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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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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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Prehospital response to respiratory distress by the public ambulance system in a Ukrainian city

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World Journal of emergency Medicine 2019年第1期10卷 42-45页

作者： Colin A.Meghoo Stanislav Gaievskyi Oleksandr Linchevskyy Bindhu Oommen Kateryna Stetsenko Research Department Patriot Defence School of Public Health Kyiv-Mohyla Academy Clinical Hospital #17 Hunt Regional medical Center Center of emergency medical Care and Disaster Medicine

BACKGROUND: The capability of the public ambulance system in Ukraine to address urgent medical complaints in a prehospital environment is unknown. Evaluation using reliable sources of patient data is needed to provide insight into current treatments and outcomes. METHODS: We obtained access to de-identifi ed computer records from the emergency medical services(EMS) dispatch center in Poltava, a medium-sized city in central Ukraine. Covering a fi vemonth period, we retrieved data for urgent calls with a patient complaint of respiratory distress. We evaluated ambulance response and treatment times, field diagnoses, and patient disposition, and analyzed factors related to fatal outcomes. RESULTS: Over the f ive-month period of the study, 2,029 urgent calls for respiratory distress were made to the Poltava EMS dispatch center. A physician-led ambulance typically responded within 10 minutes. Seventy-seven percent of patients were treated and released, twenty percent were taken to hospital, and three percent died in the prehospital phase. On univariate analysis, age over 60 and altered mental status at the time of the call were strongly associated with a fatal outcome. CONCLUSION: The EMS dispatch center in a medium-sized city in Ukraine has adequate organizational infrastructure to ensure that a physician-led public ambulance responds rapidly to complaints of respiratory distress. That EMS system was able to manage most patients without requiring hospital admission. However, a prehospital fatality rate of three percent suggests that further research is warranted to determine training, equipment, or procedural needs of the public ambulance system to manage urgent medical conditions.

关键词： emergency medical services Dyspnea Ukraine

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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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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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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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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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Significant factors associated with fatal outcome in emergency open surgery for perforated peptic ulcer

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World Journal of Gastroenterology 2003年第10期9卷 2338-2340页

作者： Mario Testini Piero Portincasa Giuseppe Piccinni Germana Lissidini Fabio Pellegrini Luigi Greco Section of General Surgery and Vascular Surgery and Clinical Oncology Department of Applications in Surgery of Innovative Technologies(DACTI)University Medical SchoolBariItaly Section of Internal Medicine Department of Internal Medicine and Public Medicine(DIMIMP)University Medical SchoolBariItaly Department of Clinical Pharmacology and Epidemiology Pharmacological Research InstituteConsortium"Mario Negri"SouthMaria Imbaro(L'Aquila)Italy Section of General Surgery Department of Emergency and Organ Transplantations(DETO)University Medical SchoolBailItaly

AIM:To evaluate the main factors associated with mortality in patients undergoing surgery for perforated peptic ulcer referred to an academic department of general surgery in a large southern Italian city. METHODS:One hundred and forty-nine consecutive patients (M:F ratio=110:39,mean age 52 yrs,range 16-95) with peptic ulcer disease were investigated for clinical history (including age,sex,previous history of peptic ulcer,associated diseases,delayed abdominal surgery,ulcer site,operation type,shock on admission,postoperative general complications, and intra-abdominal and/or wound infections),serum analyses and radiological findings. RESULTS:The overall mortality rate was 4.0%.Among all factors,an age above 65 years,one or more associated diseases,delayed abdominal surgery,shock on admission, postoperative abdominal complications and/or wound infections,were significantly associated (x^2) with increased mortality in patients undergoing surgery (0.0001

关键词： Academic medical Centers numerical data Acute Disease Adolescent Adult Aged Aged, 80 and over emergency medical services Female Humans Italy Male Middle Aged Peptic Ulcer Perforation Postoperative Complications Referral and Consultation Risk Factors Shock Time Factors

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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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