Objectives: Ambulance diversion and prolonged prehospital transfer time have a significant impact on patient care outcomes. Self-harm behaviour in particular is associated with difficulty in hospital acceptance and longer prehospital transfer time. This study aimed to determine if hospitals with both medical/surgical and psychiatric inpatient beds and high-level emergency care centres are associated with a decreased rate of difficulty in hospital acceptance and shorter prehospital transfer time for patients seeking medical care after self-harm behaviour.
Design And Setting: A retrospective observational study using the database of Japanese ambulance dispatch data in 2015.
Participants: Patients who were transferred by ambulances after self-harm behaviour.
Interventions: None.
Main Outcome Measures: Multivariable logistic regression analysis and multivariable linear regression analysis were performed to assess whether the presence of hospitals with both medical/surgical and psychiatric inpatient beds and high-level emergency care centres in the city were associated with a decreased rate of difficulty in hospital acceptance and shorter prehospital transfer time.
Results: The number of transfers due to self-harm behaviour in 2015 was 32 849. There was an association between decreased difficulty in hospital acceptance and the presence of high-level emergency care centres (OR 0.63, 95% CI 0.55 to 0.71, p<0.01) and hospitals with both medical/surgical and psychiatric inpatient beds (OR 0.50, 95% CI 0.38 to 0.66, p<0.01). There was a significant reduction in prehospital transfer time in the city with high-level emergency care centres (4.21 min, 95% CI 3.53 to 4.89, p<0.01) and hospitals with medical/surgical and psychiatric inpatient beds (3.46 min, 95% CI 2.15 to 4.77, p<0.01).
Conclusion: Hospitals with both medical/surgical and psychiatric inpatient beds and high-level emergency care centres were associated with significant decrease in difficulty in hospital acceptance and shorter prehospital transfer time.
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http://dx.doi.org/10.1136/bmjopen-2022-065466 | DOI Listing |
Patient Relat Outcome Meas
December 2024
Clinical-Medical Department, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, Galati, Romania.
Introduction: Polytrauma remains a major global health challenge, with rapid intervention being critical for survival, especially during the "Golden Hour". This study examines the impact of Helicopter Emergency Medical Services (HEMS) on procedural care during the transfer of polytraumatized patients to urban hospitals in Romania.
Methods: A retrospective cohort study was conducted at the County Emergency Hospital "St.
Ann Vasc Surg
December 2024
Section of Vascular Surgery, Department of Surgery, Michigan Medicine, Ann Arbor, MI; Jobst Vascular Institute, Toledo, OH.
Objectives: The COVID-19 epidemic introduced significant systems- and disease-based uncertainty into Abdominal Aortic Aneurysm (AAA) rupture management. The goal of this work was to evaluate whether short-term AAA rupture outcomes during COVID-19 were comparable to pre-COVID era outcomes and to explore the impact of COVID status and COVID era healthcare systems restrictions on AAA rupture outcomes.
Methods: The Vascular Quality Initiative (VQI) database was queried for all ruptured AAAs that underwent intervention from January 1, 2019 to August 31, 2022.
Int J Emerg Med
December 2024
Department of Neurosurgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Introduction: Traffic accidents are a major public health concern worldwide, resulting in significant injuries, fatalities, and economic costs. In urban zones, traffic accident dynamics can vary significantly due to population density, infrastructure, and emergency response capabilities. The present study was conducted to determine the time intervals of prehospital emergencies in traffic accidents by separating the 15 zones of Isfahan city, Iran.
View Article and Find Full Text PDFScand J Trauma Resusc Emerg Med
December 2024
Medical University of Vienna, Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Division of General Anaesthesia and Intensive Care Medicine, Spitalgasse 23, 1090, Vienna, Austria.
Background: Emergency Medical Service crews are equipped with comprehensive emergency kits for routine care and to provide life-saving interventions in severely ill patients. While guidelines on contents and packing strategies of emergency kits for specific tasks and specialized situations exist, data for the design of out-of-hospital emergency kits in a general urban population is lacking. It may be possible to transfer the promising results of modern in-hospital packing strategies such as task-based package organization (TPO) to an Emergency Medical Service setting.
View Article and Find Full Text PDFJ Cardiovasc Surg (Torino)
December 2024
Department of Cardiac Surgery, Grenoble Alps University Hospital, Grenoble, France.
Background: Skiing can cause aortic syndromes. The pre-hospital management of these patients may be compromised by the mountainous terrain. A regional emergency care network helps to optimize time frames, especially in a challenging geography.
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