scholarly journals Short-Term Outcome of Transported Versus Not-Transported Seizure Patients by Tehran Emergency Medical Services; a Retrospective Cohort Study

2020 ◽  
Vol 7 (3) ◽  
Author(s):  
Peyman Saberian ◽  
Mostafa Sadeghi ◽  
Parisa Hasani-Sharamin ◽  
Fatemeh Dadashi ◽  
Yasamin Mohammad Esmaeil ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Medical Services ◽  
Short Term ◽  
Term Outcome ◽  
Patient Disposition ◽  
Short Term Outcome ◽  
Emergency Medical ◽  
Prehospital Management ◽  
Significant Difference ◽  
Short Term Mortality

Background: One of the most frequent complaints that emergency medical services (EMS) deal with is seizure. The missions of EMS on these cases may lead to transferring the patient to the emergency department (ED). Objectives: Therefore, the present study was conducted to compare the short-term outcome of transported versus not-transported cases. Methods: Our population sample was selected retrospectively from medical records in Tehran EMS center for 6 months in which the plan was transferring to a specific hospital. The cases were divided into transported or not-transported. W extracted and compared the cases’ demographic data, vital signs, conducted prehospital management, patient disposition, and their short-term outcome. Results: We evaluated 486 cases, 173 of whom were males (35.6%) and the mean age of patients was 34.8 ± 32.0 years old. 329 (67.7%) and 157 (32.3%) were in the not-transported and the transported group, respectively. Among all not-transported cases, we could follow 172 patients, 52 of whom had gone to hospital during the next 72 hours. 22 out of the 52 cases were discharged from ED the same day. Overall, the ED discharge rate was significantly more in the transported group (P < 0.001). Short-term mortality had no significant difference in the two study groups (P = 1.00). Conclusions: Most of the not-transported patients did not go to the hospital during further 72 hours, and some were hospitalized. Most of the patients transported to the hospital were discharged from the ED. The short-term mortality rate was not different.

Triage Ability of Emergency Medical Services Providers and Patient Disposition: A Prospective Study

1999 ◽  
Vol 14 (3) ◽  
pp. 67-72 ◽  
Author(s):  
John R. Richards ◽  
Stephen J. Ferrall
Keyword(s):  
Chest Pain ◽  
Emergency Medical Services ◽  
Patient Characteristics ◽  
University Hospital ◽  
Medical Services ◽  
Shortness Of Breath ◽  
Study Objective ◽  
Patient Disposition ◽  
Emergency Medical ◽  
Respiratory Complaints

AbstractStudy objective:To determine the ability of emergency medical services (EMS) providers to subjectively triage patients with respect to hospital admission and to determine patient characteristics associated with increased likelihood of admission.Methods:A prospective, cross-sectional study of a consecutive sample of patients arriving by ambulance during the month of February 1997 at an urban, university hospital, Emergency Department. Emergency medical services providers completed a questionnaire asking them to predict admission to the hospital and requested patient demographic information. Predictions were compared to actual patient disposition.Results:A total of 887 patients were included in the study, and 315 were admitted to the hospital (36%). With respect to admission, emergency medical services providers had an accuracy rate of 79%, with a sensitivity of 72% and specificity of 83% (kappa = 0.56). Blunt traumatic injury and altered mental status were the most common medical reasons for admission. Variables significantly associated with high admission rates were patients with age > 50 years, chest pain or cardiac complaints, shortness of breath or respiratory complaints, Medicare insurance, and Hispanic ethnicity. The emergency medical services providers most accurately predicted admission for patients presenting with labor (kappa = 1.0), shortness of breath / respiratory complaints (kappa = 0.84), and chest pain (kappa = 0.77).Conclusion:Emergency medical services providers can predict final patient disposition with reasonable accuracy, especially for patients presenting with labor, shortness of breath, or chest pain. Certain patient characteristics are associated with a higher rate of actual admission.

Abstract WP261: Non-English-preferring Patients Have No Differences in Stroke Symptom Recognition or Emergency Care Time Metrics

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Shaw Natsui ◽  
Khawja A Siddiqui ◽  
Betty L Erfe ◽  
Nicte I Mejia ◽  
Lee H Schwamm ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Emergency Care ◽  
Medical Services ◽  
Similar Response ◽  
Language Preference ◽  
Emergency Department Care ◽  
Hospital Arrival ◽  
Stroke Symptom ◽  
Emergency Medical ◽  
Significant Difference

Introduction: The influence of patients’ language preference on the delivery of acute ischemic stroke (AIS) care in the pre-hospital and in-hospital emergency care settings is scarcely known. We hypothesize that stroke knowledge differences may be associated with non-English preferring (NEP) patients having slower time from symptom discovery to hospital presentation and less engagement of emergency medical services (EMS) than English preferring (EP) patients. Language barriers may also interfere with the delivery of time-sensitive emergency department care. Objectives: To identify whether language preference is associated with differences in patients’ time from stroke symptom discovery to hospital arrival, activation of emergency medical services, door-to-imaging time (DIT), and door-to-needle (DTN) time. Methods: We identified consecutive AIS patients presenting to a single urban, tertiary, academic center between 01/2003-04/2014. Data was abstracted from the institution’s Research Patient Data Registry and Get with the Guidelines-Stroke Registry. Bivariate and regression models evaluated the relationship between language preference and: 1) time from symptom onset to hospital arrival, 2) use of EMS, 3) DIT, and 4) DTN time. Results: Of 3,190 AIS patients who met inclusion/exclusion criteria, 9.4% were NEP (n=300). Time from symptom discovery to arrival, and EMS utilization were not significantly different between NEP and EP patients in unadjusted or adjusted analyses (overall median time 157 minutes, IQR 55-420; EMS utilization: 65% vs. 61.3% p=0.21). There was no significant difference between NEP and EP patients in DIT or in likelihood of DIT ≤ 25 minutes in unadjusted or adjusted analyses (overall median 59 minutes, IQR 29-127; DIT ≤ 25 minutes 24.3% vs. 21.3% p=0.29). There was also no significant different in DTN time or in likelihood of DTN ≤ 60 minutes in unadjusted or adjusted analyses (overall median 53 minutes, IQR 36-73; DTN ≤ 60 minutes 62.5% vs. 58.2% p=0.60). Conclusion: Non-English-preferring patients have similar response to stroke symptoms as reflected by EMS utilization and time from symptom discovery to hospital arrival. Similarly, NEP patients have no differences in in-hospital AIS care metrics of DIT and DTN time.

Abstract 203: Characteristics of Emergency Medical Service Responses for Adults With Cardiovascular Disease-related Chief Complaints in The United States, 2016

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Isaac A Nwaise ◽  
Erika C Odom
Keyword(s):  
United States ◽  
Cardiovascular Disease ◽  
Emergency Medical Services ◽  
Statistical Tests ◽  
The United States ◽  
Medical Services ◽  
National Database ◽  
Patient Disposition ◽  
Emergency Medical ◽  
Chief Complaints

Background: Gaps exist in understanding the commonality of cardiovascular disease (CVD)-related responses by emergency medical services responders in the United States (US) community setting. Objective: We examined characteristics of CVD-related responses among US adults with 9-1-1 emergency medical services (EMS) responses in a national database. Methods: The 2016 National Emergency Medical Services Information System (NEMSIS) database (Version 2.2.1) from 49 states was used. CVD-related chief complaints were defined by data element E09_12 in the NEMSIS code book. Exclusions were EMS cancellations, persons not found, those with unknown sex, and patients aged <18 years. Rates (per 1,000 EMS responses) were calculated for total population and by patient demographics. Chi-square statistical tests were used to assess associations. Percentages of CVD-related chief complaints were calculated for EMS responses (incident patient disposition, type of destination, and reasons for destination), and clinical characteristics (provider’s primary impression, provider’s secondary impression, primary symptom, and EMS condition code). Results: We identified over 19.8 million EMS responses among adults aged ≥18 years old in 2016, including 1,336,684 (67.4 per 1,000 EMS responses) with CVD-related chief complaints. Rates of CVD-related chief complaints per 1,000 EMS responses for females (68.5), patients aged 65-74 years old (87.7), Hawaiian Pacific Islanders (83.6), whites (73.4), and those living in the South census region (72.8) were significantly higher than their respective counterparts. Among EMS responses, most CVD-related chief complaints were treated and transported by EMS (83.1%), and of those transported by EMS, 83.5% were transported to a hospital. Reasons for hospital destinations among adults with CVD-related chief complaints were patient’s preferred hospital (34%) and closest facility (32.9%). Most CVD-related chief complaints were chest pain or discomfort according to provider’s primary impression (48%) and provider’s secondary impressions (6.1%). Finally, pain (46.2%) was the most frequently reported condition as primary symptom among EMS patient with CVD-related chief complaints. Conclusion: Approximately 1-in-15 EMS (9-1-1) responses among adults involved a CVD-related chief complaint. Future research could focus on trends for CVD-related EMS responses overtime. Keyword: 9-1-1 emergency system, prehospital cardiovascular disease, CVD-related events.

scholarly journals Prehospital Management of COPD Patients in Respiratory Failure and Short-term Outcome

CHEST Journal ◽  
2013 ◽  
Vol 144 (4) ◽  
pp. 724A
Author(s):  
Jerome Cuny ◽  
Guilaume Campagne ◽  
Nathalie Assez ◽  
Patrick Goldstein ◽  
Eric Wiel
Keyword(s):  
Respiratory Failure ◽  
Short Term ◽  
Term Outcome ◽  
Short Term Outcome ◽  
Copd Patients ◽  
Prehospital Management

scholarly journals Emergency Medical Services vs. Police: Impact of Pre-Hospital Transportation Method on Outcomes of Trauma Patients with Firearm Injuries

2020 ◽  
Author(s):  
Christina Wohler ◽  
Rachel Denneny ◽  
Allegra Bermudez ◽  
Robert Wilson ◽  
Douglas Gouchoe ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
The United States ◽  
Hospital Length Of Stay ◽  
Medical Services ◽  
Hospital Treatment ◽  
Firearm Injuries ◽  
Patient Demographics ◽  
Emergency Medical ◽  
Significant Difference ◽  
The Impact

Abstract Background Firearms are a significant cause of morbidity and mortality in the United States. Few studies exist to investigate the impact of pre-hospital transportation methods on trauma patient outcomes. Methods Patients with firearm injuries were identified using an institutional trauma registry (2008 to 2017). Data on patient demographics, hospital transportation, treatments, and outcomes was collected and analyzed. Patient characteristics between Emergency Medical Services (EMS) vs. police transport groups were compared using Kruskal-Wallis, chi-square, or Fisher’s exact tests as appropriate. Results Of 224 patients identified, 147 (66%) were transported by EMS and 77 (34%) were transported by police. There was no significant difference in patient demographics between groups. Most patients were male (94.2%) and African American (69.2%), with a mean age of 27.1 years. 84.4% of patients suffered from an externally-inflicted gunshot wound, while 9.4% of patients had inflicted the wound themselves. Handguns were the weapon most commonly used. There was no significant difference in in-hospital treatments or mortality between patients transported by EMS vs. police. 44.1% of patients underwent surgery, and 34.8% required specialist consultation. The mean hospital length of stay for all patients was 1 day, and 27.7% of all patients expired during admission. Conclusions There is no difference in hospital treatment or mortality between firearm victims transported by EMS vs. police.

Prehospital management of pediatric asthma patients in a large emergency medical services system

2019 ◽  
Vol 55 (1) ◽  
pp. 83-89 ◽  
Author(s):  
Sriram Ramgopal ◽  
Angelica Mazzarini ◽  
Christian Martin‐Gill ◽  
Sylvia Owusu‐Ansah
Keyword(s):  
Emergency Medical Services ◽  
Pediatric Asthma ◽  
Medical Services ◽  
Emergency Medical ◽  
Prehospital Management ◽  
Asthma Patients

Trial to End Ambulance Diversion in Boston: Report from the Conference of the Boston Teaching Hospitals Consortium

2011 ◽  
Vol 26 (2) ◽  
pp. 122-126 ◽  
Author(s):  
Franklin D. Friedman ◽  
Niels K. Rathlev ◽  
Laura White ◽  
Stephen K. Epstein ◽  
Assaad Sayah ◽  
...  
Keyword(s):  
Emergency Department ◽  
Emergency Medical Services ◽  
Online Survey ◽  
Medical Services ◽  
Teaching Hospitals ◽  
Routine Practice ◽  
Ambulance Diversion ◽  
Emergency Medical ◽  
Significant Difference ◽  
The Difference

AbstractIntroduction: Annual ambulance diversion hours in Boston increased more than six-fold from 1997 to 2006. Although interventions and best practices were implemented, there was no reduction in the number of diversion hours.Objectives: A consortium of Boston teaching hospitals instituted a two-week moratorium on citywide diversion from 02 October 2006 to 15 October 2006. The hypothesis was that there would be no significant difference in measures of hospital and emergency medical services (EMS) efficiency compared with the two weeks immediately prior.Methods: A total of nine hospitals and the municipal emergency medical services in Boston submitted data for analysis. The following mean daily hospital measures were studied: (1) emergency department volume; (2) number of emergency department admissions; (3) length of stay (LOS) for all patients; and (4) number of elopements. Mean EMS at-hospital time by destination and the percent of all Boston EMS transports to each hospital destination were calculated. The median differences (MD) were calculated as “before” minus “during” the study period and were compared with paired, Wilcoxon, non-parametric tests. Additional mean EMS measures for all destinations included: (1) to hospital time; (2) number of responses with transport initiated per day; (3) incident entry to arrival; and (4) at-hospital time.Results: The LOS for admitted patients (MD = 0.30 hours; IQR 0.10,1.30; p = 0.03) and number of daily admissions (MD = -1.50 patients; IQR -1.50, -0.10; p = 0.04) were significantly different statistically. The results for LOS for all patients, LOS for discharged patients, ED volume, EMS time at hospital by destination, number of elopements, and percent of Boston EMS transports to each hospital revealed no statistically significant differences. The difference between the study and control periods for mean EMS to hospital time, at-hospital time, and incident entry to arrival was a maximum of 0.6 minutes. The vast majority of EMS respondents to an online survey believed that the “no diversion” policy should be made routine practice.Conclusions: The LOS for admitted patients decreased by 18 minutes, and the number of admissions increased by 1.5 patients per day during the study period. The “no diversion” policy resulted in minimal changes in EMS efficiency and operations. Diversion was temporarily eliminated in a major city without significant detrimental changes in ED, hospital, or EMS efficiency.

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