Mobile satellite EMS communications Bruce P Jackson
DOI: http://dx.doi.org/10.1016/0735-6757(95)90274-0
The American Journal of Emergency Medicine , Vol. 13 , Issue 1 ,
Published in issue: January 1995
Emergency Medical Services (EMS) versus non-EMS transport of critically injured patients: Cornell EE, Belzberg H, Hennigan K, et al. JAMA 2000;135:315–319
DOI: http://dx.doi.org/10.1016/S0735-6757(01)80092-9
The American Journal of Emergency Medicine , Vol. 19 , Issue 5 ,
Published in issue: September 2001
Emergency medical services use by stroke patients: a population-based study Opeolu Adeoye, Christopher Lindsell, Joseph Broderick, Kathy Alwell, Edward Jauch, Charles J. Moomaw, Matthew L. Flaherty, Arthur Pancioli, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2008.02.004
The American Journal of Emergency Medicine , Vol. 27 , Issue 2 ,
Published in issue: February 2009
x Emergency medical services (EMS) use by stroke patients varies from 38% to 65%. In an epidemiological study, we determined the proportion of stroke patients who used EMS, hypothesizing that demographics, stroke severity, stroke type, and location at stroke onset would be associated with EMS use.
Sustainable emergency medical service systems: how much energy do we need? Lawrence H. Brown, Ian E. Blanchard
DOI: http://dx.doi.org/10.1016/j.ajem.2014.11.011
The American Journal of Emergency Medicine , Vol. 33 , Issue 2 ,
Published online: November 14 2014
x Modern emergency medical service (EMS) systems are vulnerable to both rising energy prices and potential energy shortages. Ensuring the sustainability of EMS systems requires an empirical understanding of the total energy requirements of EMS operations. This study was undertaken to determine the life cycle energy requirements of US EMS systems.
The Second International Urban EMS Conference Alexander Kuehl, James T. Kerr, Jamie Fenwick
DOI: http://dx.doi.org/10.1016/0735-6757(85)90173-1
The American Journal of Emergency Medicine , Vol. 3 , Issue 6 ,
Published in issue: November 1985
Epinephrine use and outcomes in anaphylaxis patients transported by emergency medical services Veena Manivannan, Robert J. Hyde, Daniel G. Hankins, M. Fernanda Bellolio, Martin G. Fedko, Wyatt W. Decker, Ronna L. Campbell
DOI: http://dx.doi.org/10.1016/j.ajem.2014.05.014
The American Journal of Emergency Medicine , Vol. 32 , Issue 9 ,
Published online: May 19 2014
x Anaphylaxis is a potentially life-threatening allergic reaction that may require emergency medical system (EMS) transport. Fatal anaphylaxis is associated with delayed epinephrine administration. Patient outcome data to assess appropriateness of EMS epinephrine administration are sparse.
Patterns of use of EMS transport Charles McConnel, Rosemary W. Wilson
DOI: http://dx.doi.org/10.1053/ajem.2001.16252
The American Journal of Emergency Medicine , Vol. 19 , Issue 1 ,
Published in issue: January 2001
x My colleague and I were pleased to review Dr Svenson's emergency medical service (EMS) transport study in this Journal 1 and hope that its publication is a sign of a heightened interest in population-based studies that focus on the socioeconomic and demographic factors underlying EMS use. It is a rich study with a variety of important findings that reinforce the view of previous research regarding the necessity for planning the public provision of emergency health resources as our society ages. Nonetheless, having pursued a similar research program over the past decade, we are compelled to quarrel with the investigator's assertion of priority in reporting EMS transport use rates across all age groups.
Emergency medical services: An annotated bibliography of the recent literature Jon R. Krohmer, Howard A. Werman, Members of the EMS Educators Committee, Stem
DOI: http://dx.doi.org/10.1016/0735-6757(89)90105-8
The American Journal of Emergency Medicine , Vol. 7 , Issue 1 ,
Published in issue: January 1989
The impact of emergency medical services on the ED care of severe sepsis Jonathan R. Studnek, Melanie R. Artho, Craymon L. Garner Jr, Alan E. Jones
DOI: http://dx.doi.org/10.1016/j.ajem.2010.09.015
The American Journal of Emergency Medicine , Vol. 30 , Issue 1 ,
Published online: October 28 2010
x The identification and treatment of critical illness is often initiated by emergency medical services (EMS) providers. We hypothesized that emergency department (ED) patients with severe sepsis who received EMS care had more rapid recognition and treatment compared to non-EMS patients.
Outcomes of non–STEMI patients transported by emergency medical services vs private vehicle Mary Colleen Bhalla, Jennifer Frey, Sarah Dials, Kristin Baughman
DOI: http://dx.doi.org/10.1016/j.ajem.2015.12.070
The American Journal of Emergency Medicine , Vol. 34 , Issue 3 ,
Published online: December 24 2015
x Non–ST-segment elevation myocardial infarctions (NSTEMIs) are more common but less studied than ST-segment elevation myocardial infarctions (STEMIs) treated by emergency medical services (EMS).
Type of arrhythmia at EMS arrival on scene in out-of-hospital cardiac arrest in relation to interval from collapse and whether a bystander initiated CPR Johan Herlitz, Lars Ekström, Bertil Wennerblom, Åsa Axelsson, Angela Bång, Stig Holmberg
DOI: http://dx.doi.org/10.1016/S0735-6757(96)90116-3
The American Journal of Emergency Medicine , Vol. 14 , Issue 2 ,
Published in issue: March 1996
x Outcome after cardiac arrest is strongly related to whether the patient has ventricular fibrillation at the time the emergency medical service (EMS) arrives on the scene. The occurrence of various arrhythmias at the time of EMS arrival among patients with out-of-hospital cardiac arrest was studied in relation to the interval from collapse and whether cardiopulmonary resuscitation (CPR) was initiated by a bystander. The patients studied were all those with out-of-hospital cardiac arrest in Göteborg, Sweden, between 1980 and 1992 in whom CPR was attempted by the arriving EMS and for whom the interval between collapse and the arrival of EMS was known.
Cardiac arrests witnessed by EMS personnel in a multitiered system: Epidemiology and outcome Markku Kuisma, Teuvo Määttä, Jukka Repo
DOI: http://dx.doi.org/10.1016/S0735-6757(98)90058-4
The American Journal of Emergency Medicine , Vol. 16 , Issue 1 ,
Published in issue: January 1998
x The purpose of the study was to determine the epidemiology and the etiology of cardiac arrests witnessed by emergency medical services (EMS) personnel and the survival from resuscitation according to the Utstein style. Consecutive prehospital cardiac arrests witnessed by EMS personnel in the Helsinki City EMS system between January 1, 1994 and December 31, 1995 were included in this prospective cohort study. A total of 809 cardiac arrests were registered during the study period, 108 (13.3%) of which were EMS-witnessed.
Characteristics of and outcome for patients with chest pain in relation to transport by the emergency medical services in a 20-year perspective Nguyen Dang Thang, Björn Wilgot Karlson, Bo Bergman, Marco Santos, Thomas Karlsson, Ann Bengtson, Per Johanson, Araz Rawshani, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2012.02.014
The American Journal of Emergency Medicine , Vol. 30 , Issue 9 ,
Published online: May 25 2012
x The aims of this study were to describe the characteristics of and outcome of patients with chest pain in relation to transport by the emergency medical services (EMS) and to describe possible changes in this relationship in a 20-year perspective.
Prehospital recognition of severe sepsis: development and validation of a novel EMS screening tool Carmen C. Polito, Alex Isakov, Arthur H. Yancey II, Duncan K. Wilson, Blake A. Anderson, Ingrid Bloom, Greg S. Martin, Jonathan E. Sevransky
DOI: http://dx.doi.org/10.1016/j.ajem.2015.04.024
The American Journal of Emergency Medicine , Vol. 33 , Issue 9 ,
Published online: April 22 2015
x To derive and validate a predictive model and novel emergency medical services (EMS) screening tool for severe sepsis (SS).
Case definition in survival studies of out-of-hospital cardiac arrest Sue A. Joslyn
DOI: http://dx.doi.org/10.1016/0735-6757(94)90143-0
The American Journal of Emergency Medicine , Vol. 12 , Issue 3 ,
Published in issue: May 1994
x The purpose of this investigation was to determine problems with case definition and selection biases in studies of survival from out-of-hospital cardiac arrest, by comparing characteristics of subjects with cardiac arrest who entered the emergency medical services (EMS) system and those who did not enter the system. Data for 143 prehospital cardiac arrest patients in Johnson County, Iowa, were obtained from death certificates and EMS reports. Approximately one half of cardiac arrest patients entered the EMS system.
Isolated trapezium subluxation in EMS provider with a novel reduction technique Christopher Gee
DOI: http://dx.doi.org/10.1016/j.ajem.2011.05.012
The American Journal of Emergency Medicine , Vol. 30 , Issue 7 ,
Published online: December 8 2011
x Hand injuries are a common complaint in the emergency department (ED). Oftentimes, these injuries occur in work settings. We report a case of a healthy EMS provider presenting to the ED with a left thumb injury that turned out to be an isolated trapezium subluxation. Using bedside fluoroscopy, the thumb carpometacarpal joint was isolated, injected, and subsequently reduced. The clinical course and management are discussed as well as a brief review of hand injuries.
Operation care: a pilot case management intervention for frequent emergency medical system users Michael L. Rinke, Elisabeth Dietrich, Traci Kodeck, Kathleen Westcoat
DOI: http://dx.doi.org/10.1016/j.ajem.2010.12.012
The American Journal of Emergency Medicine , Vol. 30 , Issue 2 ,
Published online: January 27 2011
x This study aims to determine if a prehospital case management intervention reduces transport and nontransport emergency medical system (EMS) responses to frequent EMS users.
The effect of bystander CPR and arrival time of EMS on successful out-of-hospital resuscitation : George Ritter, Sidney Goldstein, Richard Leighton, Richard Landis, Robert Wolfe, C. Mark Vasu, Allyn Acheson, Steven Kuritz. Henry Ford Hospital, Detroit, MI 48202
DOI: http://dx.doi.org/10.1016/0735-6757(84)90161-X
The American Journal of Emergency Medicine , Vol. 2 , Issue 4 ,
Published in issue: July 1984
Community surveillance of falls among the elderly using computerized EMS transport data James L. Wofford, Mark D. Heuser, William P. Moran, Earl Schwartz, Maurice B. Mittelmark
DOI: http://dx.doi.org/10.1016/0735-6757(94)90055-8
The American Journal of Emergency Medicine , Vol. 12 , Issue 4 ,
Published in issue: July 1994
x Because falls are common among the elderly and are associated with high morbidity and mortality, community surveillance has been recommended. The purpose of this study was to characterize the impact of falls among the elderly on emergency medical transport services (EMS) and to explore the potential for community surveillance of falls through the use of computerized EMS data. Computerized EMS data and United States census data for 1990 for persons aged ≥65 in Forsyth County, NC, were used to produce EMS transport rates for falls and to make comparisons by age, gender, race, and residence (nursing home vs community).
Does out-of-hospital EMS time affect trauma survival? Stan Feero, Jerris R Hedges, Erik Simmons, Lisa Irwin
DOI: http://dx.doi.org/10.1016/0735-6757(95)90078-0
The American Journal of Emergency Medicine , Vol. 13 , Issue 2 ,
Published in issue: March 1995
x To determine if out-of-hospital emergency medical services (EMS) time intervals are associated with unexpected survival and death in urban major trauma, a retrospective review was conducted of major trauma cases entered into an urban trauma system by an EMS system during a one-year period. Patients with unexpected death or unexpected survival were identified using TRISS methodology. The EMS response, on-scene time, transport time, and total EMS out-of-hospital time intervals were compared for the two groups using the unpaired t test (two-tailed analysis).
Description of procedures performed on patients by emergency medical services during mass casualty incidents in the United States Mazen El Sayed, Hani Tamim, N. Clay Mann
DOI: http://dx.doi.org/10.1016/j.ajem.2015.04.035
The American Journal of Emergency Medicine , Vol. 33 , Issue 8 ,
Published online: April 25 2015
x Emergency medical services (EMS) preparedness is essential to reduce morbidity and mortality from mass casualty incidents (MCIs).
Performance of a system to determine EMS dispatch priorities Liz Palumbo, John Kubincanek, Charles Emerman, Nick Jouriles, Rita Cydulka, Bruce Shade
DOI: http://dx.doi.org/10.1016/S0735-6757(96)90056-X
The American Journal of Emergency Medicine , Vol. 14 , Issue 4 ,
Published in issue: July 1996
x Inappropriate use of emergency medical services (EMS) for nonemergencies strains EMS resources and limits efficiency. Protocol-driven dispatch systems attempt to correct the imbalance that exists between demand and available resources by prioritizing 911 calls. This study compared dispatch priority decisions with apparent patient need, based on emergency department (ED) presentation, by matching 320 ED charts with corresponding EMS dispatch and run information. The priorities assigned by the system based on dispatch information were compared with those assigned by a three-member panel of physicians based on ED presentation.
Characteristics and outcomes of injured patients presenting by private vehicle in a state trauma system Nicholas J. Johnson, Brendan G. Carr, Rama Salhi, Daniel N. Holena, Catherine Wolff, Roger A. Band
DOI: http://dx.doi.org/10.1016/j.ajem.2012.07.023
The American Journal of Emergency Medicine , Vol. 31 , Issue 2 ,
Published online: September 24 2012
x Previous studies have demonstrated lower mortality among patients transported to single urban trauma centers by private vehicle (PV) compared with Emergency Medical Services (EMS). We sought to describe the characteristics and outcomes of injured patients transported by PV in a state trauma system compared to patients transported by EMS.
Emergency medical services management of ST-segment elevation myocardial infarction in the United States—a report from the American Heart Association Mission: Lifeline Program Robert E. O'Connor, Graham Nichol, Louis Gonzales, Steven V. Manoukian, Peter H. Moyer, Ivan Rokos, Michael R. Sayre, Robert C. Solomon, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2014.04.029
The American Journal of Emergency Medicine , Vol. 32 , Issue 8 ,
Published online: April 21 2014
x ST-segment elevation myocardial infarction (STEMI) is a major cause of morbidity and mortality in the United States. Emergency medical services (EMS) agencies play a critical role in its initial identification and treatment. We conducted this study to assess EMS management of STEMI care in the United States.
Factors associated with use of emergency medical services in patients with acute stroke Nai-Chuan Chen, Ming-Ju Hsieh, Sung-Chun Tang, Wen-Chu Chiang, Kuang-Yu Huang, Li-Kai Tsai, Patrick Chow-In Ko, Matthew Huei-Ming Ma, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2013.01.019
The American Journal of Emergency Medicine , Vol. 31 , Issue 5 ,
Published online: March 4 2013
x The aim of this study was to investigate the factors associated with use of emergency medical services (EMS) in patients with acute stroke.
The Three Rivers Regatta accident: An EMS perspective RAde B. Vukmir, Paul M. Paris
DOI: http://dx.doi.org/10.1016/0735-6757(91)90020-K
The American Journal of Emergency Medicine , Vol. 9 , Issue 1 ,
Published in issue: January 1991
x The Three Rivers Regatta accident occurred on August 7, 1988 when a Formula I racing craft collided with shore, injuring 24 spectators. The authors retrospectively examined the prehospital-based response for this multiple-casualty incident that used emergency medical service (EMS) physicians and 32 paramedics stationed at water and land-based posts to triage and evacuate 24 patients in 32 minutes. Patients were transported to 5 hospitals including 4 Level I trauma centers; this was accomplished in 53 minutes.
Prehospital neurologic deterioration is independent predictor of outcome in traumatic brain injury: analysis from National Trauma Data Bank Shahram Majidi, Farhan Siddiq, Adnan I. Qureshi
DOI: http://dx.doi.org/10.1016/j.ajem.2013.05.026
The American Journal of Emergency Medicine , Vol. 31 , Issue 8 ,
Published online: June 27 2013
x The prevalence and impact of prehospital neurologic deterioration (PhND) in patients with traumatic brain injury (TBI) have not been investigated. We aimed to determine the prevalence of PhND during emergency medical service (EMS) transportation among patients with TBI and its impact on patient's outcome.
EMS characteristics in an Asian metroplis Sheng-Chuan Hu, Jeffrey Tsai, Yun-Lin Lu, Chung-Fu Lan
DOI: http://dx.doi.org/10.1016/S0735-6757(96)90022-4
The American Journal of Emergency Medicine , Vol. 14 , Issue 1 ,
Published in issue: January 1996
x A prospective citywide cohort study was conducted from August 1, 1993, through May 31, 1994 to analyze the epidemiological characteristics of emergency medical services (EMS) in an Asian city. Of 5,459 studied cases, the leading 3 causes were trauma (49.7%), alcohol intoxication (8.6%), and altered mental status (AMS) (6.9%). Half of the studied cases needed no prehospital care and 16.4% needed advanced life support (ALS) care. Traffic accidents accounted for 68% of trauma cases. Of 897 cases requiring ALS care, the two most common causes were AMS and dead on arrival (DOA) (32.1% and 21.2% in medical group, 10.1% and 4.5% in trauma group, respectively).
Anxiety levels in EMS providers: Effects of violence and shift schedules Elisabeth Fowlie Mock, Keith D Wrenn, Seth W Wright, T.Chadwick Eustis, Corey M Slovis
DOI: http://dx.doi.org/10.1016/S0735-6757(99)90186-9
The American Journal of Emergency Medicine , Vol. 17 , Issue 6 ,
Published in issue: October 1999
x We tried to measure anxiety levels in emergency medical service (EMS) providers to determine the effects of (1) having had a violent encounter during a shift and (2) different shift schedules, conducting a prospective observational study over 3 months in an urban EMS system setting. A convenience sample of 23 EMTs and 40 EMT-Ps was observed. Anxiety levels were measured using the Spielberger State-Trait Anxiety Inventory. A total of 99 inventories were completed by 63 EMS providers. The mean state (32.6 ± 8) and trait (31.7 ± 7.1) scores were less than normative scores (35.7 ± 10.4 and 34.9 ± 9.2 respectively) for working adult males (P = .004 and .007, respectively).
How well do General EMS 911 dispatch protocols predict ED resource utilization for pediatric patients? Stephanie J. Fessler, Harold K. Simon, Arthur H. Yancey II, Michael Colman, Daniel A. Hirsh
DOI: http://dx.doi.org/10.1016/j.ajem.2013.09.018
The American Journal of Emergency Medicine , Vol. 32 , Issue 3 ,
Published online: December 26 2013
x The use of Emergency Medical Services (EMS) for low-acuity pediatric problems is well documented. Attempts have been made to curb potentially unnecessary transports, including using EMS dispatch protocols, shown to predict acuity and needs of adults. However, there are limited data about this in children. The primary objective of this study is to determine the pediatric emergency department (PED) resource utilization (surrogate of acuity level) for pediatric patients categorized as “low-acuity” by initial EMS protocols.
Patterns of use of emergency medical transport: A population-based study James E Svenson
DOI: http://dx.doi.org/10.1016/S0735-6757(00)90002-0
The American Journal of Emergency Medicine , Vol. 18 , Issue 2 ,
Published in issue: March 2000
x The objective of this study was to characterize population-based emergency medical service (EMS) use rates and examine some of the factors associated with usage of prehospital services. The design was a population-based observational study with multiple regression analysis. Transports reported by prehospital services to the Kentucky Emergency Medical Services Information System from Kentucky counties in which all EMS units submit computerized data was the data source. There were 102,321 emergent transports reported.
Emergency medical transport of the elderly: A population-based study James L Wofford, William P Moran, Mark D Heuser, Earl Schwartz, Ramon Velez, Maurice B Mittelmark
DOI: http://dx.doi.org/10.1016/0735-6757(95)90203-1
The American Journal of Emergency Medicine , Vol. 13 , Issue 3 ,
Published in issue: May 1995
x Patterns of utilization of emergency medical services transport (EMS) by the elderly are poorly understood. We determined population-based rates of EMS utilization by the elderly and characterized utilization patterns by age, gender, race, and reason for transport. This observational, population-based study was conducted in Forsyth County, NC, a semi-urban county served by one convalescent ambulance service and one EMS service. Using data on all 1990 EMS transports and the 1990 U.S. census data, age-, gender-, and race-specific transport rates for persons aged 60 or older were calculated.
Emergency medical services development in the Seychelles islands Eric Savitsky, Gwen Bourgeault Rehnborg, Kathryn Ibarra
DOI: http://dx.doi.org/10.1016/S0735-6757(00)90131-1
The American Journal of Emergency Medicine , Vol. 18 , Issue 3 ,
Published in issue: May 2000
x The Republic of the Seychelles enjoys a sophisticated health care system by developing country standards. Basic food, water, sanitation, and preventative health care needs have been addressed and the Seychelles Ministry of Health has recently focused on the need to improve the country's emergency medical services (EMS). In response to this need, a joint international collaborative effort designed to improve the island's EMS was launched. This report profiles the current health care system in the Seychelles, with special emphasis on EMS.
Accuracy of weight estimates in pediatric patients by prehospital Emergency Medical Services personnel C. Anthoney E. Lim, Bradley J. Kaufman, John O’Connor Jr., Sandra J. Cunningham
DOI: http://dx.doi.org/10.1016/j.ajem.2013.04.018
The American Journal of Emergency Medicine , Vol. 31 , Issue 7 ,
Published online: May 23 2013
x Most medications administered to children are weight-based, and inaccurate weight estimation may contribute to medical errors. Previous studies have been limited to hypothetical patients and those in cardiopulmonary arrest. We aim to determine the accuracy of weight estimates by Emergency Medical Services (EMS) personnel of children receiving medications and to identify factors associated with accuracy.
Prehospital intervention probability score: a novel method for determining necessity of emergency medical service units Denise Livingston, Andreia Marques-Baptista, Richard Brown, Junfeng Liu, Mark A. Merlin
DOI: http://dx.doi.org/10.1016/j.ajem.2009.02.002
The American Journal of Emergency Medicine , Vol. 28 , Issue 5 ,
Published online: November 23 2009
x This article models use of emergency medical services (EMS) within a defined geographical area. Our goal was to develop an original quantitative method to delineate the need for EMS units within a geographical population.
The impact of a freestanding ED on a regional emergency medical services system Benjamin J. Lawner, Jon Mark Hirshon, Angela C. Comer, Jose V. Nable, Jeffrey Kelly, Richard L. Alcorta, Laura Pimentel, Christina L. Tupe, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2015.11.042
Publication stage: In Press Corrected Proof
The American Journal of Emergency Medicine
Published online: November 18 2015
x The objective of the study is to examine the effect of the opening of a freestanding emergency department (FED) on the surrounding emergency medical services (EMS) system through an examination of EMS system metrics such as ambulance call volume, ambulance response times, and turnaround times.
Implementation of standing field treatment protocols in an urban EMS system Marc Eckstein
DOI: http://dx.doi.org/10.1053/ajem.2001.22666
The American Journal of Emergency Medicine , Vol. 19 , Issue 4 ,
Published in issue: July 2001
x The objective was to describe our experience with implementation of standing field treatment protocols (SFTP) in a large, urban EMS system. A prospective, consecutive observational study examining the first 21 days of implementation of SFTPs in the City of Los Angeles, California. SFTPs were developed for 7 medical chief complaints and all major trauma patients. There were 13,586 EMS incidents, of which 4,037 (30%) received ALS treatment. SFTPs were used on 2,177 of these incidents, representing 54% of all ALS runs and 16% of all EMS incidents.
Paramedic decisions with placement of out-of-hospital intravenous lines Steven A Pace, Frederick P Fuller, Timothy J Dahlgren
DOI: http://dx.doi.org/10.1016/S0735-6757(99)90193-6
The American Journal of Emergency Medicine , Vol. 17 , Issue 6 ,
Published in issue: October 1999
x To determine the incidence of unused out-of-hospital intravenous line (IV) placements, we prospectively studied IV placement in emergency medical services (EMS) patients. Unused IV placement was defined as any patient having an EMS initiated IV that was not used for fluid bolus or medication administration in the field or in the emergency department (ED). Data were analyzed on placement and use of IV lines in the field and in the ED, transport time, years of paramedic practice, and paramedic student presence.
The impact of prehospital activation of the cardiac catheterization team on time to treatment for patients presenting with ST-segment-elevation myocardial infarction Teresa Camp-Rogers, Siddhartha Dante, Michael C. Kontos, Charlotte S. Roberts, Laura Kreisa, Michael Christopher Kurz
DOI: http://dx.doi.org/10.1016/j.ajem.2010.08.005
The American Journal of Emergency Medicine , Vol. 29 , Issue 9 ,
Published online: October 28 2010
x We sought to evaluate the accuracy of emergency medical services (EMS) activation of the cardiac catheterization laboratory (CCL) for patients with ST-elevation myocardial infarction (STEMI) and its impact on treatment intervals from dispatch to reperfusion.
Inappropriate dispatcher decision for emergency medical service users with acute myocardial infarction Magali Fourny, Anne-Sophie Lucas, Loïc Belle, Guillaume Debaty, Pierre Casez, Hélène Bouvaist, Patrice François, Gérald Vanzetto, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2009.07.008
The American Journal of Emergency Medicine , Vol. 29 , Issue 1 ,
Published online: March 10 2010
x Current guidelines recommend utilization of prehospital emergency medical services (EMSs) by patients with ST-elevation myocardial infarction (STEMI). The aims of this study were to estimate the percentage of inappropriate initial dispatcher decisions and determine their impact on delays in reperfusion therapy for EMS users with STEMI.
Can prehospital personnel detect hypoxemia without the aid of pulse oximeters? Lawrence H Brown, Erik A Manring, Hervy B Kornegay, N.Heramba Prasad
DOI: http://dx.doi.org/10.1016/S0735-6757(96)90012-1
The American Journal of Emergency Medicine , Vol. 14 , Issue 1 ,
Published in issue: January 1996
x Although pulse oximeters have been proven accurate in the prehospital environment, they have not been proven to be necessary. This study was undertaken to determine if emergency medical services (EMS) providers can identify hypoxemia without pulse oximetry. An oximeter was placed at the ambulance entrance to the emergency department (ED), and EMS personnel obtained saturation levels on all patients on arrival. Hypoxemia was defined as a saturation level of 95% or less. The hypoxemia was classified as “recognized” if the patient received aggressive intervention and “unrecognized” if the patient did not.
The use of TRISS methodology to validate prehospital intubation by urban EMS providers Heidi Frankel, Grace Rozycki, Howard Champion, J.Duncan Harviel, Robert Bass
DOI: http://dx.doi.org/10.1016/S0735-6757(97)90174-1
The American Journal of Emergency Medicine , Vol. 15 , Issue 7 ,
Published in issue: November 1997
x The purpose of this study was to determine the impact of field orotracheal intubation (OI) by urban emergency medical technician-paramedics (EMT-Ps) on outcome compared with trauma score and injury severity score (TRISS) expectations. The records of all trauma patients intubated by EMT-Ps or hospital personnel were abstracted for OI attempts/successes, use of neuromuscular blockade (NMB), scene time, discharge neurological status, and hospital survival compared with TRISS. EMT-Ps attempted 43% of all intubations; 81% were successful versus 98% by hospital staff (P < .05).
GPS computer navigators to shorten EMS response and transport times Floyd S. Ota, Russ S. Muramatsu, Blake H. Yoshida, Loren G. Yamamoto
DOI: http://dx.doi.org/10.1053/ajem.2001.22662
The American Journal of Emergency Medicine , Vol. 19 , Issue 3 ,
Published in issue: May 2001
x GPS (global positioning satellite system to determine one's position on earth) units have become inexpensive and compact. The purpose of this study is to assess the effectiveness of a GPS enhanced computer street map navigator to improve the ability of EMS drivers in an urban setting to locate their destination and shorten response times. For part I, residential addresses in the city were randomly selected from a telephone directory. Two driver/navigator teams were assigned to drive to the address adhering to speed limits.
Language disparities in patients transported by emergency medical services N.R. Weiss, S.J. Weiss, R. Tate, S. Oglesbee, A.A. Ernst
DOI: http://dx.doi.org/10.1016/j.ajem.2015.08.007
The American Journal of Emergency Medicine , Vol. 33 , Issue 12 ,
Published online: August 6 2015
x The population of the United States continues to diversify with an increasing percentage of residents with limited English proficiency (LEP). A major concern facing emergency medical services (EMS) providers is increasing scene and transport times. We hypothesized that there would be a significant difference in EMS scene and transport times when comparing LEP and English-speaking (ES) patients and there would be a difference in care, both in and out of hospital.
The prehospital and hospital costs of emergency care for frequent ED patients Robert G. Solberg, Brandy L. Edwards, Jeffrey P. Chidester, Debra G. Perina, William J. Brady, Michael D. Williams
DOI: http://dx.doi.org/10.1016/j.ajem.2015.11.066
The American Journal of Emergency Medicine , Vol. 34 , Issue 3 ,
Published online: December 4 2015
x Frequent emergency department (ED) use has been identified as a cause of ED overcrowding and increasing health care costs. Studies have examined the expense of frequent patients (FPs) to hospitals but have not added the cost Emergency Medical Services (EMS) to estimate the total cost of this pattern of care.
Factors associated with the safety of EMS helicopters Ronald B. Low, Mary Jo Dunne, Ira J. Blumen, Gail Tagney
DOI: http://dx.doi.org/10.1016/0735-6757(91)90167-I
The American Journal of Emergency Medicine , Vol. 9 , Issue 2 ,
Published in issue: March 1991
x The accident rate for emergency medical service (EMS) helicopters is thought to be approximately twice the rate for other commercial (Part 135) helicopters. This observation has led to numerous news reports and to the publication of conclusions of a National Transportation Safety Board investigation. The data for these reports come from investigations of EMS helicopter accidents and incidents. The authors surveyed all listed civilian EMS helicopter programs to examine both helicopter ambulance mishaps and the number of safely completed missions.
Wilderness emergency medical services: The experiences at Sequoia and Kings Canyon National Parks Jeffrey Johnson, Mark Maertins, Marc Shalit, Tucker J. Bierbaum, Douglas E. Goldman, Robert A. Lowe
DOI: http://dx.doi.org/10.1016/0735-6757(91)90078-X
The American Journal of Emergency Medicine , Vol. 9 , Issue 3 ,
Published in issue: May 1991
x This article describes the National Park Service wilderness emergency medical services (EMS) system, as implemented at Sequola-Kings Canyon National Park. EMS records on all 434 patients in the period from August 1, 1986, to July 31, 1987, were reviewed. Most patients had minor problems. Overall, 77% of patients contacting the EMS system were released at the scene, and base hospital contact was made in only 28% of cases. However, there were three deaths, 44 (10%) patients who received advanced life support, and 292 (67%) patients who received basic life support.
Staffing and equipping emergency medical services systems: Rapid identification and treatment of acute myocardial infarction National Heart Attack Alert Program Coordinating Committee Access to Care Subcommittee
DOI: http://dx.doi.org/10.1016/0735-6757(95)90245-7
The American Journal of Emergency Medicine , Vol. 13 , Issue 1 ,
Published in issue: January 1995
x Each year, about 1,250,000 people in the United States experience an acute myocardial infarction (AMI). Emergency medical services (EMS) systems play a key part in the prehospital care and transportation of AMI patients. Rapid, state-of-the-art treatment by EMS personnel is essential for improving AMI survival and outcomes, as dramatized by the patient who is the victim of out-of-hospital cardiac arrest. In order to improve the prehospital care provided to AMI patients, this article by the Access to Care Subcommittee of the National Heart Attack Alert Program Coordinating Committee makes a number of recommendations regarding the staffing and equipping of EMS systems.
A geographic information system simulation model of EMS: reducing ambulance response time Kobi Peleg, Joseph S. Pliskin
DOI: http://dx.doi.org/10.1016/j.ajem.2004.02.003
The American Journal of Emergency Medicine , Vol. 22 , Issue 3 ,
Published in issue: May 2004
x Response time is a very important factor in determining the quality of prehospital EMS. Our objective was to model the response by Israeli ambulances and to offer model-derived strategies for improved deployment of ambulances to reduce response time. Using a geographic information system (GIS), a retrospective review of computerized ambulance call and dispatch logs was performed in two different regional districts, one large and urban and the other rural. All calls that were pinpointed geographically by the GIS were included, and their data were stratified by weekday and by daily shifts.
Improving emergency medical services for children with special health care needs: Does training make a difference? Daniel W. Spaite, Carol Conroy, Katherine J. Karriker, Marsha Seng, Norma Battaglia
DOI: http://dx.doi.org/10.1053/ajem.2001.27146
The American Journal of Emergency Medicine , Vol. 19 , Issue 6 ,
Published in issue: October 2001
x This study evaluated the impact of a paramedic training program on emergency medical services (EMS) responses for children with special health care needs. EMS responses for children with a congenital or acquired condition or a chronic physical or mental illness, were reviewed. Responses, related to the child's special health care need, involving paramedics who had completed our training program were compared with responses with paramedics not participating in the training. There was significantly more advanced life support treatment for responses with paramedics completing the training program compared with other responses.
