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

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

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

2019 ◽  
Vol 6 (4) ◽  
pp. 1219
Author(s):  
Mrutyunjay I. Uppin ◽  
Kapildev K. Hannurkar ◽  
Archana M. Uppin
Keyword(s):  
Patient Satisfaction ◽  
Emergency Medical Services ◽  
Trauma Center ◽  
Road Traffic ◽  
Trauma Centre ◽  
Medical Services ◽  
Research Centre ◽  
Trauma Patients ◽  
Quality Health Care ◽  
Emergency Medical

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.

Diagnostic value of prehospital ECG in acute stroke patients

Neurology ◽  
2017 ◽  
Vol 88 (20) ◽  
pp. 1894-1898 ◽  
Author(s):  
Tobias Bobinger ◽  
Bernd Kallmünzer ◽  
Markus Kopp ◽  
Natalia Kurka ◽  
Martin Arnold ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Emergency Medical Services ◽  
Stroke Unit ◽  
Diagnostic Yield ◽  
Prehospital Care ◽  
Diagnostic Value ◽  
Medical Services ◽  
Ecg Monitoring ◽  
St Segment Elevation ◽  
Emergency Medical

Objective:To investigate the diagnostic yield of prehospital ECG monitoring provided by emergency medical services in the case of suspected stroke.Methods:Consecutive patients with acute stroke admitted to our tertiary stroke center via emergency medical services and with available prehospital ECG were prospectively included during a 12-month study period. We assessed prehospital ECG recordings and compared the results to regular 12-lead ECG on admission and after continuous ECG monitoring at the stroke unit.Results:Overall, 259 patients with prehospital ECG recording were included in the study (90.3% ischemic stroke, 9.7% intracerebral hemorrhage). Atrial fibrillation (AF) was detected in 25.1% of patients, second-degree or greater atrioventricular block in 5.4%, significant ST-segment elevation in 5.0%, and ventricular ectopy in 9.7%. In 18 patients, a diagnosis of new-onset AF with direct clinical consequences for the evaluation and secondary prevention of stroke was established by the prehospital recordings. In 2 patients, the AF episodes were limited to the prehospital period and were not detected by ECG on admission or during subsequent monitoring at the stroke unit. Of 126 patients (48.6%) with relevant abnormalities in the prehospital ECG, 16.7% received medical antiarrhythmic therapy during transport to the hospital, and 6.4% were transferred to a cardiology unit within the first 24 hours in the hospital.Conclusions:In a selected cohort of patients with stroke, the in-field recordings of the ECG detected a relevant rate of cardiac arrhythmia. The results can add to the in-hospital evaluation and should be considered in prehospital care of acute stroke.

scholarly journals Priority accuracy by dispatch centers and Emergency Medical Services professionals in trauma patients: a cohort study

2021 ◽  
Author(s):  
Job F. Waalwijk ◽  
◽  
Robin D. Lokerman ◽  
Rogier van der Sluijs ◽  
Audrey A. A. Fiddelers ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Priority Setting ◽  
Injury Severity ◽  
Medical Services ◽  
Trauma Patients ◽  
Trauma Centers ◽  
Reference Standard ◽  
Emergency Medical ◽  
Specialized Care ◽  
Primary Reference

Abstract Purpose Priority-setting by dispatch centers and Emergency Medical Services professionals has a major impact on pre-hospital triage and times of trauma patients. Patients requiring specialized care benefit from expedited transport to higher-level trauma centers, while transportation of these patients to lower-level trauma centers is associated with higher mortality rates. This study aims to evaluate the accuracy of priority-setting by dispatch centers and Emergency Medical Services professionals. Methods This observational study included trauma patients transported from the scene of injury to a trauma center. Priority-setting was evaluated in terms of the proportion of patients requiring specialized trauma care assigned with the highest priority (i.e., sensitivity), undertriage, and overtriage. Patients in need of specialized care were defined by a composite resource-based endpoint. An Injury Severity Score ≥ 16 served as a secondary reference standard. Results Between January 2015 and December 2017, records of 114,459 trauma patients were collected, of which 3327 (2.9%) patients were in need of specialized care according to the primary reference standard. Dispatch centers and Emergency Medical Services professionals assigned 83.8% and 74.5% of these patients with the highest priority, respectively. Undertriage rates ranged between 22.7 and 65.5% in the different prioritization subgroups. There were differences between dispatch and transport priorities in 17.7% of the patients. Conclusion The majority of patients that required specialized care were assigned with the highest priority by the dispatch centers and Emergency Medical Services professionals. Highly accurate priority criteria could improve the quality of pre-hospital triage.

scholarly journals Examining emergency medical services' prehospital transport times for trauma patients during COVID-19

2021 ◽  
Vol 44 ◽  
pp. 33-37
Author(s):  
Stephanie Jarvis ◽  
Kristin Salottolo ◽  
Gina M. Berg ◽  
Matthew Carrick ◽  
Rachel Caiafa ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Medical Services ◽  
Trauma Patients ◽  
Emergency Medical

Comparison of physician-staffed helicopter with ground-based emergency medical services for trauma patients

2021 ◽  
Author(s):  
Masakazu Nabeta ◽  
Kenta Murotani ◽  
Mikinori Kannae ◽  
Keita Tashiro ◽  
Nobuhisa Hirayu ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Medical Services ◽  
Trauma Patients ◽  
Emergency Medical

Mode of Transport and Clinical Outcome in Rural Trauma: A Helicopter versus Ambulance Comparison

2017 ◽  
Vol 83 (12) ◽  
pp. 1413-1417 ◽  
Author(s):  
Mahdi Malekpour ◽  
Jabran M. Younus ◽  
Kathryn Jaap ◽  
Nina Neuhaus ◽  
Kenneth Widom ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Emergency Medical Services ◽  
Glasgow Coma Score ◽  
Injury Severity ◽  
Medical Services ◽  
Blunt Injury ◽  
Trauma Patients ◽  
Emergency Medical ◽  
Younger Men ◽  
Mode Of Transport

Helicopter Emergency Medical Services (HEMS) is presumably an effective way of patient transport in rural trauma, yet the literature addressing its effectiveness is scarce. In this study, we compared the clinical outcome of rural trauma patients between Ground Emergency Medical Services (GEMS) and HEMS transportation from the beginning of 2006 to the end of 2012. Focus was placed on identifying factors associated with survival to discharge in these patients. Over the seven-year study period, 4492 patients met the inclusion criteria with 2414 patients (54%) being transferred by GEMS and 2078 patients (46%) being transferred by HEMS. In comparison with GEMS, patients transferred by HEMS were younger men who were admitted with a higher mean Injury Severity Score and a lower mean Glasgow Coma Score (all Ps < 0.0001). HEMS patients were more frequently intubated before arrival at the trauma center (32% vs 9%, P < 0.0001) and were more frequently transferred to the operating room from the emergency department (11% vs 5%, P < 0.0001). In multivariate analysis, transfer by HEMS was associated with a significant increase in survival to discharge (odds ratio: 1.57, 95% confidence interval: 1.03–2.40, P = 0.036). Blunt injury, no intubation, and Glasgow Coma Score >8 were also associated with significantly improved odds of survival to discharge (all P < 0.0001). These findings show that although patients transferred by HEMS arrived in less favorable clinical conditions, HEMS transfer was associated with significantly higher odds of survival in rural trauma.

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