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.
