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نتیجه جستجو - Emergency medical services

تعداد مقالات یافته شده: 8
ردیف عنوان نوع
1 Emergency care providers perspectives of acute pain assessment and management in the prehospital setting, in the Western Cape, South Africa: A qualitative study
دیدگاه های ارائه دهندگان مراقبت های اورژانس ارزیابی درد و مدیریت درد حاد در محیط پیش دبستانی، در کیپ غربی، آفریقای جنوبی: یک مطالعه کیفی-2021
Introduction: A growing body of evidence suggests that pain knowledge and management are poor, perhaps more so in the prehospital setting. The daily challenges that emergency care providers face in dealing with prehospital pain remain unclear. This study aimed to gain a deeper understanding of acute prehospital pain assessment and management in the Western Cape, South Africa. Methods: A series of focus group discussions, using a constructivist paradigm and qualitative content analysis were conducted. Results: The key themes emerging from six focus groups (total 25 emergency care providers) related to the difficulties of assessing pain in this setting, factors affecting clinical reasoning in this (hostile) setting, the re- alities of prehospital pain care for non-advanced life support practitioners, along with emergency departments’ lack of understanding and appreciation of the prehospital environment, and participants’ suggestions to improve pain practice. Conclusion: Several barriers and enablers, some novel, to pain assessment and management in the South African prehospital setting were identified. Our findings provide valuable insight and understanding of the challenges related to pain care prehospital providers face, in other similar prehospital settings, but also to the global body of knowledge on prehospital barriers and enablers of pain assessment and management.
keywords: پیش بیمارستان | آمبولانس (مش) | خدمات اورژانس پزشکی (مش) | درد حاد (مش) | اندازه گیری درد (مش) | ضد درد (مش) | Prehospital | Ambulances (MeSH) | Emergency Medical Services (MeSH) | Acute pain (MeSH) | Pain Measurement (MeSH) | Analgesics (MeSH)
مقاله انگلیسی
2 Cost-effectiveness analysis of alternative naloxone distribution strategies: First responder and lay distribution in the United States
تجزیه و تحلیل مقرون به صرفه استراتژی های توزیع naloxone جایگزین: اولین پاسخ دهنده و توزیع در ایالات متحده -2020
Background: The U.S. is facing an unprecedented number of opioid-related overdose deaths, and an array of other countries have experienced increases in opioid-related fatalities. In the U.S., naloxone is increasingly distributed to first responders to improve early administration to overdose victims, but its cost-effectiveness has not been studied. Lay distribution, in contrast, has been found to be cost-effective, but rising naloxone prices and increased mortality due to synthetic opioids may reduce cost-effectiveness. We evaluate the cost-effectiveness of increased naloxone distribution to (a) people likely to witness or experience overdose (“laypeople”); (b) police and firefighters; (c) emergency medical services (EMS) personnel; and (d) combinations of these groups. Methods: We use a decision-analytic model to analyze the cost-effectiveness of eight naloxone distribution strategies. We use a lifetime horizon and conduct both a societal analysis (accounting for productivity and criminal justice system costs) and a health sector analysis. We calculate: the ranking of strategies by net monetary benefit; incremental cost-effectiveness ratios; and number of fatal overdoses. Results: High distribution to all three groups maximized net monetary benefit and minimized fatal overdoses; it averted 21% of overdose deaths compared to minimum distribution. High distribution to laypeople and one of the other groups comprised the second and third best strategies. The majority of health gains resulted from increased lay distribution. In the societal analysis, every strategy was cost-saving compared to its next-best alternative; cost savings were greatest in the maximum distribution strategy. In the health sector analysis, all undominated strategies were cost-effective. Results were highly robust to deterministic and probabilistic sensitivity analysis. Conclusions: Increasing naloxone distribution to laypeople and first responder groups would maximize health gains and be cost-effective. If feasible, communities should distribute naloxone to all groups; otherwise, distribution to laypeople and one of the first responder groups should be emphasized.
Keywords: Opioids | Naloxone | Cost-effectiveness analysis | Overdose | First responders | Take-home
مقاله انگلیسی
3 Developing interagency collaboration to address the opioid epidemic: A scoping review of joint criminal justice and healthcare initiatives
در حال توسعه همکاری بین سازمانی برای رسیدگی به اپیدمی مواد مخدر: یک بررسی گسترده از ابتکارات مشترک کیفری و بهداشت و درمان-2020
Background: With the current opioid epidemic impacting well over half of all counties across the United States, initiatives that encourage interagency collaboration between first responder organizations appear necessary to comprehensively address this crisis. Police, fire, and emergency medical services (EMS) are in a unique position to identify substance users and provide necessary resources to initiate treatment, yet there is not sufficient evidence of joint collaborative programs between law enforcement/first responders and healthcare providers. Methods: In this scoping review we examine the current state of joint criminal justice and healthcare interventions, specifically, opioid and substance use pre-arrest initiatives via emergency first responders and police officers. We relied on data from the last 10 years across three major databases to assess the extent of criminal justice (CJ) and healthcare collaborations as a response to individuals with opioid use disorder (OUD). We specifically focused on interventional programs between criminal justice first responders (pre-arrest) and healthcare providers where specific outcomes were documented. Results: We identified only a small number (6) of studies involving interventions that met this criteria, suggesting very limited study of joint interagency collaboration between law enforcement first responders and healthcare providers. Most had small samples, none were in the southern states, and all but one were initiated within the last 5 years. Conclusions: Although studies describing joint efforts of early intercept criminal justice responses and healthcare interventions were few, existing studies suggest that such programs were effective at improving treatment referral and retention outcomes. Greater resources are needed to encourage criminal justice and healthcare collaboration and policies, making it easier to share data, refer patients, and coordinate care for individuals with OUD.
Keywords: Opioid use disorder | First responder | Interagency collaboration | Mortality
مقاله انگلیسی
4 The effectiveness of drug-related Good Samaritan laws: A review of the literature
اثربخشی قوانین سامری خوب مربوط به مواد مخدر: مروری بر ادبیات-2020
Background: The United States (US) and Canada are in the midst of an opioid overdose epidemic. Many people who use illicit drugs (PWUD) do not call an emergency number 911 at the scene of an overdose due to fear of arrest. In the US and Canada, when an individual calls 911, both emergency medical services (EMS) and police are notified to attend the overdose event. In response, many settings in North America have introduced drugrelated ‘Good Samaritan’ laws (GSLs) that aim to encourage PWUD to call 911 by providing legal immunity (mainly protections from drugs possessed for personal use) to those at the scene of the overdose. However, little is known about the effectiveness of these laws in increasing calls to 911. Methods: We conducted a literature review of the published literature between 2005 and 2019 to examine the effectiveness of GSLs. Searches were referenced using keywords that included: “good samaritan”, “overdose”, “emergency services”, and “drug use”. Results: Among 68 articles identified, after eligibility screening, 12 publications were deemed to meet the inclusion criteria. These publications were largely quantitative observational studies (9/12), with a minority (3/ 12) being qualitative in design. Two major themes emerged: “knowledge of GSLs and calling EMS” and “overdose- related hospital admissions and mortality assessment”. Conclusion: At this time, the current body of evidence regarding the effectiveness of GSLs in increasing calls to EMS and reducing drug-related harms is limited and mixed. Studies show that PWUD have low levels of knowledge regarding GSLs while some evidence suggests their effectiveness in increasing calls to EMS at the scene of an overdose. Given the current overdose crisis, further investigation is warranted to establish the effectiveness of these laws in reducing drug-related harms.
Keywords: Overdose | good samaritan | drug policy | emergency services | illicit drugs
مقاله انگلیسی
5 Non-fatal drug overdose after release from prison: A prospective data linkage study
مصرف بیش از حد مواد مخدر غیر کشنده پس از آزادی از زندان: یک مطالعه پیوند داده ای آینده نگر-2020
Background: Adults released from prison are at increased risk of poor health outcomes and preventable mortality, including from overdose. Non-fatal overdose (NFOD) is a strong predictor of future overdose and associated with considerable morbidity. This study aims to the determine the incidence, predictors and clinical characteristics of NFOD following release from prison. Methods: We used pre-release interview data collected for a randomised controlled trial in 2008–2010, and linked person-level, state-wide ambulance, emergency department, and hospital records, from a representative sample of 1307 adults incarcerated in Queensland, Australia. The incidence of NFOD following release from prison was calculated. A multivariate Andersen-Gill model was used to identify demographic, health, social, and criminal justice predictors of NFOD. Results: The crude incidence rate (IR) of NFOD was 47.6 (95%CI 41.1–55.0) per 1000 person-years and was highest in the first 14 days after release from prison (IR=296 per 1000 person-years, 95%CI 206–426). In multivariate analyses, NFOD after release from prison was positively associated with a recent history of substance use disorder (SUD), dual diagnosis of mental illness and SUD, lifetime history of injecting drug use, lifetime history of NFOD, being dispensed benzodiazepines after release, a shorter index incarceration, and low perceived social support. The risk of NFOD was lower for people with high-risk alcohol use and while incarcerated. Conclusions: Adults released from prison are at high risk of non-fatal overdose, particularly in the first 14 days after release. Providing coordinated transitional care between prison and the community is likely critical to reduce the risk of overdose.
Keywords: Drug overdose | Prisons | Cohort studies | Ambulance | Hospital | Emergency medical services
مقاله انگلیسی
6 Ontology Based Public Healthcare System in Internet of Things (IoT)
هستی شناسی مبتنی بر سیستم مراقبت بهداشتی عمومی در اینترنت اشیاء (IOT)-2015
Internet of Things is a growing technology that is predicted to discover new drugs and medical treatments. The efficiency and quality of healthcare have high potential features as flexibility, adaptability, affinity, cost shrinkage, and high speed. This technology helps us to understand the specific risks related to security and privacy. This paper targets on a Healthcare information system based on ontology method. In particular, security and privacy challenges are analyzed in the proposed Ontology-based healthcare information system. Emergency medical services (EMS) are a type of emergency service dedicated to providing out-of-hospital acute medical care, transport to definitive care. Moreover, a functional infrastructure plan is provided to exhibit the unification between the proposed application architecture with the Internet of Things and ontology hierarchy.
keywords: Internet of Things (IoT) | Emergency Medical Services (EMS) | Healthcare Information System | Ontology
مقاله انگلیسی
7 هستی شناسی مبتنی بر سیستم بهداشت و درمان عمومی در اینترنت اشیا
سال انتشار: 2015 - تعداد صفحات فایل pdf انگلیسی: 4 - تعداد صفحات فایل doc فارسی: 8
اینترنت اشیا، تکنولوژی روبه رشدی است که پیش بینی می شود به کشف داروهای جدید و روش های درمان پزشکی کمک نماید. کارایی و کیفیت مراقبت های بهداشتی دارای ویژگی های بالقوه زیادی همچون انعطاف پذیری، سازگاری، وابستگی، کاهش هزینه و سرعت بالا است. این تکنولوژی به ما کمک می کند تا ریسک های مرتبط با موضوع امنیت و حفظ حریم خصوصی را درک کنیم. لذا هدف از مقاله حاضر، بررسی سیستم اطلاعات مراقبت های بهداشتی براساس روش هستی شناسی است. به ویژه، چالش های امنیت و حفظ حریم خصوصی به روش سیستم پیشنهاد شده اطلاعات بهداشت و درمان مبتنی بر هستی شناسی، مورد تجزیه و تحلیل قرار می گیرد. خدمات پزشکی اضطراری (EMS) نوعی از خدمات فوری اختصاص یافته برای ارائه مراقبت های حاد پزشکی خارج از بیمارستان، برای انتقال و تبدیل به مراقبت های قطعی، هستند. علاوه براین، برنامه سازمانی کارکردی، برای نمایش یک شکلی میان ساختار کاربردی پیشنهادی با اینترنت اشیا و سلسله مراتب هستی شناسی، ارائه می شود.
کلمات کلیدی: اینترنت اشیا (IoT) | خدمات پزشکی اضطراری (EMS) | سیستم اطلاعات بهداشت و درمان | هستی شناسی
مقاله ترجمه شده
8 مسئله حداکثر پوشش مکانی با ظرفیت تعدیل گشته برای جایگاه یابی وسایل نقلیه اورژانس
سال انتشار: 2012 - تعداد صفحات فایل pdf انگلیسی: 8 - تعداد صفحات فایل doc فارسی: 29
جهت بهبودی کاربرد مسئله حداکثر پوشش مکانی، چندین مدل ظرفیت سازی شده MCLP جهت مدنظر قرار دادن محدودیت های ظرفیت وسایل مطرح شده است. هرچند، اکثر این مدل ها تنها یک سطح ظرفیت ثابت برای مرکز در هر محل بالقوه در نظر گرفته اند. این فرضیه می تواند کاربرد MCLP ظرفیت سازی شده را محدود سازد. در این مقاله، مسئله حداکثر پوشش مکانی با ظرفیت تعدیل گشته MCMCLP برای امکان پذیر ساختن چندین سطح ظرفیت محتمل برای مرکز در هر محل بالقوه، مطرح و فرمول بندی شده است. این مدل جدید جهت تعیین محل بهینه وسایل نقلیه اورژانس، تخصیص تقاضاهایی بالاتر از استاندرد پوشش خدمات را نیز در نظر گرفته است. دو موقعیت این مدل مورد بحث قرار می¬گیرد. محدودیت مرکز MCMCLP (FC) که تعداد کل مرکز ها برای تعیین محل را مشخص میکند و محدودیت غیرمرکز MCMCLP (NFC) که چنین نیست. به عنوان مثال، MCMClP به همراه سیستم اطلاعات جغرافیایی (GIS) و بسته های نرم افزار بهینه سازی به کار می رود تا به طور بهینه آمبولانس ها را برای خدمات فوریتهای پزشکی (EMS) ناحیه 10 ایالات جورجیا تعیین محل نمایند. محدودیت های این مدل نیز مورد بحث قرار گرفته شده است.
کلمات کلیدی: مسئله حداکثر پوشش مکانی با ظرفیت تعدیل گشته | تخصیص تقاضاهایی بالاتر | سیستم اطلاعات جغرافیایی | ماشین اورژانس
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