Evaluating feasibility of a novel mobile emergency medical dispatch tool for lay first responder prehospital response coordination in Sierra Leone: A simulation-based study
Peter G. DelaneyZachary J. EisnerAlfred H. ThullahP TurayKpawuru SandyPhilip S. BoonstraKrishnan Raghavendran
7
Citation
35
Reference
10
Related Paper
Citation Trend
Keywords:
Triage
Natural and human-initiated disasters are occurring with greater devastating consequences and increased frequency. During these events, hospitals have the burden to care for acutely ill and injured patients. The aim of this study was to evaluate the level of disaster preparedness of Italian hospitals.Site visits were conducted from January, 2014 to December, 2014. The hospital emergency response checklist, developed by the WHO, was used as an evaluation toolkit. It consists of 92 items classified as 9 key components, such as command and control, triage, and critical services. The status of each component was determined by consensus of 3 independent evaluators.The study selected 15 hospitals from different areas in Italy. Out of the 15 hospitals, 12 were considered to be at insufficients level of preparedness, only 3 were considered to have an effective level of preparedness. The average preparedness of all components were lower than the optimal level suggested by the WHO checklist.The study revealed that a large majority of Italian hospitals evaluated are not well prepared to manage potential disasters. Also, all important elements of hospital preparedness, such as the command system, surge capacity, and safety, were insufficiently implemented. Nationwide standards, guidelines and procedures are required to improve hospital disaster preparedness in Italy.
Preparedness
Triage
Surge Capacity
Disaster preparedness
Cite
Citations (44)
In man-made andnatural disasters, prehospital providers andtheir emergency medical services systems may find it necessary to shift their triage methodology from a daily operational framework of treating the most severely injured patient first andproviding the highest level of care for each patient to the concept of providing the greatest good for the greatest number of casualties. In a scenario where there are an overwhelming number of casualties, this shift will be necessary, both to identify critically injured patients who can benefit from immediate, life-saving interventions andto preserve prehospital andhospital resources. This report examines triage issues as they apply to mass casualty events.
Triage
Mass Casualty
Mass-casualty incident
Cite
Citations (22)
- The prehospital trauma triage system consisting of regional ambulance services and overarching availability of mobile medical teams, the level criteria for trauma centres and in-hospital care for trauma patients are well-organised in the Netherlands.- However, the quality of prehospital triage in the Netherlands is inadequate at the moment, with an average under-triage rate of more than 30%. There is, thus, much room for improvement in the quality of prehospital triage.- Research in this area is now taking off, partly because of the arrival of a new quality indicator from the Netherlands National Health Care Institute, which states that at least 90% of multiple-trauma patients should be primarily taken to a level 1 trauma centre.
Triage
Trauma care
Cite
Citations (1)
Abstract Introduction: Mass gatherings may result in an acute increase in the number of people seeking medical care potentially causing undue stress to local emergencymedical services (EMS) and hospitals. Often, temporary medical facilities are established within the mass gathering venue. Emergency Medical Services providers encountering patients in the field should be equipped with effective protocols to determine transport destination (venue facility vs. hospital). Hypothesis: Paramedics are capable of appropriately using triage criteria written specifically for a particular mass gathering. The use of triage criteria, when appliedcorrectly, decreases over-triage to the venue facility and under-triage to the hospital. Methods: Paramedics triaged patients at a mass gathering to a temporary venue facility or to a single emergency department using criteria specific for the event. Cases were reviewed to determine if the patients transported went to an appropriate facility and if the triage criteria were applied appropriately. Results: Transport destination was consistent with that dictated by the criteria for 78% of cases. Analysis of these cases shows that the criteria had a sensitivity of 100% (95% CI = 58–100%) and a specificity of 90% (95% CI = 73–98%) for predicting which patients needed hospital services and which could be cared for safely in the temporary clinic setting. Conclusions: Triage by paramedics at the point of patient contact may reduce transporting of patients to hospitals unnecessarily. Patients in need of hospital services were identified. Point-of-contact triage should be applied in mass gatherings.
Triage
Mass gathering
Mass-casualty incident
Mass Casualty
Cite
Citations (35)
Purpose of review The purpose of this review is to assess literature pertinent to outcomes benefits accrued by the use of helicopter emergency medical services for trauma transport. A previous annotated bibliography assessed literature published between 1980 and 2000. The goal of this paper is to address developments since fall 2001, and to cast recent studies in the light of earlier work in an attempt to provide a long-range overview of the relevant literature. Recent findings In the year covered by this review, we identified four papers that directly assessed the association between the helicopter emergency medical services utilization and trauma outcome, and three that addressed the closely related issue of the helicopter emergency medical services triage appropriateness. An Italian study found no benefit associated with advanced prehospital care for patients with severe head injury. A US multicenter trial assessing blunt trauma transports found a substantial mortality reduction associated with helicopter use. Two other US studies, characterized by a similar 'natural experiment' design of assessing mortality changes on either side of a timepoint at which the helicopter emergency medical services availability ceased, reached opposite conclusions about the benefits of the service. Recent studies addressing the helicopter emergency medical services utilization in terms of triage were characterized by varying levels of agreement with the widely held belief that this service is characterized by overtriage. Summary The preponderance of recent and previously extant evidence supports an argument that the helicopter emergency medical services transport is associated with significant benefit for some injured patients. The primary challenges at this time include the determination of which patients benefit and the elucidation of which aspects of the helicopter emergency medical services are responsible for any salutary effects of its utilization.
Triage
Medical literature
Cite
Citations (40)
Triage
Emergency Response
Disaster Response
Cite
Citations (43)
Triage
Trauma care
Cite
Citations (1)
Perhaps the greatest operational problem faced by the New York City Emergency Medical Service (EMS) today is the sheer volume of calls entering the system, and the fact that many of those requests for medical aid are not life-threatening emergencies requiring ambulance transport. This creates two situations that New York City is all too familiar with: (l) ambulances are not available for true emergencies; and (2) response times for ambulances to arrive at the scene of an emergency are extended. A four-month pilot “on-scene triage” program was initiated by EMS as a possible solution to these problems. The program ran from May to August of 1980. A marked EMS car was designated as the “Triage Car” and was in operation during those hours when ambulance requests were at their peak (usually two to ten PM).
Triage
Ambulance service
Emergency Response
Cite
Citations (0)
Бұл зерттеужұмысындaКaно моделітурaлы жәнеоғaн қaтыстытолықмәліметберілгенжәнеуниверситетстуденттерінебaғыттaлғaн қолдaнбaлы (кейстік)зерттеужүргізілген.АхметЯссaуи университетініңстуденттеріүшін Кaно моделіқолдaнылғaн, олaрдың жоғaры білімберусaпaсынa қоятынмaңыздытaлaптaры, яғнисaпaлық қaжеттіліктері,олaрдың мaңыздылығытурaлы жәнесaпaлық қaжеттіліктерінеқaтыстыөз университетінқaлaй бaғaлaйтындығытурaлы сұрaқтaр қойылғaн. Осы зерттеудіңмaқсaты АхметЯсaуи университетіндетуризмменеджментіжәнеқaржы бaкaлaвриaт бaғдaрлaмaлaрыныңсaпaсынa қaтыстыстуденттердіңқaжеттіліктерінaнықтaу, студенттердіңқaнaғaттaну, қaнaғaттaнбaу дәрежелерінбелгілеу,білімберусaпaсын aнықтaу мен жетілдіружолдaрын тaлдaу болыптaбылaды. Осы мaқсaтқaжетуүшін, ең aлдыменКaно сaуaлнaмaсы түзіліп,116 студенткеқолдaнылдыжәнебілімберугежәнеоның сaпaсынa қaтыстыстуденттердіңтaлaптaры мен қaжеттіліктерітоптықжұмыстaрaрқылыaнықтaлды. Екіншіден,бұл aнықтaлғaн тaлaптaр мен қaжеттіліктерКaно бaғaлaу кестесіменжіктелді.Осылaйшa, сaпa тaлaптaры төрт сaнaтқa бөлінді:болуытиіс, бір өлшемді,тaртымдыжәнебейтaрaп.Соңындa,қaнaғaттaну мен қaнaғaттaнбaудың мәндеріесептелдіжәнестуденттердіңқaнaғaттaну мен қaнaғaттaнбaу деңгейлерінжоғaрылaту мен төмендетудеосытaлaптaр мен қaжеттіліктердіңрөліaйқын aнықтaлды.Түйінсөздер:сaпa, сaпaлық қaжеттіліктер,білімберусaпaсы, Кaно моделі.
Cite
Citations (0)
Objective: Stroke is the leading cause of disability in the United States with most of these patients being transported by emergency medical services. These providers are the first medical point of contact and must be able to rapidly and accurately identify stroke and transport these patients to the appropriate facilities for treatment. There are many conditions that have similar presentations to stroke and can be mistakenly identified as potential strokes, thereby affecting the initial prehospital triage. Methods: A retrospective observational study examined patients with suspected strokes transported to a single comprehensive stroke center (CSC) by a helicopter emergency medical service (HEMS) agency from 2007 through 2013. Final diagnosis was extracted from the Get with the Guidelines (GWTG) database and hospital discharge diagnosis for those not included in the database. Frequencies of discharge diagnosis were calculated and then stratified into interfacility vs. scene transfers. Results: In this study 6,243 patients were transported: 3,376 patients were screened as potential strokes, of which 2,527 had a final diagnosis of stroke (2,242 ischemic stroke and 285 transient ischemic attack), 166 had intracranial hemorrhage, and 655 were stroke mimics. Stroke mimics were more common among scene transfers (223, 32%) than among interfacility transfers (432, 16%). Conclusions: In our study approximately 20% of potential stroke patients transported via HEMS were mimics. Identifying the need for CSC resources can be an important factor in creating a prehospital triage tool to facilitate patient transport to an appropriate health care facility.
Triage
Stroke
Cite
Citations (31)