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Emergency Medical Care (emergency + medical_care)

Distribution by Scientific Domains

Medical Sciences	88%

Selected Abstracts

Information Technology and Emergency Medical Care during Disasters

ACADEMIC EMERGENCY MEDICINE, Issue 11 2004
Theodore C. Chan MD
Abstract Disaster response to mass-casualty incidents represents one of the greatest challenges to a community's emergency response system. Rescuers, field medical personnel, and regional emergency departments and hospitals must often provide care to large numbers of casualties in a setting of limited resources, inadequate communication, misinformation, damaged infrastructure, and great personal risk. Emergency care providers and incident managers attempt to procure and coordinate resources and personnel, often with inaccurate data regarding the true nature of the incident, needs, and ongoing response. In this chaotic environment, new technologies in communications, the Internet, computer miniaturization, and advanced "smart devices" have the potential to vastly improve the emergency medical response to such mass-casualty incident disasters. In particular, next-generation wireless Internet and geopositioning technologies may have the greatest impact on improving communications, information management, and overall disaster response and emergency medical care. These technologies have applications in terms of enhancing mass-casualty field care, provider safety, field incident command, resource management, informatics support, and regional emergency department and hospital care of disaster victims. [source]

Knowledge Translation in International Emergency Medical Care

ACADEMIC EMERGENCY MEDICINE, Issue 11 2007
L. Kristian Arnold MD
More than 90% of the world population receives emergency medical care from different types of practitioners with little or no specific training in the field and with variable guidance and oversight. Emergency medical care is being recognized by actively practicing physicians around the world as an increasingly important domain in the overall health services package for a community. The know-do gap is well recognized as a major impediment to high-quality health care in much of the world. Knowledge translation principles for application in this highly varied young domain will require investigation of numerous aspects of the knowledge synthesis, exchange, and application domains in order to bring the greatest benefit of both explicit and tacit knowledge to increasing numbers of the world's population. This article reviews some of the issues particular to knowledge development and transfer in the international domain. The authors present a set of research proposals developed from a several-month online discussion among practitioners and teachers of emergency medical care in 16 countries from around the globe and from all economic strata, aimed at improving the flow of knowledge from developers and repositories of knowledge to the front lines of clinical care. [source]

Characteristics of Medical Surge Capacity Demand for Sudden-impact Disasters

ACADEMIC EMERGENCY MEDICINE, Issue 11 2006
Samuel J. Stratton MD
Objectives To describe the characteristics of the demand for medical care during sudden-impact disasters, focusing on local U.S. communities and the initial phases of sudden-impact disasters. Methods Established databases and published reports were used as data sources. Data were obtained to describe the baseline capacity of the U.S. medical system. Information for the initial phases of a sudden-impact disaster was sought to allow for characterization of the length of time before a U.S. community can expect arrival of outside assistance, the expected types of medical surge demands, the expected time for the peak in medical-care demand, and the expected health system access points. Results The earliest that outside assistance arrived for a community subject to a sudden-impact disaster was 24 hours, with a range from 24 to 96 hours. After sudden-impact disasters, 84% to 90% of health care demand was for conditions that were managed on an ambulatory basis. Emergency departments (EDs) were the access point for care, with peak demand time occurring within 24 hours. The U.S. emergency care system was functioning at relatively full capacity on the basis of data collected for the study that showed that annually, 90% of EDs were boarding admitted inpatients, and 75% were diverting ambulances. Conclusions As part of planning for sudden-impact disasters, communities should be expected to sustain medical services for 24 hours, and up to 96, before arrival of external resources. For effective medical surge-capacity response during sudden-impact disasters, there should be a priority for emergency medical care with a focus on ambulatory injuries and illnesses. [source]

Information Technology and Emergency Medical Care during Disasters

Antiplatelet Therapy: Anti-Ischemic Benefits versus Bleeding Risk

JOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 2008
C. MICHAEL GIBSON M.D., F.A.C.C.
Balance between efficacy and safety is a major concern in therapeutic interventions of patients with acute coronary syndromes. Identifying and managing the risks that may negatively affect this balance can potentially minimize the incidence of morbidity and/or mortality among patients with acute coronary syndromes. Unstable angina and non-ST-elevation myocardial infarction are potentially life-threatening disorders and a major cause of hospitalization and emergency medical care. At the time of presentation, the use of algorithms that provide reasonable assessment of a patient's risk of cardiovascular events, such as the Thrombolysis in Myocardial Infarction risk score, can help clinicians identify which patients will most likely benefit from a specific strategy. The ultimate goal of treatment for non-ST-elevation myocardial infarction is to reduce short- and long-term morbidity and mortality, as well as salvage myocardial cells and cardiac function. Pharmacologic intervention with antiplatelet and/or antithrombotic agents has proven to be effective in achieving this goal in numerous outcome studies. However, clinicians must balance anti-ischemic efficacy with the need to minimize the risk of serious bleeding complications (e.g., hemorrhage). Issues related to safety include timing of the dose, duration of infusion, drug compatibility, errors in estimating a patient's weight and/or age, failure to adjust the dosage based upon renal function, and errors in drug preparation. [source]

Exploring the potential of video technologies for collaboration in emergency medical care: Part II.

JOURNAL OF THE AMERICAN SOCIETY FOR INFORMATION SCIENCE AND TECHNOLOGY, Issue 14 2008
Task performance
We conducted an experiment with a posttest, between-subjects design to evaluate the potential of emerging 3D telepresence technology to support collaboration in emergency health care. 3D telepresence technology has the potential to provide richer visual information than do current 2D video conferencing techniques. This may be of benefit in diagnosing and treating patients in emergency situations where specialized medical expertise is not locally available. The experimental design and results concerning information behavior are presented in the article "Exploring the Potential of Video Technologies for Collaboration in Emergency Medical Care: Part I. Information Sharing" (Sonnenwald et al., this issue). In this article, we explore paramedics' task performance during the experiment as they diagnosed and treated a trauma victim while working alone or in collaboration with a physician via 2D videoconferencing or via a 3D proxy. Analysis of paramedics' task performance shows that paramedics working with a physician via a 3D proxy performed the fewest harmful interventions and showed the least variation in task performance time. Paramedics in the 3D proxy condition also reported the highest levels of self-efficacy. Interview data confirm these statistical results. Overall, the results indicate that 3D telepresence technology has the potential to improve paramedics' performance of complex medical tasks and improve emergency trauma health care if designed and implemented appropriately. [source]

Knowledge Translation in International Emergency Medical Care

Impact of a Triage Liaison Physician on Emergency Department Overcrowding and Throughput: A Randomized Controlled Trial

ACADEMIC EMERGENCY MEDICINE, Issue 8 2007
Brian R. Holroyd MD
BackgroundTriage liaison physicians (TLPs) have been employed in overcrowded emergency departments (EDs); however, their effectiveness remains unclear. ObjectivesTo evaluate the implementation of TLP shifts at an academic tertiary care adult ED using comprehensive outcome reporting. MethodsA six-week TLP clinical research project was conducted between December 9, 2005, and February 9, 2006. A TLP was deployed for nine hours (11 am to 8 pm) daily to initiate patient management, assist triage nurses, answer all medical consult or transfer calls, and manage ED administrative matters. The study was divided into three two-week blocks; within each block, seven days were randomized to TLP shifts and the other seven to control shifts. Outcomes included patient length of stay, proportion of patients who left without complete assessment, staff satisfaction, and episodes of ambulance diversion. ResultsTLPs assessed a median of 14 patients per shift (interquartile range, 13,17), received 15 telephone calls per shift (interquartile range, 14,20), and spent 17,81 minutes per shift consulting on the telephone. The number of patients and their age, gender, and triage score during the TLP and control shifts were similar. Overall, length of stay was decreased by 36 minutes compared with control days (4:21 vs. 4:57; p = 0.001). Left without complete assessment cases decreased from 6.6% to 5.4% (a 20% relative decrease) during the TLP coverage. The ambulance wait time and number of episodes of ambulance diversion were similar on TLP and control days. ConclusionsA TLP improved important outcomes in an overcrowded ED and could improve delivery of emergency medical care in similar tertiary care EDs. [source]