsOur original questionnaire survey was repeated and the results compared with those obtained previously. Additionally, a series of semi-structured qualitative interviews will be performed with staff to compliment the questionnaires.ResultsResults will be available in February 2011.ConclusionsGiven that psychiatric patients often suffer from significant physical health problems, it is imperative that staff are comfortable in delivering initial emergency medical care. We anticipate our results will demonstrate modest improvement. Clinical governance is an ongoing process, therefore the most important conclusions to be drawn will be our recommendations for future work, which will encompass the next step in our efforts to improve delivery of emergency medical care.

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Efficiency of Different Methods of Temporary External Hemostasis at the Pre-Hospital Stage of Emergency Medical Care

Novosti Khirurgii ◽

10.18484/2305-0047.2020.6.688 ◽

2020 ◽

Vol 28 (6) ◽

pp. 688-693

Author(s):

Y.V. Shkatula ◽

◽

Y.O. Badion ◽

M.V. Novikov ◽

◽

...

Keyword(s):

Medical Care ◽

Tissue Damage ◽

Clinical Status ◽

Venous Access ◽

Severe Trauma ◽

Infusion Therapy ◽

Emergency Medical Care ◽

Hemostatic Agents ◽

Emergency Medical ◽

Combined Injuries

Objective. To estimate the efficiency of different methods of temporary external hemostasis at the pre-hospital stage of emergency medical care, taking into account the localization of injuries. Material and Methods. The cases (n=86) of prehospital emergency medical care for patients with external bleeding were studied. The data on the victims (age, gender), clinical status (type and location of injuries, type of bleeding), the volume of emergency care, the hemostasis methods used to control bleeding, their efficiency, side effects, difficulty of use were collected, and the duration of the pre-hospital stage were also taken into account. Results. The study found out that the most common cause of external bleeding is domestic accident (45.35%) of cases. By the nature of tissue damage, the cut wounds prevailed. Multiple or combined injuries occurred in 13.95% of cases. A tourniquet was the main method of hemostasis. Contact hemostatic agents were used only in 2.32% of cases at the pre-hospital stage. In some cases, when attempting to control the external bleeding, several hemostatic agents were sequentially used due to the lack of their efficacy. In 17.4% of cases, the victims with multiple or combined injuries received intravenous administrationof the systemichemostatic agents. In the complex of anti-shock measures in patients with severe trauma 77.91% of the prehospital patients underwent infusion therapy. Isotonic crystalloid solutions were used. A reliable increase in the duration of the prehospital stage of victims who underwent to a combination of hemostasis methods and intravenous infusion has been registered. The increase in the length of the prehospital stay occurs at the expense of the time required for creation of venous access and initiate infusion. The authors propose the algorithm for temporal control of external bleeding during emergency medical care at the pre-hospital stage. Conclusion. The main principles that need to be guided in the choice of any methods for stopping of bleeding are the speed and reliability of hemostasis for entire time of evacuation and the minimum damaging effect on the tissues. What this paper adds The effectiveness of various methods for temporal external hemostasis at the pre-hospital stage of emergency medical treatment taking into account the localization of injuries was estimated. It has been established that the main principles that must be followed in choosing any of the methods for stopping the bleeding are the speed and reliability of hemostasis for the entire duration of evacuation and the minimal tissue damage.

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Actual problems of emergency medical care

Problems of Uninterrupted Medical Training and Science ◽

10.31071/promedosvity2018.02.005 ◽

2018 ◽

Vol 2018 (2) ◽

pp. 5-11

Author(s):

I.Z. Yakovtsov ◽

Keyword(s):

Medical Care ◽

Emergency Medical Care ◽

Emergency Medical

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Infectious safety of patients in the provision of prehospital care for burns

Medsestra (Nurse) ◽

10.33920/med-05-2004-13 ◽

2020 ◽

pp. 71-75

Author(s):

Marina Dmitryeva

Keyword(s):

Medical Care ◽

Prehospital Care ◽

Medical Professionals ◽

Emergency Medical Care ◽

Emergency Medical

The article describes the measures taken by medical professionals of emergency medical care to observe infectious safety of patients in the provision of pre-medical care in case of burns.

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