scholarly journals The Evaluation Value of Emergency and Critical Illness Scoring System for Emergency Medical Patients

2021 ◽  
Vol 83 ◽  
Author(s):  
Xiaoqing Xiong ◽  
Rong Wang ◽  
C. Zhao ◽  
Bing Wang
Keyword(s):  
Critical Illness ◽  
Scoring System ◽  
Medical Patients ◽  
Emergency Medical

Utilization Criteria for Prehospital Ultrasound in a Canadian Critical Care Helicopter Emergency Medical Service: Determining Who Might Benefit

2017 ◽  
Vol 32 (5) ◽  
pp. 536-540 ◽  
Author(s):  
Domhnall O’Dochartaigh ◽  
Matthew Douma ◽  
Chris Alexiu ◽  
Shell Ryan ◽  
Mark MacKenzie
Keyword(s):  
Critical Care ◽  
Emergency Medical Service ◽  
Medical Service ◽  
Helicopter Emergency Medical Service ◽  
Outcome Variable ◽  
Trauma Patients ◽  
Medical Patients ◽  
Shock Index ◽  
Patient Acuity ◽  
Emergency Medical

AbstractIntroductionPrehospital ultrasound (PHUS) assessments by physicians and non-physicians are performed on medical and trauma patients with increasing frequency. Prehospital ultrasound has been shown to be of benefit by supporting interventions.ProblemWhich patients may benefit from PHUS has not been clearly identified.MethodsA multi-variable logistic regression analysis was performed on a previously created retrospective dataset of five years of physician- and non-physician-performed ultrasound scans in a Canadian critical care Helicopter Emergency Medical Service (HEMS). For separate medical and trauma patient groups, the a-priori outcome assessed was patient characteristics associated with the outcome variable of “PHUS-supported intervention.”ResultsBoth models were assessed (Likelihood Ratio, Score, and Wald) as a good fit. For medical patients, the characteristics of heart rate (HR) and shock index (SI) were found to be most significant for an intervention being supported by PHUS. An extremely low HR was found to be the most significant (OR=15.86 [95% confidence interval (CI), 1.46-171.73]; P=.02). The higher the SI, the more likely that an intervention was supported by PHUS (SI 0.9 to<1.3: OR=9.15 [95% CI, 1.36-61.69]; P=.02; and SI 1.3+: OR=8.37 [95% CI, 0.69-101.66]; P=.09). For trauma patients, the characteristics of Prehospital Index (PHI) and SI were found to be most significant for PHUS support. The greatest effect was PHI, where increasing ORs were seen with increasing PHI (PHI 14-19: OR=13.36 [95% CI, 1.92-92.81]; P=.008; and PHI 20-24: OR=53.10 [95% CI, 4.83-583.86]; P=.001). Shock index was found to be similar, though, with lower impact and significance (SI 0.9 to<1.3: OR=9.11 [95% CI, 1.31-63.32]; P=.025; and SI 1.3+: OR=35.75 [95% CI, 2.51-509.81]; P=.008).Conclusions:In a critical care HEMS, markers of higher patient acuity in both medical and trauma patients were associated with occurrences when an intervention was supported by PHUS. Prospective study with in-hospital follow-up is required to confirm these hypothesis-generating results.O’DochartaighD, DoumaM, AlexiuC, RyanS, MacKenzieM. Utilization criteria for prehospital ultrasound in a Canadian critical care Helicopter Emergency Medical Service: determining who might benefit. Prehosp Disaster Med. 2017;32(5):536–540.

Use of Emergency Medical Service transport system in medical patients up to 36 months of age

1998 ◽  
Vol 14 (3) ◽  
pp. 191-193 ◽  
Author(s):  
NORMAN ROSENBERG ◽  
STEPHEN KNAZIK ◽  
SANFORD COHEN ◽  
PIPPA SIMPSON
Keyword(s):  
Emergency Medical Service ◽  
Transport System ◽  
Medical Service ◽  
Medical Patients ◽  
Emergency Medical

A simplified critical illness severity scoring system (CISSS): Development and internal validation

2021 ◽  
Vol 61 ◽  
pp. 21-28 ◽  
Author(s):  
Spyridon Fortis ◽  
Amy M.J. O'Shea ◽  
Brice F. Beck MAE ◽  
Rajeshwari Nair ◽  
Michihiko Goto ◽  
...  
Keyword(s):  
Critical Illness ◽  
Scoring System ◽  
Illness Severity ◽  
Internal Validation ◽  
Severity Scoring

Sex and Mortality of Hospitalized Adults After Admission to an Intensive Care Unit

2013 ◽  
Vol 22 (4) ◽  
pp. 314-319 ◽  
Author(s):  
Jed Lipes ◽  
Louay Mardini ◽  
Dev Jayaraman
Keyword(s):  
Intensive Care ◽  
Critical Illness ◽  
Medical Emergency Team ◽  
Mortality Rates ◽  
Medical Emergency ◽  
Mortality Data ◽  
Medical Patients ◽  
Emergency Team ◽  
Surgical Units ◽  
The Difference

Background After admission to intensive care, women have higher mortality rates than do men. The reasons for the greater mortality in women are not fully understood. Objective To determine if increased mortality in women was due to delays in the recognition of critical illness or to delays in timely admission to intensive care. Methods A total of 241 consecutive admissions to intensive care from medical and surgical units during a 12-month period were analyzed retrospectively. Patients’ demographics, illness severity, and delay between the time the patients would have fulfilled criteria for calling a medical emergency team and consultation with and admission to intensive care were analyzed. Results Delay from fulfillment of criteria for calling a medical emergency team and consultation with intensive care and from consultation to admission to intensive care did not differ between sexes. Despite similar delays in admission to intensive care, women had a higher 30-day mortality than did men (44.9% vs 30.5%; P = .02). The increased mortality was more pronounced in the medical patients (53% vs 34%; P = .02). Multivariate analysis of mortality data yielded a mortality odds ratio of 0.35 (95% CI, 0.16–0.74) for men, significantly different from values for women (P = .006). Conclusion After admission to intensive care from medical or surgical units, women had higher mortality rates than did men, and the difference was more pronounced in medical patients. The difference in mortality between sexes was not explained by delayed recognition of critical illness or delayed admission to intensive care.

scholarly journals The development of emergency medical services benefit score: a European Delphi study

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Anssi Heino ◽  
Lasse Raatiniemi ◽  
Timo Iirola ◽  
Merja Meriläinen ◽  
Janne Liisanantti ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Delphi Study ◽  
Scoring System ◽  
Prehospital Care ◽  
University Hospital ◽  
Medical Services ◽  
Original Form ◽  
Clinical Use ◽  
Emergency Medical ◽  
Delphi Round

Abstract Background The helicopter emergency services (HEMS) Benefit Score (HBS) is a nine-level scoring system developed to evaluate the benefits of HEMS missions. The HBS has been in clinical use for two decades in its original form. Advances in prehospital care, however, have produced demand for a revision of the HBS. Therefore, we developed the emergency medical services (EMS) Benefit Score (EBS) based on the former HBS. As reflected by its name, the aim of the EBS is to measure the benefits produced by the whole EMS systems to patients. Methods This is a four-round, web-based, international Delphi consensus study with a consensus definition made by experts from seven countries. Participants reviewed items of the revised HBS on a 5-point Likert scale. A content validity index (CVI) was calculated, and agreement was defined as a 70% CVI. Study included experts from seven European countries. Of these, 18 were prehospital expert panellists and 11 were in-hospital commentary board members. Results The first Delphi round resulted in 1248 intervention examples divided into ten diagnostic categories. After removing overlapping examples, 413 interventions were included in the second Delphi round, which resulted in 38 examples divided into HBS categories 3–8. In the third Delphi round, these resulted in 37 prehospital interventions, examples of which were given revised version of the score. In the fourth and final Delphi round, the expert panel was given an opportunity to accept or comment on the revised scoring system. Conclusions The former HBS was revised by a Delphi methodology and EBS developed to represent its structural purpose better. The EBS includes 37 exemplar prehospital interventions to guide its clinical use. Trial registration The study permission was requested and granted by Turku University Hospital (decision number TP2/010/18).

123 Identifying Critical Illness During Emergency Medical Services Care

2012 ◽  
Vol 60 (4) ◽  
pp. S45
Author(s):  
A.Z. Tobias ◽  
F.X. Guyette ◽  
C.W. Seymour ◽  
B.P. Suffoletto ◽  
C. Martin-Gill ◽  
...  
Keyword(s):  
Critical Illness ◽  
Emergency Medical Services ◽  
Medical Services ◽  
Emergency Medical
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