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The impact of prehospital blood sampling on the emergency department process of patients with chest pain:a pragmatic non-randomized controlled trial

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World Journal of emergency Medicine 2023年第4期14卷 257-264页

作者： Johan L.van Nieuwkerk M.Christien van der Linden Rolf J.Verheul Merel van Loon-van Gaalen Marije Janmaat Naomi van der Linden emergency Department Haaglanden Medical Centre&Emergency Medical Services Haaglandenthe Hague 2501 CBthe Netherlands Research and Development Haaglanden Medical Centrethe Hague 2501 CKthe Netherlands Laboratory services Haaglanden Medical Centrethe Hague 2501 CKthe Netherlands emergency Department Haaglanden Medical Centrethe Hague 2501 CKthe Netherlands Faculty of Health University of Applied Sciences LeidenLeiden 2300 AJthe Netherlands Faculty of Technology Policy and ManagementDelft University of TechnologyDelft 2628 BXthe Netherlands

BACKGROUND:In patients with chest pain who arrive at the emergency department(ED)by ambulance,venous access is frequently established prehospital,and could be utilized to sample *** blood sampling may save time in the diagnostic *** this study,the association of prehospital blood draw with blood sample arrival times,troponin turnaround times,and ED length of stay(LOS),number of blood sample mix-ups and blood sample quality were ***:The study was conducted from October 1,2019 to February 29,*** patients who were transported to the ED with acute chest pain with low suspicion for acute coronary syndrome(ACS),outcomes were compared between cases,in whom prehospital blood draw was performed,and controls,in whom blood was drawn at the *** analyses were used to assess the association of prehospital blood draw with the time ***:Prehospital blood draw was performed in 100 *** 406 patients,blood draw was performed at the *** blood draw was independently associated with shorter blood sample arrival times,shorter troponin turnaround times and decreased LOS(P0.05).CONCLUSION:For patients with acute chest pain with low suspicion for ACS,prehospital blood sampling is associated with shorter time intervals,while there were no significant differences between the two groups in the validity of the blood samples.

关键词： Blood specimen collection Crowding emergency medical services Troponin

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Focused research in emergency medical systems in Asia: a necessity for trauma system advancement

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emergency and Critical Care Medicine 2022年第2期2卷 87-93页

作者： Amila Ratnayake Shinji Nakahara Dinesh Bagaria Sohan De Silva Sri Lal De Silva April Llaneta Ratrawee Pattanarattanamolee Yonggang Li Bui Hai Hoang Army Hospital ColomboSri Lanka Kanagawa University of Human services KawasakiJapan All India Institute of medical Sciences New DelhiIndia 1990 Suwa Seriya Foundation ColomboSri Lanka University of the Philippines ManilaThe Philippines Khon Kaen Regional Hospital Khon KaenThailand Department of emergency Surgery and Traumatic Orthopedics Qilu Hospital of Shandong UniversityJinanShandongChina Hanoi medical University HanoiVietnam

Since trauma is a growing health problem worldwide,emergency trauma care including emergency medical services(EMS)is becoming an integral part of the healthcare *** optimal EMS which will improve access to trauma care,will be different in each country because of different healthcare systems,trauma etiology,and economic *** adopt models that have succeeded in developed countries is not always *** order to identify the optimal EMS model in developing countries,comparing the systems among many countries in detail and examining their advantages and disadvantages would be ***,this article tries to identify important elements of EMS to achieve mature EMS systems based on comparisons of 7 Asian countries,and discusses the need to conduct more detailed and extensive comparisons.

关键词： Asia emergency medical services Healthcare system International comparison Trauma

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Rapid acupuncture for musculoskeletal pain in the emergency room of the Hospital Servidor Publico Estadual, Brazil: A quasi-experimental study

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Journal of Integrative Medicine 2020年第4期18卷 313-318页

作者： Luciana Aikawa Alexandre Massao Yoshizumi Mirian Matsura Shirassu Marcia Kiyomi Koike Programa de Pós-Graduação em Ciências da Saúde Instituto de Assistência Médica ao Servidor Público Estadual(IAMSPE)Vila ClementinoSão PauloSP 04029-000Brazil Associação Médica Brasileira de Acupuntura Vila MarianaSão PauloSP 04011-002Brazil

Objective:To compare differences in self-reported musculoskeletal pain before and after receiving rapid acupuncture for pain at an outpatient emergency ***:Exactly 102 patients presenting to the emergency room of the Hospital Servidor Publico Estadual in Sao Paulo,Brazil,participated in this before-and-after *** participants had musculoskeletal pain and were treated with the technique proposed by Marques *** emergency acupuncture involved inserting a needle at a point defined by traditional Chinese medicine and applying intense stimulation for 10 s;no more than two points were used on any individual *** was measured using a numerical visual scale before and immediately after the ***:Participants in this study were mostly women(78%),had a college degree(47%)and were below the age of 60(56%).The most common region of pain was the lower back(31%),and the most common type of pain was acute and exacerbated chronic *** meridians most commonly involved were the eight extra meridians(40%),and the points most often used for treatment were Houxi(SI3),Shenmai(BL62)and Zulinqi(GB41).Almost all participants reported a decrease in pain intensity,independent of sex,education level,pain site and pain type(acute/chronic;Pemergency acupuncture technique for analgesia appears to reduce musculoskeletal *** registration:Brazilian Registry of Clinical Trials(http://***/)with ***-8 dmfjf.

关键词： Acupuncture analgesia emergency medical services Acute pain Acupuncture therapy

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Trends and characteristics in pre-hospital emergency care in Beijing from 2008 to 2017

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Chinese medical Journal 2020年第11期133卷 1268-1275页

作者： Wei Huang Tian-Bing Wang Ying-Dong He Huan Zhang Xiao-Hua Zhou Hui Liu Jin-Jun Zhang Zhen-Biao Tian Bao-Guo Jiang Departm ent of Trauma Rescue Center Peking University People's HospitalBeijing 100044China Department of Trauma and Orthopaedics Peking University People's HospitalBeijing 100044China Key Laboratory of Trauma and Neural Regeneration(Peking University) Ministry of EducationBeijing 100044China Department of Epidemiology and Biostatistics School of Public HealthPeking University Health Science CenterBeijingChina medical Informatics Center Peking UniversityBeijing 100191China Beijing emergency Center Beijing 100031China Beijing Red Cross emergency Center Beijing 100085China

Background: We aimed to describe and analyze the pre-hospital emergency medical service (EMS) in Beijing and provide information for the government and medical institutions to optimize ***: We collected all pre-hospital emergency data in Beijing from 2008 to 2017. The chief complaint in each case was classified according to the medical Priority Dispatch System (MPDS). The sites’ administrative districts were determined through geo-encoding of addresses and then classified into four functional regions. We analyzed the demand for EMS, emergency response times (ERT), and disease spectrum for Beijing as a whole, and for each functional ***: A total of 4,192,870 pre-hospital EMS cases met the inclusion criteria, with a significant increase (P < 0.001) of 51.60% from 2008 to 2017. EMS demand was positively associated with population (r= 0.946,P < 0.001). The pre-hospital EMS demand rate was 1907.05 in 2008 and 2172.23 in 2017 per 100,000, with no significant change (P = 0.57). ERT increased significantly (P = 0.001), from 19.18 min in 2008 to 24.51 min in 2016. According to MPDS classifications, the demand for pre-hospital care increased for 14 diseases, remained stable for 19, and decreased for only 1 disease. Cases of injury-related disease increased significantly from approximately 90,000 in 2017, accounting for 20% of all pre-hospital EMS cases, and the demand rate decreased in the core region but increased in the sub-urban regions. Cases of heart problems and stroke/transient ischemic attack also increased significantly in the four functional regions, with the highest demand rate in the Core Functional ***: More resources and effort should be devoted to pre-hospital EMS according to the increased pre-hospital EMS demand and prolonged ERT in Beijing over our 10-year study period. Changes in disease spectrum and differences between functional regions should also be considered.

关键词： China emergency medical services emergency response time

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Prehospital road traffic injuries among the elderly in Beijing, China： data from the Beijing emergency medical Center, 2004-2010

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Chinese medical Journal 2013年第15期126卷 2859-2865页

作者： AN Shuai ZHANG Jin-jun ZHANG Pei-xun YIN Xiao-feng KOU Yu-hui WANG Yan-hua WANG Zhen-wei JIANG Bao-guo WANG Tian-bing Peking Univ Peoples Hosp Dept Orthopaed & Traumatol Beijing 100044 Peoples R China Peking Univ Traff Med Ctr Beijing 100191 Peoples R China Beijing emergency Med Ctr Beijing 100031 Peoples R China

Background Road traffic injuries （RTIs） are a worldwide issue associated with increasing development and motorization. However, statistical studies do not include any analyses of Beijing＇s geriatric population. Using data from the Beijing emergency medical Center, we present the main characteristics of traffic injuries involving the elderly in Beijing. We also provide objective information for those concerned with the safety of traffic systems and the prevention of traffic injuries. Methods In a longitudinal, retrospective study, data were collected on 1706 victims aged 65 years and older who sustained traffic injuries in Beijing between 2004 and 2010. Personal information, time of injury event, emergency care response time, road user type, striking vehicle type, injury site, and severity of injury were analyzed using ;~2 tests and Logistic regression analysis. Results The annual rate of traffic injuries was 21.80 per 100 000 elderly people in Beijing, and the morbidity rate decreased from 2004 to 2010 （P 〈0.001）. The mean age was （72.92＋5.67） years, and 911 （53.40%） of the victims were male. The majority of victims sustained head and lower limb injuries and were classified as being of medium severity. Traffic collisions occurred most frequently in the daytime excluding rush hours; these collisions included being hit by a car （85.64%） and pedestrian victim injuries （79.19%）. Our statistical analysis found three factors for injury severity： abdominal injuries （P 〈0.001）, number of injury sites （P=0.027）, and head injuries （P=0.034）. The decline in traffic injuries is due to a decrease in victims aged 65-74 years and pedestrians; the sevedty of RTIs also decreased. Conclusions This study highlights the declining trend in traffic injuries among older adults in Beijing. However, traffic injuries remain a serious public health problem for the elderly and effective measures are required to reduce their incidence.

关键词： road traffic injury older adults emergency medical services

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Effect of Temperature on emergency Ambulance Call-Outs for Cardiovascular Causes:A Scoping Review

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环境与健康(英文) 2023年第1期1卷 6-14页

作者： Santiago Gestal Romaní Adolfo Figueiras Dominic Royé Hospital Clínico Universitario de Santiago de Compostela 15706 Santiago de CompostelaA CoruñaSpain Spanish Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health-CIBERESP)28029 MadridSpain Department of Public Health Faculty of FarmacyUniversity of Santiago de Compostela15782 Santiago de CompostelaA CoruñaSpain Health Research Institute of Santiago de Compostela(IDIS) University of Santiago de Compostela15706 Santiago de CompostelaA CoruñaSpain Climate Research Foundation 28013 MadridSpain

Climate change has increased interest in the effects of the thermal environment on cardiovascular *** studies have focused on mortality ***,pre-hospital care data are better able to evaluate these effects,as they can register the full spectrum of the disease in real *** scoping review aims to synthesize the epidemiological evidence regarding the effects of the thermal environment on cardiovascular morbidity in the pre-hospital setting,evaluated through ambulance calls.A staged literature search was performed using the PubMed database for the period between 1st January 2000 and 30th March 2023,using the MeSH terms“Weather”AND“emergency medical services”.A total of 987 publications were identified that examined the correlation between the thermal environment and ambulance call-outs for cardiovascular *** studies were mostly ecological time series,with significant variability in the methodological aspects *** increase in the number of ambulance call-outs has been observed in association with low temperatures,both for overall cardiovascular pathologies and for certain pathological *** high temperatures,no effect has been observed in overall call-outs,although an increase has been observed during heat *** demand for ambulances for cardiac arrests is increased by both low and high temperatures and during heat *** call-outs for cardiovascular causes increase with low temperatures and heat waves,with no significant increase in the overall demand associated with high *** call-outs for cardiac arrests are the only subtype that is increased by high temperatures.

关键词： cardiovascular diseases weather cold exposure heat exposure ambulance call-out emergency medical services

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Improving hospital-based trauma care for road traffic injuries in Malawi

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World Journal of emergency Medicine 2017年第2期8卷 85-90页

作者： Linda Chokotho Wakisa Mulwafu Isaac Singini Yasin Sjalale Kathryn H. Jacobsen Belt Cure Hospital Blantyre Malawi Department of Surgery College of Medicine University of Malawi Blantyre Malawi Johns Hopkins Project Blantyre Malawi Blantyre Adventist Hospital Blantyre Malawi Department of Global & Community Health George Mason University Fairfax Virginia USA

BACKGROUND: The mortality rate from road traffic injuries has increased in sub-Saharan Africa as the number of motor vehicles increase. This study examined the capacity of hospitals along Malawi's main north-south highway to provide emergency trauma ***: Structured interviews and checklists were used to evaluate the infrastructure, personnel, supplies, and equipment at all four of Malawi's central hospitals, ten district hospitals, and one mission hospital in 2014. Most of these facilities are along the main north-south highway that spans the ***: Between July 2013 and March 2014, more than 9 200 road traffic injuries(RTIs) and 100 RTI deaths were recorded by the participating hospitals. All of the hospitals reported staff shortages, especially during nights and weekends. Few clinicians had completed formal training in emergency trauma management, and healthcare workers reported gaps in knowledge and skills, especially at district hospitals. Most central hospitals had access to the critical supplies and medications necessary for trauma care, but district hospitals lacked some of the supplies and equipment needed for diagnosis, treatment, and personal ***: The mortality and disability burden from road traffi c injuries in Malawi(and other low-income countries in sub-Saharan Africa) can be reduced by ensuring that every central and district hospital has a dedicated trauma unit with qualified staff who have completed primary trauma care courses and have access to the equipment necessary to save lives.

关键词： Traffic accidents emergency medical services Developing countries Road traffi c injuries Sub-Saharan Africa

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Facilitators of and barriers to emergency medical service use by acute ischemic stroke patients: A retrospective survey

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International Journal of Nursing Sciences 2017年第1期4卷 52-57页

作者： Cha-Nam Shin Kyungeh An Jeongha Sim College of Nursing and Health Innovation Arizona State University500 N.Third St.PhoenixAZ 85004United States College of Nursing Virginia Commonwealth University1100 E.Leigh StRichmondVAUnited States Department of Nursing Jeonju University303 Cheonjam-roWansan-guJeonju560-759South Korea

Objective: The objective of the study was to identify facilitators and barriers to emergency medical service use among acute ischemic stroke patients in ***: This paper presents a secondary analysis of a retrospective survey that collected data from questionnaires and medical *** 233 acute ischemic stroke patients enrolled in a large-scale study,160 patients who had arrived at a hospital within 72 h after symptom onset were included in the data ***: Users of emergency medical services needed a shorter time than non-users to arrive at hospital (140 min vs.625 min.,p =0.001) and were more likely to arrive at hospital within 3 h of symptom onset (51.9% vs.31.5%,p =0.013).For those who first contacted emergency medical service,the facilitators of emergency medical service use were the presence of hemiparesis (p =0.003),bilateral paralysis (p =0.040),and loss of balance (p =0.021).The predominant barrier was the failure to recognize the urgency of symptoms (p 0.006).Conclusions: The use of emergency medical services reduced prehospital delay and increased the likelihood of patient arrival at hospital within 3 *** that experiencing typical stroke symptoms was a facilitator of emergency medical service use yet failure to recognize the urgency of symptoms was a barrier,public awareness should be raised as regards stroke symptoms and the benefits of using emergency medical services.

关键词： Barrier emergency medical services Facilitator Social norms Stroke

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Do the Right Patients use the Ambulance Service in South-Eastern Finland?-A Prospective Descriptive Study of Ambulance Dispatching in Relation to the Ambulance Staff’s Assessment of Patients’Needs in a Subset in the South East of Finland

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International Journal of Clinical Medicine 2011年第5期2卷 544-549页

作者： Bjorn-Ove Suserud Lena Beillon Ingvar Karlberg Jukka Pappinen Maaret Castren Johan Herlitz University of Boras BorasSweden Nordic School of Public Health GoteborgSweden Center for Health System Analysis GothenburgSweden Tampere University TampereFinland Karolinska Institutet StockholmSweden

Background: Several emergency medical Systems use a criteria-based prioritization system for ambulance response. The emergency medical priority dispatching of ambulances was introduced in the 1980s. In a system of this kind, the operators at the medical emergency dispatch centers have to assess the patients’ symptoms and the need for ambulance response. The prioritization of the ambulance response is based on the seriousness of the patient’s symptoms, his/her current condition and, in the case of trauma, the trauma mechanism. The priority system is supposed to optimize the use of the ambulance service and to match and meet the patients’ needs with an adequate response from the ambulances. The aim of this study was to describe the dispatching and utilization of the ambulance service in a part of Finland. Results: There was a substantial divergence between the initial priority assigned and the patients’ medical status at the scene. The ambulance staff confirmed the need for ambulance transport for 65% of all the patients who were assigned an ambulance by the dispatch center. Conclusions: Using a criteria-based dispatch protocol, the dispatch operator works with a wider safety margin in the priority assessments for ambulance response than was actually confirmed by the ambulance personnel at the scene. In this sample, there may be some overuse of the ambulance service. According to the assessments made by the ambulance staff, 35% of the patients did not require ambulance transport. The emergency system has to accept and work with safety margins. At the same time, there must be a balance between a safety margin and a waste of limited resources.

关键词： Ambulance Dispatching emergency medical services Prioritizing

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Self-Reported Use of Personal Protective Equipment during the SARS-CoV-2 Pandemic in emergency medical Service Employees in Germany—A Survey

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Open Journal of Preventive Medicine 2021年第11期11卷 391-409页

作者： Theresa Berthold Jan-Thorsten Gräsner Janina Kosan Marcel Zill Leonie Hannappel Birgitt Alpers Jan Wnent Institute for emergency Medicine University Hospital Schleswig-Holstein Kiel Germany COVID-19 Expert Working Group Intensive Care Infectiology and Emergency Medicine (COVRIIN) Berlin Germany Department of Anesthesiology and Intensive Care Medicine University Hospital Schleswig-Holstein Kiel Germany Scientific Working Group emergency Medicine of the German Society of Anesthesiology and Intensive Care Medicine (DGAI) Nuremberg Germany School of Medicine University of Namibia Windhoek Namibia

Background: Multicentric prospective cohort investigation survey conducted between 1st of March and 1st of April 2021on SARS-CoV-2 occupational risk for German emergency medical services (EMS) personnel. Study Objectives: Primary: The objective is to take stock of the use and availability of Personal Protective Equipment (PPE) in German EMS, both at managerial and employee level, during the SARS-CoV-2 pandemic. Secondary: Generate additional data on individual perceptions of risk of infection and occurrence of infections at respective places of service. Methods: Multicentric prospective cohort investigation survey conducted online at two levels of German EMS personnel—EMS managers and EMS employees, both medical and paramedical—with questions adapted slightly to fit the respective study population. Results: A total of 34 responses were received in the managerial group;a total of 2389 responses were received in the group of employees. Self-reported PPE adherence of EMS employees for confirmed SARS-CoV-2 positive patients: use of gloves (99.8%), FFP2 or FFP3 masks (99.8%), gowns or coveralls (99.1%), goggles (89.7%), face shields (24.0%), surgical masks (0.0%). Self-reported PPE adherence of EMS employees for suspected SARS-CoV-2 positive patients: gloves (98.8%), FFP2 or FFP3 masks (total: 99.4%), gowns or coveralls (total: 95.9%), goggles (85.6%), face shields (19.2%), surgical masks (0.2%). Conclusions: Findings included an overall improved self-reported adherence to PPE compared to studies that were conducted before the pandemic. Self-reported general adherence to PPE recommendations when attending to confirmed SARS-CoV-2 positive patients was good, with the exception of goggles. Self-reported adherence to PPE recommendations dropped when attending to suspected SARS-CoV-2 positive patients.

关键词： SARS-CoV-2 Personal Protective Equipment emergency medical services

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