Emergency situation: Working harder unlikely to solve crisis in emergency room overcrowding
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Overcrowding
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Emergency medicine is subjected worldwide to financial stringencies and organizational evaluations of cost-effectiveness. The various links in the chain of survival are affected differently. Bystander assistance or bystander CPR is available in only 30% of the emergencies, response intervals--if at all required by legislation--are observed to only a limited degree or are too extended for survival in cardiac arrest. A single emergency telephone number is lacking. Too many different phone numbers for emergency reporting result in confusion and delays. Organizational realities are not fully overcome and impair efficiency. The position of the emergency physician in the EMS System is inadequately defined, the qualification of too many emergency physicians are unsatisfactory. In spite of this, emergency physicians are frequently forced to answer out-of-hospital emergency calls. Conflicts between emergency physicians and EMTs may be overcome by providing both groups with comparable qualifications as well as by providing an explicit definition of emergency competence. A further source of conflict occurs at the juncture of prehospital and inhospital emergency care in the emergency department. Deficiencies on either side play a decisive role. At least in principle there are solutions to the deficiencies in the EMSS and in intensive care medicine. They are among others: Adequate financial compensation of emergency personnel, availability of sufficient numbers of highly qualified personnel, availability of a central receiving area with an adjacent emergency ward, constant information flow to the dispatch center on the number of available emergency beds, maintaining 5% of all beds as emergency beds, establishing intermediate care facilities. Efficiency of emergency physician activities can be demonstrated in polytraumatized patients or in patients with ventricular fibrillation or acute myocardial infarction, in patients with acute myocardial insufficiency and other emergency clinical pictures. Cost effectiveness is clearly in favor of emergency medicine. Future developments will be characterized by the consequences of new health care legislation and by effects of financial stringencies on the emergency medical services.
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First aid is a primary part in the medical system; however, large-scale medical centers are facing the dilemma of overcrowding. When the number of emergency patients increases over the allocation of manpower and equipment, emergency is likely to be overloaded. Such a dilemma might crowd out the resources for critical patients, seriously affect the emergency service quality, and reduce the morale of staff before the patients being safe.With system simulation, this study establishes an emergency simulation model aiming at the researched subjects to discuss the authenticity of present emergency room. Furthermore, National Emergency Department Overcrowding Scale (NEDOCS), the emergency compound standard, is utilized for evaluating the overcrowding degree in emergency rooms. Two strategies, proposed for improving the overcrowded emergency rooms receiving emergency patients, are also evaluated the effects on the overcrowding degree with NEDOCS. The outcomes show that the proposed strategies could actually improve the overcrowding in emergency rooms.
Overcrowding
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Triage
Emergency medical care
Medical care
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In the past 20 years, emergency medicine in China has witnessed rapid development and emergency care has contributed considerably to safeguarding people's life and health. The emergency departments in most hospitals have completed the transition from being dependent to being supportive and some hospitals have set up autonomous emergency departments. The functions and business scope of emergency care have gradually been clarified. However, some problems remain to be solved in such aspects of emergency care as training, management, scientific research, and professional promotion.
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Scope (computer science)
Promotion (chess)
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As the society is being industrialized, the fast-paced economic development that has caused substantial increase in cerebrovascular and coronary artery diseases and the industrial development and increased use of means of transportation have resulted in the rapid rise of incidents in external injuries as well. So the pubic has become acutely aware of the need for fast and effective emergency care delivery system. The goal of emergency care delivery system is to meet the emergency care needs of patients. The emergency care delivery system is seeking to efficiently satisfy the care needs of people. Therefore the purpose of this study is designed to develop an effective programs for emergency care delivery system in Korea. The following specific objectives were investigated. This emergency care delivery system must have the necessary man power, for transfering the patients, communication net work, and emergency care facilities. 1) Man power Emergency care requires n0t only specialized traning in the emergency treatment but also knowledge and experience i11 other related area, so emergency care personnel traning program should be designed in order to adapt to the specific need of emergency patients. It will be necessary to ensure professional personnel who aquires the sufficient traning and experience for emergency care and to look for legal basis. We have to develop re-educational programs for emergency nurse specialist. They should be received speciality of emergency nursing care so that they will work actively and positively in emergency part. Emergency medical doctor and nurse specialist should be given an education which is related in emergency and critical care. Emergency care personnel will continue to provide both acute and continuing care as partner with other medical team. 2) Transfering the patients. Successful management of pre-hospital care requires adequate traning for the emergency medical technician. Traning program should be required to participate in a actual first aids activites in order to have apportunities to acquire practical skills as well as theoretical knowledge. The system of emergency medical technician should be remarkablly successful with first responder firefighters. Establishing this system must add necessary ambulances operating at any given time. It will be necessary to standardize the ambulance size and equipment. Ambulance should be arranged with each and every fire station. 3) Communication net work. The head office of emergency commumication network should be arranged with the head office of fire station in community. It is proposed that Hot-line system for emergency care should be introduce. High controlled ambulance and thirtial emergency center should simultaneously equip critical-line in order to communication with each other. Ordinary ambulance and secondary emergency facility should also simultaneously equip emergency-line in order to communication with each other. 4) Emergency care facilities. Primary emergency care facilities should be covered with the ambulatory emergency patients-minor illness and injuires. Secondary emergency care facilities should be covered with the emergency admission patients. Third emergency care center should be covered with the critical patients who need special treatments and operation. Secondary and third emergency care facilities should employ emergency medical doctor and emergency nurse specialist to treat in-patients with severe and acute illness and multiple injuires. It should be fashioned for a system of emergency facilities that meets emergency patients needs. Provide incentives for increased number of emergency care facilities with traning in personal/clinical emergency care. 5) Finance It is recommended to put the finance of a emergency care on a firm basis. The emergency care delivery system should be managed by the government or accreditted organizations. In order to facilitate this relevant program the fund is needed for more efficient and effective emergency researchs, service, programs, and policy. 6) Gaining understanding and co-operation of pubic It is also important to undertake pubic education to improve understanding of first aids and C. P. R of individuals, communities and business. It is proposed that teachers and health officers be certified in C. P. R. The C. P. R education can be powerful influence save lives. Lastly appropriate emergency care information must be provided to the pubic for assisting them in choosing emergency care.
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Voluntary general hospitals may be viewed as emergency organizations in that the emergency treatment of the sick and injured is a part of their normal operations. The typical emergency patient most often becomes an input into the organization through the emergency facility of the hospital (Stallings, 1970). While under ordinary conditions an emergency case can be handled rather routinely in the emergency facility of the hospital, during crisis or large-scale disaster situations, the ongoing capability of the organization is likely to be inadequate to meet the sudden increase in demands it must now confront. When this situation occurs, the organization can be though of as experiencing stress
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The difficulties and problems New York State faced in fulfilling training for an ambulance attendant population of over 31,000 are discussed. A program is developed that would raise the level of pre-hospital emergency care on a broad base as an expedient measure, followed by a progression of steps to insure effective and efficient emergency care to national acceptable standards.
Technician
Emergency medical care
Emergency Response
State of emergency
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Overcrowding in emergency rooms (ERs) is a common yet nagging problem. It not only is costly for hospitals but also compromises care quality and patient experience. Our paper provides solid evidence that telemedicine can significantly improve ER care delivery, especially in the presence of demand and supply fluctuations. We believe such findings are critical for ERs, due to the special setting of unscheduled arrivals leading to high unpredictability of patient traffic. Additional evidence suggests that the efficiency gained from telemedicine does not come at the expense of lower care quality or higher medical expenditure, which points to telemedicine as a feasible solution to the ER overcrowding problem. For healthcare practitioners, our paper highlights the general applicability of telemedicine through the “hub and spoke” architecture. Besides increasing patients’ access to more immediate care from specialists who were not available otherwise, telemedicine enables flexible resource allocation for any hospitals, regardless of where hospitals are located. Our research also provides ground for policymakers to incentivize hospitals to adopt telemedicine in ER, which we believe is critical given the relatively low adoption rate, the lack of direct evidence on its effectiveness, and the current inflexibility of reimbursement policies regarding the application of ER telemedicine.
Overcrowding
Nagging
Reimbursement
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고품질의 맞춤형 서비스는 사회가 고령화, 초핵가족화, 재난 취약 계층의 증가로 인하여 급격히 늘어나게 되었다. 급성 질환, 심뇌혈관 질환, 자살 등 예방 가능한 사망률이 선진국에 비해 높으므로 빠르고 전문적인 구조 및 구급 서비스가 요구된다. 본 논문에서는 응급 환자가 발생하여 병원에 도착하기 전에 환자의 정보를 이용하여 응급처치가 가능하도록 한다. 그리고 응급 의료 기관에서는 환자 진료 준비를 사전에 갖출 수 있도록 하여 응급 환자 진료의 효율성을 높였다. 사회적 인지도가 높은 119번호를 이용하여 다양한 복합 응급 신고를 접수하고 있고, 유관기관과 통합적 대응 체계를 구축하는 효율적 응급의료서비스 선진화 전략을 제시하고자 한다. High-quality customized services demand was growing due to the increase of aging, extremely nuclear family, disaster vulnerable of society. Ambulance service is required of fast and professional rescue and emergency service because of preventable death rate such as acute diseases, cerebral and cardiovascular diseases, suicides, etc. was higher than in developed countries. First aid will be available using patients information when emergency occurs, before arriving at the hospital. And emergency department is equipped with that patient care can be prepared in advance, increase the efficiency of emergency care. We received a variety of complex emergency call using high social awareness of 119 number and propose an efficient emergency medical service advancement strategy building an integrated response system with relevant organization.
Healthcare service
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