Structure of emergencies at the prehospital stage in Moldova from 2019-2020 years

Background: In the last 2 years, some changes have occurred in the structure of emergencies at the prehospital stage in the Republic of Moldova, being largely influenced by the COVID-19 pandemic. Material and methods: Retrospective analysis of the Prehospital Emergency Medical Service (PEMS) Request Sheets of the National Centre of Prehospital Emergency Medicine (NCPEM) of the Republic of Moldova for the years 2019-2020. Results: According to the nosological profile in 2020 at the prehospital stage, respiratory emergencies were on the first place with 23% of the 761.416 of total number of requests. On the second – cardiovascular (20.6%), on the third – neurological (13.3%), infectious – 3.1%. In 2019, on the first place – cardiovascular with 22.3% of the 845.572 of total number of requests, followed by respiratory – 19.3%, neurological – 13.6%, infectious – 2.2%. In 2020, on the first place were respiratory emergencies, which compared to 2019 increased practically by 4% and the infectious emergencies by almost 1%. The number of endotracheal intubation procedures and medical-assisted transportations practically doubled in y.2020 compared to y.2019. Conclusions: All these changes: increased respiratory and infectious emergencies, intubation procedures, and assisted-medical transportations, have occurred exeptionally due to COVID-19 infection.

Impact of videolaryngoscopy introduction into prehospital emergency medicine practice: a quality improvement project

IntroductionAdvanced airway management is necessary in the prehospital environment and difficult airways occur more commonly in this setting. Failed intubation is closely associated with the most devastating complications of airway management. In an attempt to improve the safety and success of tracheal intubation, we implemented videolaryngoscopy (VL) as our first-line device for tracheal intubation within a UK prehospital emergency medicine (PHEM) setting.MethodsAn East of England physician–paramedic PHEM team adopted VL as first line for undertaking all prehospital advanced airway management. The study period was 2016–2020. Statistical process control charts were used to assess whether use of VL altered first-pass intubation success, frequency of intubation-related hypoxia and laryngeal inlet views. A survey was used to collect the team’s views of VL introduction.Results919 patients underwent advanced airway management during the study period. The introduction of VL did not improve first-pass intubation success, view of laryngeal inlet or intubation-associated hypoxia. VL improved situational awareness and opportunities for training but performed poorly in some environments.ConclusionDespite the lack of objective improvement in care, subjective improvements meant that overall PHEM clinicians wanted to retain VL within their practice.

M-Health in Prehospital Emergency Medicine

Prehospital emergency medicine strives to treat (potentially) life-threatening conditions as early as possible and thus reduce preventable disabilities and deaths. MHealth enables the transfer of knowledge to the emergency site. The purpose of this chapter is to display different approaches. Knowledge can be brought to the emergency site e.g. by smart phone applications allowing retrieval of data or by real-time communication with a remote medical expert. High definition video communication in real time offers the highest amount of mHealth communication currently available in prehospital emergency medicine. Projects, using such a video communication are discussed. In the European Union funded project LiveCity a special video camera was developed and tested. After having encountered simulated emergency scenarios, emergency doctors and paramedics rated the video connection as helpful, an improvement of the quality of patient care and could imagine working with such a video consultation. MHealth has huge potential for the application in prehospital emergency medicine.

Live Video Communication in Prehospital Emergency Medicine

Prehospital emergency medicine treats time-critical diseases and conditions and aims to reduce morbidity and mortality. The progression of emergency medicine is an important topic for governments worldwide. A problem occurs when paramedics need assistance at the emergency site by emergency doctors, who cannot be present. Video-communication in real-time from the emergency site to an emergency doctor offers an opportunity to enhance the quality of emergency medicine. The core piece of this study is a video camera system called “LiveCity camera,” enabling real-time high quality video connection of paramedics and emergency doctors. The impact of video communication on emergency medicine is clearly appreciated among providers, based upon the extent of agreement that has been stated in this study's questionnaire by doctors and paramedics. This study was part of the FP7-European Union funded research project “LiveCity” (Grant Agreement No. 297291).

Live Video Communication in Prehospital Emergency Medicine

Prehospital emergency medicine treats time-critical diseases and conditions and aims to reduce morbidity and mortality. The progression of emergency medicine is an important topic for governments worldwide. A problem occurs when paramedics need assistance at the emergency site by emergency doctors, who cannot be present. Video-communication in real-time from the emergency site to an emergency doctor offers an opportunity to enhance the quality of emergency medicine. The core piece of this study is a video camera system called “LiveCity camera,” enabling real-time high quality video connection of paramedics and emergency doctors. The impact of video communication on emergency medicine is clearly appreciated among providers, based upon the extent of agreement that has been stated in this study's questionnaire by doctors and paramedics. This study was part of the FP7-European Union funded research project “LiveCity” (Grant Agreement No. 297291).

Mobile Health Applications in Prehospital Emergency Medicine

Prehospital emergency medicine treats time-critical diseases at the emergency site to reduce preventable disabilities and deaths. mHealth can assist in prehospital emergency medicine in multiple ways. This chapter provides insights into emergency medicine and presents three different forms of mHealth in this field. One is a retrieval of medical data (e.g., with aid of smartphone applications). A second one uses unmanned aerial vehicles. And the third one establishes real time communication with medical experts. Examples are given to illustrate the variety of mHealth in prehospital emergency medicine.