Objective. There is an absence of nationally representative data describing pediatric patients who use emergency medical services (EMS) andthe factors associated with EMS by children. This study characterizes department (ED) visits for which the patient arrived andidentifies those using a database. Methods. A secondary analysis ED component 1997–2000 National Hospital Ambulatory Medical Care Survey was performed. The dependent variable mode arrival to (EMS vs. not EMS), andindependent...

We describe the decision-making process used by emergency medical services (EMS) providers in order to understand how 1) injured patients are evaluated prehospital setting; 2) field triage criteria applied in-practice; and 3) selection of a destination hospital is determined. conducted separate focus groups with advanced basic life support from rural urban/suburban regions. Four exploratory were identify overarching themes five additional confirmatory verify initial group findings provide...

Objective. To identify emergency medical services (EMS) provider perceptions of factors that may affect the occurrence, identification, reporting, and reduction near misses adverse events in pediatric EMS patient. Methods. This was a subgroup analysis qualitative study examining nature as it relates to prehospital care. Complementary methods focus groups, interviews, anonymous event reporting were used collect results emerging themes identified assigned specific analytic domains. Results....

To identify and investigate the barriers enablers perceived by paramedics regarding administration of analgesia to pediatric emergency medical services (EMS) patients.This was a qualitative study in which in-depth semistructured interviews purposively-sampled group 16 were performed before achieving redundancy. The structured data thematically analyzed. Emerging themes categorized into four domains, novel identified further explored.Thirteen reported success with children at least once their...

In civilian trauma care, field triage is the process applied by prehospital care providers to identify patients who are likely have severe injuries and immediately need resources of a center. Studies efficacy used various measures define center because no "criterion standard" exists, making cross-study comparisons difficult. This study aimed develop consensus-based functional criterion standard definition need.Local national experts were recruited for participation. Blinded key informant...

Introduction: Emergency Medical Services (EMS) play a key role in stroke systems of care. Prehospital recognition is critical, but limited data exchange between prehospital and hospital entities hinders the ability to measure improve this aspect To baseline inform quality improvement efforts, we developed regional collaboration for sharing Get with Guidelines (GTWG) EMS leadership. Methods: This was retrospective analysis GWTG registry from all hospitals single county, including two...

BACKGROUND AND OBJECTIVES: Strokes disproportionately affect underprivileged populations. Mobile stroke units (MSUs) bring diagnostic and treatment tools for directly to patients. This study assessed how MSUs in Rochester, New York, address disparities care. METHODS: observational compared demographics ZIP code socioeconomic status (zSES) of patients transported by our relative who arrived at institution traditional emergency medical service private means. RESULTS: Between October 2018...

To determine the predictive value of mechanism-of-injury step American College Surgeons Field Triage Decision Scheme for determining trauma center need.Emergency medical services (EMS) providers caring injured adult patients transported to regional in three midsized communities over two years were interviewed upon emergency department (ED) arrival. Included was any patient, regardless injury severity. The interview collected patient physiologic condition, apparent anatomic injury, and...

To describe a novel model of care that uses community-based paramedics to deliver modified version the evidence-based hospital-to-home Care Transitions Intervention (CTI) new context: emergency department (ED)-to-home transition.

Lerner, E. Brooke PhD; Drendel, Amy L. DO, MS; Falcone, Richard A. Jr MD, MPH; Weitze, Keith C.; Badawy, Mohamed K. MD; Cooper, Arthur Cushman, Jeremy T. MS, EMT-P; Drayna, Patrick C. Gourlay, David M. Gray, Matthew P. Shah, Manish I. N. MPH Author Information

Objective. We sought to identify a scale or components of that optimize detection older adult traumatic brain injury (TBI) patients who require transport trauma center, regardless mechanism. Methods. assembled consensus panel consisting nine experts in geriatric emergency medicine, prehospital surgery, and TBI, as well providers, evaluate the existing scales used TBI. reviewed relevant literature solicited group feedback create list candidate criteria for evaluation. Using nominal technique,...

Approximately 20% of community-dwelling older adults discharged from the emergency department (ED) return to an ED within 30 days, occurrence partially resulting poor care transitions. Prior published interventions improve ED-to-home transition have either lacked feasibility or effectiveness. The Care Transitions Intervention (CTI) has been validated decrease rehospitalization among patients transitioning hospital home but never tested for home. Paramedics, traditionally involved only in...

Early bystander cardiopulmonary resuscitation (CPR) is one of the most important predictors out-of-hospital cardiac arrests (OHCA) survival. There a dearth literature on CPR engagement in countries such as Ghana, where cardiovascular events are increasingly prevalent. In this study, we sought to evaluate Ghanaians' knowledge and attitudes towards CPR, context country's nascent emergency medicine network.Capitalizing growing ubiquity use social media across country, used novel sampling...

In 2006, the Centers for Disease Control and Prevention (CDC) released a revised Field Triage Decision Scheme. It is unknown how this modified scheme will affect number of patients identified by emergency medical services (EMS) transport to trauma center.To determine change in transported EMS who meet 2006 scheme, compared with 1999 would under- overtriage rates.The providers charge care injured adult regional center three mid-sized cities were interviewed immediately after completing...

Background. Emergency medical dispatch systems are used to help categorize and prioritize emergency services (EMS) resources for requests assistance. Objective. We examined whether a subset of Medical Priority Dispatch System (MPDS) codes could predict patient outcomes (emergency department [ED] discharge versus hospital admission/ED death). Methods. This retrospective observational cohort study analyzed EMS through single public safety answering point (PSAP) serving mixed urban, suburban,...

Background: There is limited research on how well the American College of Surgeons/Center for Disease Control and Prevention Guidelines Field Triage Injured Patients assist EMS providers in identifying children who need resources a trauma center. Objective: To determine accuracy Physiologic Criteria (Step 1) injured Methods: transported 15 years younger to pediatric centers 3 mid-sized cities were interviewed regarding patient demographics presence or absence each criteria. Children...

Background: In 2011, revised Field Triage Guidelines were released jointly by the Centers for Disease Control and Prevention (CDC) American College of Surgeons – Committee on Trauma (ACS-COT). It is unknown how modifications will affect number injured children identified EMS providers as needing transport to a trauma center. Objective: To determine change in under- over-triage rates when 2011 are compared 2006 1999 versions. Methods: charge care (<15 years) transported pediatric centers 3...

About half of older adults with impaired cognition who are discharged home from the emergency department (ED) return for further care within 30 days. We tested effect an adapted Care Transitions Intervention (CTI) at reducing ED revisits in this vulnerable population.

Marathons pose many challenges to event planners. The medical services needed at such events have not received extensive coverage in the literature.The objective of this study was document injury patterns and usage a category III mass gathering (a marathon), with goal helping planners organize resources for large public gatherings.Prospectively obtained care reports from five first-aid stations set up along marathon route were reviewed. Primary secondary reasons seeking categorized. Weather...

Improving care transitions following emergency department (ED) visits may reduce post-ED adverse events among older adults (e.g., ED revisits, decreased function). The Care Transitions Intervention (CTI) improves hospital-to-home transitions; however, its effectiveness at improving outcomes is unknown. We tested the of CTI with community-dwelling adult patients, hypothesizing that it would revisits and increase performance self-management behaviors during 30 days discharge.We conducted a...

The neuromotor conservatism hypothesis predicts that patterns in homologous tetrapod muscles are conserved evolutionarily despite the musculoskeletal modifications of vertebrate limbs. A complete description anatomical organization neurons innervating limb is a prerequisite to any test hypothesis. This study uses retrograde neuronal tracer WGA-HRP selectively label motor neuron pools seven forelimb mice &lt;i&gt;(Mus musculus) &lt;/i&gt;and iguanas &lt;i&gt;(Iguana iguana)&lt;/i&gt;: Mm....

Research on field triage of injured patients is limited by the lack a widely used criterion standard for defining trauma center need. Injury Severity Score (ISS) >15 has been commonly outcome measure in research determining need that never validated. A multidisciplinary team recently published consensus-based definition need, but this not yet The objective was to determine if can be obtained medical record review and compare identified as needing vs. ISS >15. subanalysis data collected...