Articles: emergency-medical-services.
-
Scand J Trauma Resus · Nov 2023
Locating helicopter ambulance bases in Iceland: efficient and fair solutions.
Fixed-wing air ambulances play an important role in healthcare in rural Iceland. More frequent use of helicopter ambulances has been suggested to shorten response times and increase equity in access to advanced emergency care. In finding optimal base locations, the objective is often efficiency-maximizing the number of individuals who can be reached within a given time. This approach benefits people in densely populated areas more than people living in remote areas and the solution is not necessarily fair. This study aimed to find efficient and fair helicopter ambulance base locations in Iceland. ⋯ An efficient and fair solution would be to locate bases at Reykjavík Airport and in Akureyri or Egilsstaðir.
-
JNMA J Nepal Med Assoc · Nov 2023
Observational StudySurgical Management among Patients with Acetabular-Pelvis Fractures in a Trauma Care Centre.
Surgical management of pelvic and acetabular fractures due to high-energy trauma is one of the most challenging in orthopaedics. Most patients are often associated with other life-threatening injuries. Several studies demonstrated that accurate fracture reduction decreases the incidence of post-traumatic arthritis and improves functional outcomes. The aim of the study was to find out the prevalence of the surgical management among patients with acetabular-pelvis fractures in a trauma care centre. ⋯ acetabulum; fracture fixation; pelvis.
-
Southern medical journal · Nov 2023
Observational StudyReal-World Evaluation of a Chest Pain Digital Triage Platform at the Point of Care.
The triple aim of population health focuses on providing the right care to the right patient at the right time. Patient use of digital health tools may reduce the overuse of emergency services. We tested the safety and clinical applicability of a patient-facing, automated digital urgent care triage tool (UCTT) for patients with chest pain. ⋯ No high-risk conditions were missed by the UCTT. Our UCTT was more conservative than MD decision making, providing a sizable safety margin and adequate patient triage.
-
JNMA J Nepal Med Assoc · Nov 2023
Case ReportsCervical Ectopic Pregnancy with Unsupervised Intake of Medications for Abortion: A Case Report.
Cervical ectopic pregnancy is the rarest form of ectopic pregnancy, where implantation occurs in the mucosa of the endocervical canal, below the internal os. Medical abortion is a safe and effective method of termination of early intrauterine pregnancies when carried out under the supervision of trained service providers. Unfortunately, unsupervised misuse of such methods can lead to grave morbidities, especially in ectopic pregnancies. We report a case of a 29-year-old female with cervical ectopic pregnancy, with a history of self-induced medical abortion. Her assumption that her pregnancy had been terminated caused a delay in seeking treatment, which led to complications during management. Ultrasonography revealed features suggestive of cervical ectopic pregnancy and evacuation of the fetus and placenta was done using curettage, during which she had uncontrolled severe vaginal bleeding leading to need of emergency hysterectomy. ⋯ case reports; cervical; ectopic pregnancy; hysterectomy; induced abortion.
-
Observational Study
Associations between emergency call stroke triage and pre-hospital delay, primary hospital admission, and acute reperfusion treatment among early comers with acute ischemic stroke.
To investigate the association between the Emergency Medical Service dispatcher's initial stroke triage and prehospital stroke management, primary admission to hospitals offering revascularization treatment, prehospital time delay, and rate of acute revascularization. In an observational cohort study, patients with acute ischemic stroke (AIS) in Denmark (2017-2018) were included if the emergency call to the Emergency Medical Dispatch Center (EMDC) was made within three hours after symptom onset. Among 3546 included AIS patients, the EMS dispatcher identified 74.6% (95% confidence interval (CI) 73.1-76.0) correctly as stroke. ⋯ For all AIS patients, the adjusted difference was - 33.2 min (95% CI - 44.4; - 22.0). Among patients receiving acute revascularization treatment (n = 1687), the adjusted difference was -12.6 min (95% CI - 18.9; - 6.3). Stroke recognition by the EMS dispatcher was associated with a higher probability of primary admission to a hospital offering acute stroke treatment, and subsequently with a higher rate of acute revascularization treatment, and with an overall reduction in prehospital delay.