bluuebunny/crossref_metadata_2025_split huggingface dataset:
Potential Effect of a Heat Wave on Body Temperature of Patients at the Emergency Department and in the Hospital: A Comparative Retrospective Study
Authors: Heedfeld Juul , Devloo Jan , In Jill Van , Desruelles Didier , Sabbe Marc 
Published: June 2023

Introduction:The impact of a heat wave on body temperature of patients being admitted to the emergency department (ED) and of patients that were already hospitalized was investigated. This can provide insight into measures or infrastructural adjustments that still need to be made.Method:A retrospective study comparing the measured body temperature of patients admitted to the ED and patients already hospitalized during a heat wave from August 11-13, 2020 versus a period in which no heat wave, no manifest presence of COVID-19, and no other endemism was present (October 10 and October 20, 2019, and November 5, 2019) was conducted. Two groups were created per period: morning and afternoon measurements.Results:Comparing the heat wave to the control period, no statistical difference was observed in morning temperature measurements at the ED. In the afternoon temperature measurements at the ED, however, a statistically significant difference (p < 0.01) was measured. Afternoon measurements during the control period showed a mean of 36.842 °C, whereas the measurements during the heat wave showed a mean body temperature of 37.191 °C. For hospitalized patients, a statistical difference (p < 0.01) was measured in both morning and afternoon temperature measurements. The control period showed a mean morning body temperature of 36.629 °C and a mean afternoon body temperature of 36.7154 °C, as opposed to the heat wave mean body temperatures in the morning (36.698 °C) and afternoon (36.7937 °C).Conclusion:This study emphasizes the rise in body temperature during a heat wave, independently of other factors that influence body temperature. Hospitals should focus on preventive measures, such as air conditioning and providing good temperature control. Further research is needed.
Emergency Medical Services Response: Outcomes of Non-Transported Patients
Authors: Chermiti Ines , Mahjoubi Mokhtar , Ghazali Hanene , Jeddi Camillia , Ellouz Morsi , Keskes Syrine , Turkia Héla Ben , Souissi Sami 
Published: June 2023

Introduction:As a part of a primary intervention, Emergency Medical Services (EMS) may leave a patient at the scene. This decision is made in partnership with the dispatching center. The prognosis of these patients is often unknown. The aim of our study was to assess the outcomes of non-transported EMS patients.Method:It was a descriptive, prospective study conducted over a two-year-period. We included all alive non-transported EMS patients from the site of intervention after a primary mission of the EMS team based on a medical decision. The prognosis was assessed by unexpected events (UE) defined by death, second EMS call, urgent consultation or hospitalization/surgery within seven days. We considered two groups: a group with UME (UME+) and a group with good evolution (UE-).Results:We included 97 patients. The average age was 56±19 years. Seventeen patients (17,5%) had no medical histories. Hypoglycemia was observed in 43% of patients. Thirty-four patients (35%) had an UE. These UEs were distributed as the following: ten consulted a private doctor, ten consulted their family physician, seven called the EMS, three visited the emergency department and four died. There were no significant differences in demographic, anamnestic characteristics between two groups. Psychiatric pathology was more common in the UE- group(28% vs. 9%; p=0.0037). Intravenous injections were more common in the UE+ group (64% vs 39% ; p=0,019). Among the four deaths, three were unexpected.Conclusion:One-third of non-transported EMS patients had UE. Unexpected death was rare (one patient). Setting-up a system for these patients including scores and algorithms, and a post-EMS compulsory visit in collaboration with family physicians could be beneficial.
Increasing Effectiveness of Large-scale Prehospital Care during Crisis and Disasters.
Authors: Roessel Will , Cools Carian 
Published: June 2023

Introduction:In the Netherlands several additional facilities and working methods are created to strengthen the effectiveness and capacity of the regular daily health care during large incidents and disasters. One system is called GGB (Large-scale medical assistance). The daily healthcare is organized in 25 safety-regions, which are far too small to handle big incidents. GGB provides in organizing assistance between regions, increasing the effectiveness of ambulance care, the deployment of other emergency services and volunteers, and coordination of this all. GGB is developed to deal with an incident with 250 injuries. This method was investigated to determine value.Method:Based on a standard questionnaire, key persons of ambulance care, trauma care, Red Cross and Offices of Public Health and Safety per safety region were asked about their experiences with GGB. (125 forms)Subsequently, the regional outcomes for each discipline were evaluated in a national conferences (four conferences). To conclude, an interdisciplinary national meeting was held to bring the results together. The authors developed the questionnaires, supervised the research process, and presented the results to the authorities.Results:Results indicated that the working methods for scaled-up care is useful and should be continued. The extra financial costs outweigh the gained strength. The cooperation between professionals and volunteers also receives a lot of support. Proposals have been made for further improvements, in particular concerning cooperation between organizations. Bottlenecks have also been identified in the collaboration between health care, fire services and community care.Conclusion:In the perception of the care providers there is added value and cost-effectiveness. This is important for the support of the system. As a next step, the authors want to focus on measuring the actual effectiveness. For that, we want to be able to compare systems in several countries. The presentation ends with a call to do so.
Prevalence and Risk Factors for Workplace Violence in the Ambulance Service
Authors: Viking Magnus , Hugelius Karin , Kurland Lisa 
Published: June 2023

Introduction:Workplace violence within the ambulance services is a serious problem. A prevalence of up to 8.5% of all ambulance missions has previously been reported. Prior research used a retrospective design and the knowledge of risk factors for workplace violence is weak. Therefore, the aim of the current study was to measure the prevalence of workplace violence within the ambulance service in a Swedish region.Method:This was a prospective cohort study using data from all ambulance missions in a region in Sweden during one year. The data was analyzed with descriptive and analytic statistics using SPSS.Results:Data was collected from 28,648 ambulance missions. A total of 209 unique workplace violence incidents were reported, corresponding to a prevalence of 0.7%. Seventy-three of all incidents reported physical violence and 161 verbal threats, where some of the incidents included both physical and verbal violence. The most common risk factors for workplace violence were: the perpetrator was under the influence of alcohol or drugs (70.5%), mental illness (60.5%) and communication problems (15.3%). The perpetrator was most often a man (n=68%) between 18 and 29 years of age. Co-variation between the risk factors was high. No significant differences in the occurrence of workplace violence could be seen in relation to time of the year, weekday, or time of day.Conclusion:The prevalence of workplace violence was one of the lowest reported. An understanding of risk factors could be used within the ambulance service and dispatch centers to identify situations with an increased risk of workplace violence and mitigate the risk of such incidents.
Association Between Ambulance Prehospital Time and Maternal and Perinatal Outcomes in Sierra Leone: A Countrywide Study
Authors: Caviglia Marta , Putoto Giovanni , Conti Andrea , Tognon Francesca , Jambai Amara , Vandy Matthew , Hubloue Ives , Corte Francesco Della , Ragazzoni Luca , Barone-Adesi Francesco 
Published: June 2023

Introduction:Sierra Leone, one of the countries with the highest maternal and perinatal mortality in the world, launched its first National Emergency Medical Service (NEMS) in 2018. We carried out a countrywide assessment to analyze NEMS operational times for obstetric emergencies with access to timely essential surgery within 2 hours. Moreover, we evaluated the relationship between operational times and maternal and perinatal mortality.Method:We collected prehospital data of 6,387 obstetric emergency referrals from primary health units to hospital facilities between June 2019 and May 2020 and we estimated the proportion of referrals with a prehospital time (PT) within 2 hours. The association between PT and mortality was investigated using Poisson regression models for binary data.Results:At the national level, the proportion of emergency obstetric referrals with a PT within 2 hours was 58.5% (95% CI 56.9% to 60.1%) during the rainy season and 61.4% (95% CI 59.5% to 63.2%) during the dry season. Results were substantially different between districts, with the capital city of Freetown reporting more than 90% of referrals within the benchmark and some rural districts less than 40%. Risk of maternal death at 60, 120, and 180 min of PT was 1.8%, 3.8%, and 4.3%, respectively. Corresponding figures for perinatal mortality were 16%, 18%, and 25%.Conclusion:NEMS operational times for obstetric emergencies in Sierra Leone vary greatly and referral transports in rural areas struggle to reach essential surgery within two hours. Maternal and perinatal risk of death increased concurrently with operational times, even beyond the two-hour target, therefore, any reduction of the time to reach the hospital may translate into improved patient outcomes.
The Role of the Louisiana EMS Designated Regional Coordinator in Emergency Response During 2020/2021 COVID Pandemic and Hurricane Season
Authors: Goldfine Shayna , Volpi Nicole 
Published: June 2023

Introduction:Post Katrina Louisiana’s Health Department (LDH) used some of the Hospital Preparedness Program (HPP) funding to create a regional Emergency Medical Services liaison position entitled EMS Designated Regional Coordinators (EMS DRC). Regional EMS DRCs work with local pre-hospital agencies, hospital coalitions, and local/state/federal counterparts during the preparedness and response phases of a disaster. This presentation explores the EMS DRCs role during the 2020/2021 COVID pandemic and annual hurricane season.Method:The EMS DRCs were activated at the beginning of the COVID-19 pandemic. EMS agencies across the country were struggling to meet the call volume demand while balancing sick employees. The eleven LA Region 1 EMS agencies reached out to the EMS DRC for assistance. The EMS DRC coordinated with the LA State Health Department to provide surge ambulances to any ambulance agency in need. These units were utilized for COVID response, but once hurricane season hit in both 2020 and 2021 Surge ambulances were quickly transitioned to COVID and Hurricane response.Results:During the initial COVID outbreak, 18 state surge ambulances were divided amongst four agencies. In 2020 Louisiana saw six named storms, one of which caused significant damage. After Hurricane Laura hit in 2020 the EMS DRCs managed 80 Federal surge ambulances stationed across 41 non-congruent hotel shelters. The 2021 COVID response brought another 21 Federal Surge ambulances to the region. Once Hurricane Ida hit that year over 60 surge ambulances got reassigned to six regional EMS agencies for COVID and Hurricane response.Conclusion:The COVID-19 pandemic and subsequent hurricane devastation exposed gaps in EMS response capabilities to response. The EMS DRCs play a significant role in providing continuous care through working relationships with local, state and federal partners
Effects of the COVID-19 Pandemic on Prehospital Emergency Care for Adults With Stroke and Transient Ischaemic Attack: A Systematic Review and Meta-analysis
Authors: Burton Edel , Aladkhen Johnny , O'Donnell Cathal , Masterson Siobhán , Merwick Áine , McCarthy Vera , Kearney Patricia , Buckley Claire 
Published: June 2023

Introduction:The COVID-19 pandemic impacted on health service provision worldwide, including care for acute time sensitive conditions, like stroke and transient ischaemic attack (TIA). Thus, the aim of this study was to conduct a systematic review and meta-analysis to investigate the impact of the COVID-19 pandemic on prehospital emergency care for stroke/TIA.Method:Following a published study protocol, a systematic search of databases was conducted up to May 31, 2022. Peer-reviewed quantitative studies comparing prehospital emergency care for adults with stroke/TIA before and during the COVID-19 pandemic were considered for inclusion. The methodological quality of the included studies was assessed using the appropriate Joanna Briggs Institute tool. Overall pooled estimates of ambulance times (activation, response, patient care time) were calculated. Subgroup and sensitivity analyses included location and stroke/TIA diagnosis. Stroke/TIA emergency call volume was reported using a narrative synthesis. Clinical stakeholders and Patient and Public Involvement Contributors were involved from research question development to dissemination of results.Results:Of 4083 studies identified, 56 unique articles met the inclusion criteria. Early data from 8/12 studies reporting ambulance times, suggests that patient care time increased. Furthermore, emergency call volume for stroke/TIA decreased during the COVID-19 pandemic, according to 43/56 studies that reported this outcome. Terminology for ambulance time intervals differed between studies. The majority of studies reported time from call to hospital arrival, whereas the minority of studies reported activation time.Conclusion:Preliminary results from our systematic review and meta-analysis show that conflicting evidence exists on the impact of the COVID-19 pandemic on ambulance times and emergency call volume for stroke/TIA. Thus, this review synthesized available evidence on the varied effects across different countries, healthcare systems and ambulance time terminology. Review findings may inform our understanding of healthcare system resilience in response to crises on a broader level.
Framework and Thematic Analysis of Historical After Action Review Reports from the Australian Capital Territory Emergency Services Agency
Authors: Heslop David , Bushby Toni , New Charles , Whelan Georgeina 
Published: June 2023

Introduction:Emergency services organizations routinely undertake internal quality improvement activities following training and operational activities. One form of a quality improvement activity is the After Action Review (AAR). An AAR is a facilitator-led post-event review where data is collected from individuals and groups of individuals using either surveys, focus group-like meetings, or individual interviews. Data is collected using a semi-structured data collection tool which is usually customized to the specific tasks being reviewed and the priorities and goals of the organization. The quality of AARs has been noted to vary significantly across organizations with reporting biases and differences between exercise or real event AARs and biases introduced by utilization of internal rather than external evaluators, and limited justification for data selection and collection rationales. The Australian Capital Territory Emergency Services Agency (ACT ESA) has identified that interoperability and integration between internal ACT ESA sub-agencies and externally with other agencies is a key problem. The aim of this study was to identify specific areas of consistent interoperability concern through the examination of historical AARs.Method:In this qualitative study a Framework Analysis of historical AAR text documents was conducted, following the standard five step process. This was followed by detailed thematic analysis in aggregate and examined longitudinally, with emergent themes undergoing further analysis.Results:AARs relating to major emergency response and training activities 2016-2022 were examined. There was a substantial variation in quality, level of detail, completeness and structure across the different AAR documents. Consistent themes emerging from the data highlighted concerns regarding inter-agency culture, uncertainty when conducting joint activities and its impact on decision making, logistics concerns, resourcing and breakdown of shared understanding and communication between teams.Conclusion:Despite a centralized command structure, historical AAR analysis shows ACT ESA has had persistent operationally impacting interoperability and integration problems within the organization and with external agencies.
The Implementation and Evolution of Helicopter Emergency Medical Services in the Republic of Ireland
Authors: Hennelly David , Deasy Conor , Masterson Siobhan , O'Donnell Cathal , Jennings Paul 
Published: June 2023

Introduction:Helicopter Emergency Medical Services (HEMS) have formed an integral component of the Irish healthcare system for the past decade, yet the factors leading its commencement, its evolutions over this time, the current model of service delivery have not been widely published.Aeromedical service provision may vary significantly from country to country and may also vary regionally within countries. Health systems necessities, capacity and maturity, the level of state, corporate, private or community investment and capacity of the contracted service provider are all factors that influence the service provision.Method:This research provides a descriptive analysis of the historic factors leading to the implementation of HEMS during an era of healthcare reform, its key evolutions and current model of service delivery.Results:Health system reform in a time of global financial recession led to a unique collaboration between the Irish Defense Forces and civilian Emergency Medical Systems (EMS) to provide a sustainable foundation of primary scene landing Helicopter Emergency Medical Services for the Irish state. This sharing of professional knowledge, logistics and operational experience lead to many further system reforms and will inform future aeromedical service provision.Conclusion:Over the past decade the Irish health system has undergone significant reconfiguration and centralization of services, leading to increased demands on emergency medical ground and aeromedical services. Future advancements in aeromedical service provision require an innate understanding of the current model.This research will add to the knowledge base and inform policy makers and support decision making surrounding Helicopter Emergency Medical Services reform and enhanced service provision in the Irish state.
Evaluation of Readaction Quality of Initial Medical Certificate In An Emergency Department
Authors: Ghazali Hanene , Akkari Sarra , Chermiti Ines , Sebai Jihen , Keskes Syrine , Turkia Héla Ben , Mejdoub Yosra , Souissi Sami 
Published: June 2023

Introduction:The initial medical certificate (CMI) is a medico-legal document of great importance. Writing CMIs is a frequent act in emergency medicine. In 2011, the Haute Authority of Medicine (HAS) published good practice recommendations concerning the writing and content of these certificates. Nevertheless, this practice faces a difficult reality in the emergency services. The aim of this study was to analyze the writing quality of CMIs in terms of compliance of all the criteria collected with respect to HAS recommendations.Method:This was a retrospective study, evaluating professional practices over a period of two years in Ben Arous ED. We analyzed CMIs written by EPs. The certificates were subjected to a critical reading to begin a comparative study of the quality of writing of these certificates with the HAS recommendations using a criteria grid relating to the theoretical content of the certificates.Results:207 CMIs were analyzed (Acts of violence 88%, work accidents 12% and AVP less than 1%). The medical writers were mainly represented by general practitioners (98%). Not all of the CMIs complied with writing recommendations. The identity of the physician, the identity of the patient, the date of the examination and of the facts, the nature of the lesions, the handwritten signature of the doctor and the stamp were mentioned in more than 95% of the CMIs. The presence of CNOM registration number, the profession, the address and the number of the national identity of the patient, the place of the facts, the medical history and the previous condition of the patient were absent in more than 95% of the CMIs. The duration of the ITT was written in full in 36% of the cases.Conclusion:The study revealed insufficiencies in the quality of CMI drafting written by EP. Specific training is underway to improve certificate redactions.
Aiming for a Society Where No One is Left Behind in a Humanitarian Crisis: Examples of Cooperation Among Health, Medical Care, and Welfare
Authors: Harada Nahoko , Koda Masahide , Chishima Kayako , Suzuki Nobuaki , Ichikawa Manabu 
Published: June 2023

Introduction:Japan is geographically prone to natural disasters such as earthquakes, volcanoes, and tsunamis, economically advanced, and socially characterized as a super-aged society. The SDGs are a concrete strategy to achieve a society where no one is left behind. So what exactly can we do to protect the vulnerable populace? This presentation will introduce the system of cooperation and implementation of medical, health, and welfare disaster relief in Japan.Method:Government documents were received on developing national policies regarding the strategy for the unification of medical, health, and welfare. For implementation, the status of support teams specializing in disaster welfare and training status was reviewed.Results:National policy level achievements: The Ministry of Health, Labor and Welfare (MHLW) issued a "Notification on Enhancing and Strengthening the Medical System in Times of Disaster" in 2012 and conducted a critical review of the initial response to the Kumamoto earthquake in 2016 in the "Initial Response Verification Report." This process reaffirmed the need to support vulnerable populations such as the disabled, children, and the elderly. In 2021, the Disaster Welfare Assistance Team was added to the Basic Plan for Disaster Management and the MHLW Disaster Management Work Plan.Implementation level Achievement: As of 2022, 24 of the 47 prefectures have a DWAT in place. Gunma, Kyoto, and Miyazaki prefectures were the most advanced, with 1) ongoing meetings to strengthen cooperation with medical and health care teams, 2) participation in joint drills, and 3) DWAT awareness-raising activities through training for municipal administrative staff.Conclusion:While this review revealed that the national government had made progress in developing policies, the implementation revealed that some prefectures have not yet established DWATs.