scholarly journals GIS Mapping Evaluation of Stroke Service Areas in Bangkok Using Emergency Medical Services

2021 ◽  
Vol 10 (10) ◽  
pp. 651
Author(s):  
Kiatirat Sreemongkol ◽  
Manoj Lohatepanont ◽  
Pannee Cheewinsiriwat ◽  
Tanyaluk O. Bunlikitkul ◽  
Jirapong Supasaovapak
Keyword(s):  
Emergency Medical Services ◽  
Medical Services ◽  
Gis Mapping ◽  
Conditioning Factors ◽  
Stroke Service ◽  
Emergency Medical ◽  
Time Period ◽  
Service Areas ◽  
Travelling Time ◽  
Delivery Models

Stroke is a major cause of death in Thailand. It requires a specific time period of 4.5 h from onset to treatment to increase recovery rates, and therefore, it can be categorized as a time-sensitive disease. The objective of this research is to identify whether the service areas of the main existing Emergency Medical Services (EMS) prehospital stroke practices cover all areas in Bangkok. This is determined by using GIS mapping. After verifying the current EMS delivery models, comparisons are drawn to find the travelling time of each model. The conditioning factors for GIS mapping were collected and verified, including the traffic speed and duration spent in each mode of the prehospital stroke process. After inputting all of the data into GIS, the service areas were visualized to show the area serviced in each delivery model. The results also show the different hospital groups, including the service areas for (1) non-network hospitals and (2) hospitals with stroke networks. Suggestions for re-networking and adding more hospitals to the existing networks were also identified using GIS. Regularly updating the service area with up-to-date data in GIS is key to improving stroke service areas.

scholarly journals Emergency medical services evaluations for chest pain during first COVID-19 lockdown in Hollands-Midden, the Netherlands

2021 ◽  
Vol 29 (4) ◽  
pp. 224-229 ◽  
Author(s):  
E. R. de Koning ◽  
M. J. Boogers ◽  
J. Bosch ◽  
M. de Visser ◽  
M. J. Schalij ◽  
...  
Keyword(s):  
Chest Pain ◽  
Emergency Medical Services ◽  
Medical Services ◽  
Cardiac Symptoms ◽  
Emergency Medical ◽  
Time Period ◽  
Number Of Patients ◽  
St Elevation ◽  
Pain Patients ◽  
Hospital Cardiac Arrest

Abstract Objective To assess whether the COVID-19 lockdown in 2020 had negative indirect health effects, as people seem to have been reluctant to seek medical care. Methods All emergency medical services (EMS) transports for chest pain or out-of-hospital cardiac arrest (OHCA) in the Dutch region Hollands-Midden (population served > 800,000) were evaluated during the initial 6 weeks of the COVID-19 lockdown and during the same time period in 2019. The primary endpoint was the number of evaluated chest pain patients in both cohorts. In addition, the number of EMS evaluations of ST-elevation myocardial infarction (STEMI) and OHCA were assessed. Results During the COVID-19 lockdown period, the EMS evaluated 927 chest pain patients (49% male, age 62 ± 17 years) compared with 1041 patients (51% male, 63 ± 17 years) in the same period in 2019, which corresponded with a significant relative risk (RR) reduction of 0.88 (95% confidence interval (CI) 0.81–0.96). Similarly, there was a significant reduction in the number of STEMI patients (RR 0.52, 95% CI 0.32–0.85), the incidence of OHCA remained unchanged (RR 1.23, 95% CI 0.83–1.83). Conclusion During the first COVID-19 lockdown, there was a significant reduction in the number of patients with chest pain or STEMI evaluated by the EMS, while the incidence of OHCA remained similar. Although the reason for the decrease in chest pain and STEMI consultations is not entirely clear, more attention should be paid to the importance of contacting the EMS in case of suspected cardiac symptoms in possible future lockdowns.

Survey of Iowa Emergency Medical Services on the Effects of the 1993 Floods

1997 ◽  
Vol 12 (3) ◽  
pp. 37-41 ◽  
Author(s):  
Stanley E. Chartoff ◽  
Joann M. Gren
Keyword(s):  
Emergency Medical Services ◽  
Missouri River ◽  
Medical Services ◽  
Cross Sectional ◽  
Emergency Medical ◽  
First Response ◽  
Service Areas ◽  
The Government ◽  
Survey Questionnaires

AbstractIntroduction:From June through August 1993, extensive flooding in the Mississippi and Missouri River basins resulted in 50 deaths and 12 billion dollars [U.S.] in damages in nine Midwestern states. In Iowa (1990 population 2,777,000), the government declared all 99 counties Federal Disaster Areas. This study examines how this event impacted local emergency medical services (EMS).Methods:All 797 registered prehospital ambulance, rescue, and first-response companies in Iowa received survey questionnaires. Two follow-up mailings were provided for non-responders.Results:A total of 468 EMS companies (59%) returned completed questionnaires. The geographic distribution ofresponders and non-responders was similar. Of the companies responding, 132 (28%) reported an impact on their operations from the flood disaster. The most frequently reported operational changes included the use of non-traditional vehicles, providing aid to regions outside usual service areas, and involvement in non-medical rescue operations.Conclusion:A major flood provides unique challenges for emergency medical services. Cross-sectional surveys can identify areas of improvement for prehospital systems located in flood-prone areas. Results from this study provide a basis for constructing a more refined instrument to study future flood disasters.

The Utilization of Bicycles in the Delivery of Emergency Medical Services: A Preliminary Report

1997 ◽  
Vol 12 (2) ◽  
pp. 102-108 ◽  
Author(s):  
John F. Gorham ◽  
Todd S. Kramer
Keyword(s):  
Emergency Medical Services ◽  
Response Times ◽  
Cost Effective ◽  
Mean Value ◽  
Medical Services ◽  
Special Events ◽  
Emergency Medical ◽  
Service Areas ◽  
Minor Injuries ◽  
The Impact

AbstractIntroduction:Bicycles may be useful in the delivery of out-of-hospital emergency medical services. The use of bicycles in providing emergency medical services was investigated by surveying currently existing bicycle-medic systems.Methods:Two questionnaires were developed to gain information on service areas, injuries, gear used, missions, and specific data from bicycle-medic response.Results:Of 210 surveys mailed to bicyclemedics, 21 (10%) were completed and returned by the pre-established deadline. Of 11 surveys mailed to bicycle-medic supervisors, four (36%) were returned. Preliminary results showed that 76% of respondents are career providers and the remainder serve as volunteers. Mean age for respondents was 33±7.4 years, with 96% being males. Most teams have been in existence for three to four years. Job satisfaction was greater when participating on the bicycle crews than when not performing on the bicycle crew, t = 4.15, p = 0.0002. The teams varied in size (6–100 persons) with a mean value of 31. On the average, team size represented 10% of total number of personnel for the respective organizations.The majority of bicycle teams operate all year in all conditions. Most bicycle-medic teams were initiated for special events. Nineteen percent reported injuries while on duty or in training. Ninety percent of units that responded use existing agency protocols and have no special protocols related to the bicycle team. Eighty percent of the units are dispatched through the normal agency procedures. Eighty-five percent of respondents coordinate for transport units via dispatch. Reported response times were under two minutes for special event responses. These were within established agency response times. In approximately 25% of the responses, the patients refused transport, and another 65% of the responses were for relatively minor injuries or complaints that did not require transport to a hospital.Conclusion:This survey begins to characterize the utilization of bicycles as a tool to gain patient access in specialized situations. The use of bicycle-medics may be cost-effective, may help to improve employee morale, and possibly reduce employee health-care costs. Further study is needed to determine the impact of bicycle-medics on patient outcomes and response times.

Abstract 105: Geographic Disparities in Emergency Medical Services Calls for Stroke in Chicago

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Shyam Prabhakaran ◽  
Todd Schuble ◽  
Eric Beck ◽  
Christopher Richards ◽  
Leslee Stein-Spencer ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Hot Spots ◽  
Policy Development ◽  
Hot Spot ◽  
Tracking System ◽  
Public Health Intervention ◽  
Educational Outreach ◽  
Medical Services ◽  
Gis Mapping ◽  
Emergency Medical

Introduction: Geographic Information Systems (GIS) is a methodology for matching clinical and spatial metrics to inform public health intervention and policy development. We evaluated statistical hot spots for emergency medical services (EMS) calls for stroke and compared these with stroke admission rates in Chicago. Methods: In a retrospective review, we compared stroke hospitalizations (ICD-9 code 430-436) for residents of Chicago using Illinois Hospital Association CompData to EMS stroke calls between May 15, 2012 and November 30, 2012. EMS stroke calls were identified through the patient tracking system of the Chicago Fire Department which also captured the scene coordinates (latitude and longitude). Using the Getis-Ord Gi* method, we identified hot spots for EMS stroke calls. Statistical hot spots are defined as areas where there is <1% chance of the case clusters occurring by chance. We then calculated a ratio of EMS calls to stroke admissions for each zip code in Chicago to identify areas where EMS usage was disproportionately low. Results: During the study period, there were 4,135 stroke admissions and 919 EMS stroke calls. Stroke admissions were more frequent in the south, west, and northwest sides of Chicago. While hot spot data for EMS stroke calls overlapped with areas of greatest stroke density and mortality, there were some areas with disproportionately low rates of EMS calls (figure). In particular, the regions in the northwest area of the city and downtown/south loop of Chicago appear to have low (4-11%) rates of EMS calls per stroke admissions. Conclusion: Discrete areas within Chicago were identified as hot spots for EMS-treated stroke which correspond generally with regions of greatest stroke density and stroke mortality. GIS mapping of EMS stroke calls may be valuable for targeted neighborhood educational outreach, operational deployment of EMS resources, and monitoring performance improvement initiatives.

Reduction in unavailable-for-response episodes in a private emergency medical services agency

2016 ◽  
Vol 14 (1) ◽  
pp. 79 ◽  
Author(s):  
Brian L. Risavi, DO, MS, FACEP, FAAEM ◽  
Saad Mahmood, DO ◽  
Kevin Andryc, DO ◽  
John Libonati, EMT-P ◽  
Mark A. Terrell, EdD
Keyword(s):  
Emergency Medical Services ◽  
Critical Time ◽  
Internal Audit ◽  
Cost Benefit ◽  
Temporal Patterns ◽  
Cost Effective ◽  
Medical Services ◽  
Emergency Medical ◽  
Time Period ◽  
Time Periods

Objective: Increased demand for emergency medical services (EMS), financial constraints, emergency department overcrowding, EMS crews kept in hospital, all result in ambulance unavailability. This study seeks to identify daily temporal patterns for unavailable-for-response episodes, impact of increasing staffing during peak periods, and evaluating the extent of reduction in unavailable-for-response episodes due to temporally precise increases in staffing during critical time periods and the resulting cost/ benefit analysis.Design: The authors evaluated all EMS responses during a 7-month time period and recorded all unavailable-for-response episodes. This identified clusters of unavailable-for-response episodes for which incremental staffing changes were implemented. Internal audit of cost/revenues was recorded.Setting: Midsized private EMS agency in Northwest Pennsylvania.Subjects/participants: EMS Responders/Agency calls.Interventions: Temporally precise increases in staffing during critical time periods/unavailable-for-response episodes.Main outcome measure(s): Reduction in unavailable-for-response episodes, cost effectiveness.Results: Evaluating 23,833 EMS responses that occurred during the study period, staffing changes resulted in a 93 percent average reduction and 100 percent maximum reduction in unavailable-for-response episodes and were cost effective, based on evaluation of cost versus revenue, in this EMS agency.Conclusions: Identification of opportunities for system staffing improvement in a midsized EMS agency demonstrated feasibility and usability of mapping temporal patterns of unavailable-for-response episodes to substantially reduce the number of unavailable-for-response episodes and was cost effective.

Sign in / Sign up

Export Citation Format

Share Document