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Dissertations / Theses on the topic 'Ambulance transport'
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Lindgren, Raimo. "Does the use of ambulance helicopter shorten the transport time for trauma patients in Arvika Hospitals catchment area in comparison with land-based ambulance transport?" Thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-70089.
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Introduction: The ambulance helicopter has been an established part of the trauma care in Värmland since 2014. European studies comparing the ambulance helicopters with land-based ambulance often show reduced mortality among patients handled by helicopter. A factor often considered as a risk reducer is shortened transport time. As a step to evaluate trauma care in Swedish rural areas, a study of pre-hospital transport times is required. Aim: The aim of this pilot study was to compare the transport times of the ambulance helicopter with the ground ambulance for trauma patients in the Arvika Hospital catchment area. Methods: Retrospective data from the ambulance register in Värmland and the ambulance helicopter register in Värmland from September to December in 2017 were compared. The transport time of trauma patients from alarm to the start of medical care in hospital was compared between ground- and airborne ambulances. Results: 9 ground ambulance transports were compared with 4 airborne. All helicopter transports in the study were faster than land-based ambulance services with comparable transport distances. No helicopter transport for shorter transports than 134 km was included in the study. Conclusion: In our study, it is shown that for a total transport distance of more than 134 km the transport with helicopter of trauma patients from Arvika Hospital's catchment area to the nearest healthcare facility is faster than by regular ambulance.This study includes only a few transports, and to ensure statistical significance, a larger sample and a more accurate analysis of the complex trauma care are required.
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Dahlström, Elin, and Janina Sundman. "Patienters uppfattning av delaktighet i beslutet att lämnas kvar hemma av ambulansen i Uppsala län." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-295955.
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Introduktion: Vid ca 10 % av alla ambulansuppdrag i Uppsala län åker patienten inte med till sjukhus. Trots att det är viktigt att patienten känner sig delaktig i beslut som tas inom vården finns få studier som undersöker patienters uppfattning av delaktighet i beslutet att lämnas hemma av ambulanspersonalen. Syfte: Att undersöka patienters uppfattningar av delaktighet i mötet med ambulanspersonalen och i beslutet att lämnas kvar hemma av ambulansen i Uppsala län. Metod: En retrospektiv enkätstudie med kvantitativ ansats där svaren samlades in per telefon. Totalt 84 patienter deltog (svarsfrekvens 64 %). Resultat: Majoriteten av patienterna svarade att de kände sig delaktiga under mötet med ambulanspersonalen och i beslutet att lämnas kvar hemma. De patienter som svarat att ambulanspersonalen tog beslutet att de skulle stanna kvar hemma svarade i signifikant lägre grad att de känt sig delaktiga i beslutet att stanna kvar hemma (p<0,001). De patienter som uppsökt vård inom 24 timmar efter mötet med ambulanspersonalen svarade i signifikant lägre grad att de känt sig delaktiga jämfört med de som inte uppsökt vård (p=0,002). Slutsats: Patienter som inte känner sig delaktiga under mötet med ambulanspersonalen uppsöker i högre grad ny vårdinstans inom ett dygn. Det är viktigt att tillräcklig tid tas av ambulanspersonalen för att göra korrekta bedömningar och få patienterna att känna sig delaktiga. Fler studier om situationer där patienter lämnas hemma och sedan söker ny vårdinstans av samma orsak inom ett dygn behövs för att få ökade kunskaper, och därmed kunna minska det antal situationer där patienter i onödan söker ny vård eller undvika att rätt vård fördröjs vid akuta tillstånd.Introduction: In 10 % of all ambulance missions in Uppsala the patients are left at home by the ambulance staff. There are few studies made that investigates patients participation in the decision to be left at home. Aim: To study patients' perceptions of participation in the meeting with the ambulance staff and in the decision to be left at home by the ambulance staff in Uppsala county. Method: A retrospective questionnaire survey with quantitative approach in which the answers were collected by telephone. A total of 84 patients participated (answering frequency 64 %). Result: The majority of patients responded that they felt they participated in the meeting with the ambulance staff and in the decision to be left at home. The patients who responded that the ambulance staff took the decision that they would stay at home responded, to a significantly lower degree, that they felt involved in the decision to stay at home (p<0.001). The patients who sought care within 24 hours after the meeting with the ambulance staff responded, to a significantly lower degree, that they felt they participated compared to those who had not sought care (p=0.002). Conclusion: The patients who don’t feel involved in the meeting with the ambulance staff seeks in higher extent new healthcare within a day. Sufficient time must be taken to make accurate assessments and get the patients to feel involved. More studies of situations where patients are left at home and then seek new care instance of the same cause within a day is needed to get better understanding, and thereby reduce situations where patients unnecessarily seek new healthcare or avoid the right care is delayed in urgent conditions.
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Symons, Andy. "Is the treatment and transport of asystolic cardiac arrest patients to hospital by ambulance services appropriate?" Connect to thesis, 2007. http://portal.ecu.edu.au/adt-public/adt-ECU2007.0031.html.
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Tavares, Tabata Luna Garavazzo. "Caracterização e avaliação do impacto prognóstico das intercorrências clínicas observadas durante o transporte pré-hospitalar e inter-hospitalar de crianças gravemente enfermas." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/17/17157/tde-29032017-155055/.
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Introdução: O transporte médico de crianças gravemente enfermas envolve particularidades que aumentam o risco de complicações, que podem contribuir para o aumento no tempo de internação e mortalidade. Objetivos: Avaliar a frequência e os tipos de complicações observadas durante o transporte pré- hospitalar e inter-hospitalar de crianças gravemente enfermas, assim como o impacto dessas complicações na mortalidade, no tempo de internação hospitalar e nos custos hospitalares. Pacientes e Métodos: Estudo realizado em duas etapas: a primeira foi um estudo transversal, no qual, por meio de entrevista padronizada com o médico que admitiu as crianças gravemente enfermas que necessitaram de transporte pré-hospitalar ou inter-hospitalar, foram identificadas e caracterizadas possíveis complicações ocorridas durante esse transporte. Estes dados foram auditados por três médicos independentes que definiram a presença ou ausência de complicações durante o transporte. A segunda etapa constituiu-se de uma coorte prospectiva, na qual os pacientes, divididos em dois grupos distintos (com e sem complicações durante o transporte), foram seguidos, prospectivamente, por 60 dias, observando-se a ocorrência de morte ou alta hospitalar. Resultados: Foram incluídas 143 crianças no estudo. Pelo menos uma complicação durante o transporte foi observada em 74 pacientes (52%). As complicações mais frequentes foram relacionadas com as vias aéreas (69%), seguidas por distúrbios metabólicos (47%), alterações cardiovasculares (40%) e falhas relacionadas aos dispositivos e à monitorização (37%). Na análise univariada, os seguintes preditores para ocorrência de complicações durante o transporte foram observados: peso <10Kg (risco relativo - RR: 1,52; intervalo de confiança (IC 95%: 1,11-2,09); distância >100Km (RR: 1,67; IC 95%: 1,16-2,40); presença de doença respiratória (RR: 1,46; IC 95%: 1,06-1,95) e comorbidades (RR: 1,68; IC 95%: 1,23-2,30). Já na análise multivariada, não foram observados preditores independentes para ocorrência de complicações. A ocorrência de complicações durante o transporte foi associada com maior taxa de mortalidade hospitalar (hazard ratio - HR: 5,668; IC 95%: 1,26-26,65; p=0,0130) e menor taxa de alta hospitalar (HR: 0,48; IC 95%: 0,31-0,74; p=0,0007). Após a aplicação da regressão de Cox para ajuste de potenciais fatores de confusão, a presença de complicação durante o transporte permaneceu associada com o índice de mortalidade hospitalar (HR: 6,74; IC 95%: 1,40-32,34; p=0,017), contudo deixou de ser associada com o tempo para a alta hospitalar (HR: 0,76; IC 95%: 0,49- 1,16; p=0,213). Conclusões: As complicações foram frequentes durante o transporte pediátrico. A presença de doenças respiratórias, peso <10Kg, presença de comorbidades e a distância >100 Km foram preditores de risco para a ocorrência dessas complicações. As complicações ocorridas durante o transporte foram associadas com o aumento nas taxas de mortalidade hospitalar.Introduction: The medical transport of critically ill children involves characteristics that increase the risk of complications, which can contribute to an increase in length of stay and mortality. Objectives: To evaluate the frequency and type of complications observed during the pre-hospital and inter-hospital transport of critically ill children, as well as the impact of these complications on mortality, length of hospital stay and hospital costs. Patients and Methods: A study carried out in two stages: the first was a cross-sectional study where through a standardized interview with the doctor who admitted the critically ill children requiring pre-hospital or inter-hospital transport identified and characterized possible complications during this transport. These data were audited by three independent doctors who defined the presence or absence of complications during transport. The second stage consists of a prospective cohort study, where patients divided into two groups (with and without complications during transportation) were followed prospectively for 60 days observing the occurrence of death or hospital discharge. Results: We included 143 children in the study. At least one complication during transportation was observed in 74 patients (52%). The most frequent complications have been associated with airway (69%), followed by metabolic disorders (47%), cardiovascular disorders (40%) and failure in the device and monitoring (37%). In the uni-variate analysis, the following predictors for the occurrence of complications during transport were observed: weight <10 kg (relative risk - RR: 1.52; 95% confidence interval - CI: 1.11-2.09); distance greater than 100 km (RR: 1.67; 95% CI: 1.16-2.40); presence of respiratory disease (RR: 1.46; 95% CI: 1.06-1.95) and associated comorbidity (RR: 1.68; 95% CI: 1.23- 2.30). In the multivariate analysis, no independent predictors were observed for the occurrence of complications. The occurrence of complications during transport was associated with higher hospital mortality (hazard ratio - HR: 5.668; 95% CI: 1.26-26.65; p=0.0130) and a lower hospital discharge rate (HR: 0.48; 95% CI: 0.31-0.74; p=0.0007). After Cox regression to adjust for potential confounding factors, the presence of complications during transport remained associated with hospital mortality (HR: 6.74; IC 95%: 1.40-32.34; p=0.017), however, was not associated with hospital discharge rates (HR: 0.76; 95% CI: 0.49-1.16; p=0.213). Conclusions: The complications were common during pediatric transport. Distance greater than 100 km, presence of respiratory disease, associated comorbidity and weight <10 kg were risk predictors for occurrence of complications. Complications during pediatric transport were associated with increased hospital mortality rates.
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Eriksson, Ingela, and Christina Werner. "Ambulanspersonalens upplevelser av trafiksäkerheten i vårdutrymmet i vägburna ambulanser." Thesis, Karlstad University, Faculty of Social and Life Sciences, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-1312.
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Ambulanssjukvård bedrivs både på hämtplats och under transporten till mottagande enhet. Detta medför att personalen utför vårdåtgärder i vårdutrymmet under transporten enligt tidigare forskning sker detta ofta utan att personalen använder sig av bilbältet.
Syftet med denna studie var att undersöka ambulanspersonalens upplevelser av trafiksäkerheten i vägburna ambulanser.
Metoden har varit intervjuer med semistrukturerade frågor samt en öppen fråga. Intervjuerna har genomförts med ambulanspersonalen i deras arbetsmiljö, det vill säga ambulansens vårdutrymme. Intervjuerna har sammanställts och en innehållsanalys har gjorts på den öppna frågan.
Resultatet visar att personalen inte använder säkerhetsutrustningen i den utsträckning som de borde och vill göra. Arbetsmiljön och patientens tillstånd var helt avgörande. Personalen satte sin egen säkerhet åt sidan och fokuserade helt på patienten och dennes behov. Personalen upplevde dock att patienterna var trygga i vårdutrymmet.
Enligt flera forskare så har problemet med bilbältesanvändning i vårdutrymmet uppmärksammats under flera år. Men inga nya metoder eller idéer har anammats. Denna studies resultat förväntas öka förståelsen för den problematik som finns med att arbeta i ambulansens vårdutrymme på ett för personalen säkert sätt.
Prehospital care is carried out on the scene and during transport to a reciving unit. Thus, the ambulance staff is performing care assignment in the patient compartment during transport. According to prior research, the care is often made by the attending personal not using the seatbelts.
The aim of this study was to examine the ambulance staff´s experiences of traffic saftey in the patient compartment in a road ambulance.
The method used was semi structured interviews and one open question. The interviews have been carried out in the ambulance staff own working environment, the patient compartment. The interviews were put together and the open question was analysed by means of a qualitative content analysis.
The result shows that the ambulance staff did not use the saftey equipment in the patient compartment to the extent they should and whished to do. The working environment and the patient´s condition were the reason for not using seatbelts. The ambulance staff put their own saftey a side, and focused completley on the patient and his or her needs. However, the ambulance staff felt that the patient was safe in the patient compartment.
Several studies have previously shown that there is a problem with the lack of use of seatbelts in the patient compartment. However, no new ideas or method for consistent use of seatbelts has been adopted. The result of this study should increase awareness for the complex problems concerning work saftey for ambulance staff in the patient compartment.
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Insulander, Ahnmark Kajsa, and Jonny Wennberg. "Då patienten inte åker med ambulansen för fortsatt vård, en studie med aspekt på patientsäkerheten : En retrospektiv journalgranskningsstudie av 137 utlarmningar." Thesis, Sophiahemmet Högskola, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-990.
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ABSTRACT Introduction: During the past 40 years the ambulance service in Sweden has evolved from mainly being a source of transport to today’s high-tech caring facilities that enable qualified care to start already in the patient’s home. This first level of care is now provided by registered nurses and registered nurses with specialist training in pre hospital care. At the same time as the care provided is becoming more advanced, results from studies demonstrate that the amount of dispatches to patients that lack the need for ambulance care and transport is increasing. Nurses in pre-hospital care possess the knowledge, training and authority to perform an initial assessment of patients and also treat patients according to local and national guidelines. After the treatment it would sometimes be possible for the patients to remain at home without having to use ambulance transport to an emergency department or in other cases find other means of transport to hospital. Today this is, in Sweden, an accepted standard for by district nurses who are mandated to refer, even after only telephone consulting, the patients to self-care. Ambulance nurses lack this according to present guidelines. If a patient is to remain on-scene or home, a strict protocol of documentation has to be filled-in as well as the ambulance crew being in contact with a doctor. In this study, the authors visualize what patient categories stay on-scene or home, what types of examinations was performed and if the patient safety is ensured. Objective: The aim of this study was to visualize patient safety when the patient is not transported to hospital by ambulance. Method: A quantitative, descriptive and retrospective design and analysis of 137 ambulance medical records where the patient was left at home after the initial assessment. Results: The results demonstrate that the patients who wish to remain on-scene have various different conditions. The majority stayed home at their own request and without any further treatment being performed by the pre hospital care provider. In 28 per cent the patients received some kind of treatment, and in some of the cases patients refused ambulance transport even when the ambulance nurse strongly recommended this. This study also demonstrated that, in many cases, the patients´ history as well as the patients´ status were incomplete documented. The ambulance nurse performed, in median, four different examinations on the patients. In more than half of the cases the nurses had documented that the patient had some kind of attendance. Counseling was given both to patients and sometimes to the patients’ family member. A lack of sufficient documentation in the patients’ medical record was found and also that consultation of a doctor only has been completed in 15 per cent. Of a total of 137 patients there were three patients who called for an ambulance within the following 24 hours. One of these became aggressive during the first time of visit, and therefore the nurse wasn´t able to examine her thoroughly. The two other patients do not differ regarding the extent of the examination compared to those who didn´t call for ambulance again. Conclusion: Although this paper demonstrates that patients´ safety has not been compromised in the examined records, the authors recommend further studies on patient safety when patient remain on-scene. There is also a need for more specific and valid indicators. Documentation and adherence to guidelines were, however, in this study found to be insufficient. Key words: patient safety, ambulance, patient, specialist nurse in pre hospital care science, nurse, transport, journal.
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Lind, Rose-Marie, and Pär Lindblad. "Från prio ett larm enligt medicinskt index till bedömning av egenvård enligt RETTS : En kvantitativ granskning av ambulansjournaler." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-62508.
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Bakgrund: Enligt statistiken har ambulansutryckningarna ökat men ambulanstätheten minskat. Det behövs därför en väl fungerande prioritering av patienterna som söker akut vård från larmcentralen. De som inte är i akut behov av ambulanstransport till sjukhus ska kunna omdirigeras till att söka annan vård som vårdcentral eller stanna hemma med egenvård. Syfte: är att jämföra patienter med samma ESS kod i ambulansjournalerna som endera transporterades till sjukhus eller kvarstannande med egenvård vid prio ett larm. Metod: En retrospektiv fallkontroll studie med en kvantitativ ansats. En journalgranskning med 139 inkluderade ambulansjournaler från södra Sverige. Resultat: Andelen prio ett uppdrag där patienten lämnades hemma med egenvård i föreliggande studie var 193 stycken, 7,2 procent. Utifrån resultatet fanns det inga skillnader i åldern mellan patienter som stannade kvar respektive transporterades med ambulans till akuten på respektive sjukhus. Det fanns heller inga signifikanta skillnader mellan könen utifrån tid på dygnet. Dock fanns det en signifikant skillnad då det gällde avstånd till sjukhus. För patienterna som bodde ≤ 8 km radie från ett sjukhus stannade 83st (59,7%) kvar i hemmet med egenvård. För patienter med ≥ 8 km ifrån ett sjukhus stannade 106 (76,3 %) kvar i hemmet med egenvård. Totalt för patienter som transporterades överensstämde larmcentralens index med ambulanssjuksköterskans ESS-kod vid 52%. För patienter som kunde kvarstanna i hemmet var överensstämmelsen 42% mellan larmcentralens index och ambulanssjuksköterskans ESS. Slutsats: Studien kunde inte påvisa någon skillnad mellan kön och tidpunkt av de som transporterades mot de som kunde stanna hemma, dock fanns det en signifikant skillnad på antal patienter som transporterades och kunde stanna hemma beroende på avstånd mellan deras boende och sjukhus. Även fanns det en förbättringspotential mellan SOS index och ambulanssjuksköterskans ESS kod, att denna skulle stämma mer överens. För ambulanssjuksköterskan är det viktigt att behandla alla patienter lika oberoende på yttre faktorer, i denna studie framkom att avståndet hade en betydelse. Detta får vi som ambulanssjuksköterskor ta till oss och inte låta ha en avgörande betydelse för den vård vi beslutar oss för att ge patienten.Background: According to statistics, ambulance emergency were increased but the density decreases, which requires a well-functioning prioritization of patients seeking emergency care from the central station. Those who are not in need of urgent ambulance transport to the hospital to be redirected to seek other care medical center or stay at home with self-care. Purpose: is to compare patients with the same ESS Code of ambulance records that are either transported to a hospital or keeping people with self-care at priority alarm. Method: A retrospective case-control study with a quantitative approach. A medical record review of 139 included ambulance records from southern Sweden. Results: The proportion of priority a mission in which the patient was at home with self-care in this study were 193 pieces, 7.2 per cent. Based on the results, there were no differences in age between patients who remained and was transported by ambulance to the emergency room and hospital. There were also no significant differences between the sexes based on time of day. However, there was a significant difference as regards the distance to the hospital. For patients who lived ≤ 8 km radius of a hospital stayed 83st (59.7%) remain in the home with self-care. For patients with ≥ 8 km from the hospital stayed 106 (76.3%) remain in the home with self-care. Total of patients transported consistent monitoring center index with the ambulance nurse ESS Code at 52%. For patients who were able to remain in the home was the consistency 42% between the central station's index and the ambulance nurse ESS. Conclusion: The study did not demonstrate a difference between gender and time of the transported toward those who could stay at home, however, there was a significant difference in the number of patients who were transported and could stay home, depending on the distance between their accommodation and hospitals. Although there was an improvement in potential between SOS Index and the ambulance nurse ESS code. For ambulance nurse, it is important to treat all patients equally regardless of external factors, in this study revealed that the distance had a meaning. This we get that ambulance nurses bring to us and not let be crucial for the care we decide to give.
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Moore, Simon Peter. "Delays in the emergency department and their effects on the ambulance provider." CSUSB ScholarWorks, 2002. https://scholarworks.lib.csusb.edu/etd-project/2067.
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Axelsson, Isabelle, and Kyander Christina Bolin. "Ambulanssjuksköterskans upplevelser och uppfattningar av säkerhetsbältets användning på patienten under ambulanstransport : En intervjustudie." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-85270.
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Bakgrund: Det prehospitala arbetet är utmanande i avseende att kombinera ett patientsäkert vårdarbete och yrkesmässig bilkörning. Vårdutrymmet i en ambulans är en riskfylld miljö både då bilen står parkerad på en olycksplats samt när den är i rullning. Trafiksäkerhet i ambulanssjukvård är därav en avgörande faktor för patientsäkerheten och ambulanssjuksköterskans arbetsmiljö. Brister denna säkerhet riskerar patienten att bli utsatt för ett vårdlidande och ambulanssjuksköterskan för en arbetsmiljöskada. Syfte: Syftet med studien är att beskriva ambulanssjuksköterskans upplevelser och uppfattningar av säkerhetsbältets användning på patienten under ambulanstransport och på så vis öka följsamheten gällande säkerhetsbältes användning. Metod: En kvalitativ intervjustudie genomfördes med enskilda intervjuer. Kvalitativ innehållsanalys med induktiv ansats användes som analysmetod. Resultat: Analysen resulterade i 5 kategorier som bildade resultatets rubriker “bältets betydelse”, “svagheter och brister”, “hinder för säkerhetsbälte”, “arbetsmiljö och säkerhet” samt “samverkan mellan förare och vårdare”. Slutsats: Av studiens resultat kunde slutsatsen dras att säkerhetsbältesanvändningen i ambulansen har stor förbättringspotential samt att upplevelse och uppfattning går i sär med hur verkligheten ser ut. Resultatet visar även vilka orsaker till en bristande bältesanvändning som är vanligast och förslag på hur man kan komma till rätta med dessa. Att säkerhetsbältesanvändningen för patienterna i ambulansen förs upp till diskussion är av stor vikt för att främja patientsäkerheten och ambulanssjuksköterskans Arbetsmiljö̈. För att öka följsamheten gällande säkerhetsbältesanvändningen är det av värde att flera studier utöver denna genomförs utifrån olika synvinklar, exempelvis patientens upplevelseBackground: The pre-hospital work is challenging in terms of combining apatient-safe care work and professional driving. The care room in an ambulance is a risky environment both when the car is parked on an accident site and when it is rolling. Traffic safety in ambulance care is therefore a crucial factor for patient safety and the ambulance nurse's work environment. If this safety fails, the patient risks being exposed to a suffering patient and the ambulance nurse for a work environment injury. Purpose: The purpose of the study is to describe the ambulance nurses experiences and perceptions of the safety belts use on the patient during ambulance transport and in this way increase compliance with seat belt use. Method: A qualitative interview study was conducted with individual interviews. Qualitative content analysis with inductive approach was used as analysis method. Result: The analysis resulted in 5 categories that formed the results headings “the importance of the belt”, “weaknesses and deficiencies”, “obstacles to safety belts”, “work environment and safety” and “collaboration between driver and carer”. Conclusion: From the results of the study, it could be concluded that the seat belt use in the ambulance has great improvement potential and that experience and perception go in particular with the reality. The result also shows the reasons for a lack of belt use that is most common and suggestions for how to deal with these. The fact that the safety belt use for the patients in the ambulance is brought up for discussion is of great importance for promoting patient safety and the ambulance nurses working environment. In order to increase adherence to seat belt use, it is of value that several studies in addition to this are carried out on the basis of different perspectives, forexample the
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Gaute, Gilles. "Evaluation et perspectives de restructuration du système des transports ambulanciers intrahospitaliers au C. H. U. De Bordeaux." Bordeaux 2, 2001. http://www.theses.fr/2001BOR2M041.
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Stewart, Kenneth Edward. "Emergency medical transport of trauma patients a comparision of helicopter and ground ambulances /." Oklahoma City : [s.n.], 2010.
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Lepy, Christophe. "Transport de nouveaux nés : bilan d' activité du SAMU de Montluçon : années 1985-1986." Clermont-Ferrand 1, 1987. http://www.theses.fr/1987CLF13025.
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L' auteur, après avoir rappelé les problèmes généraux concernant les transports de malades et les exigences propres des transferts de nouveau-nés, fait le point sur les possibilités matérielles et médicales du SMUR de Montluçon et sur les activtés de ce service dans le domaine pédiatrique. Il analyse l' aspect quantitatif et qualitatif, la réussite et les facteurs limitants de l' activité pédiatrique du SMUR durant les transferts primaires et secondaires.
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Ferzli, Raphaële. "Organiser des ambulants : une analyse sociologique de la coordination des flux d'hommes, de véhicules, de marchandises." Versailles-St Quentin en Yvelines, 2007. http://www.theses.fr/2007VERS001S.
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Comment organiser la coordination des flux dans les entreprises de transport et de logistique ? Quelles sont les logiques de coopération et /ou de segmentation qui y sont à l’œuvre ? Comment s’opèrent les articulations entre processus dans des organisations dans lesquelles il n’y a pas d’unité de temps, de lieu ou d’action pour les simplifier ? En s ‘appuyant sur plus d’une cinquantaine d’entretiens et de nombreuses observations réalisées dans trois entreprises différentes, notre analyse s ‘attache à apporter des réponses à ces questions. Ainsi, dans une perspective qui ne considère pas les processus de coordination comme dotés d’une évidence naturelle, nous proposons à travers cette recherche une analyse des mécanismes sociaux qui les sous-tendent et en permettent la mise en œuvre, ainsi qu’une analyse des supports sur lesquels ils prennent appui. Ainsi, des outils informationnels à la confiance, en passant par les indicateurs de gestion, les vecteurs de la coopération sont mis en perspective, pour éclairer, finalement, la complexité qui entoure les mécanismes de coordinationThe purpose of this research-work/ thesis is to determine how the coordination of the flows in transport and logistic companies is to be organized? Let us focus on the logic of human cooperation and/or segmentation which is actually in use? How do the articulations between the various processes - meant to simplify them- work together within the organizations deprived of time units, space units and action units? Relying on about fifty interviews and numerous observations carried out in three different companies, our analysis aims at providing answers to these questions? Thus, considering that coordination is not an obvious natural agent/factor, this research-work may enable us to analyse the implied social mechanisms which help them work as well as the media upon which they rely. So, from management tools of information to the notion of confidence, going through management indicators, all those cooperation agents/factors are compared in order to clarify the complexity which surrounds the coordination mechanisms
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Sjöberg, Victoria, and Ellen Dahlgren. "Att vårda i en ambulans: : Intensivvårdssjuksköterskors upplevelser av att vårda kritiskt sjuka patienter under markbundna interhospitala transporter." Thesis, Umeå universitet, Institutionen för omvårdnad, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-99063.
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ABSTRAKT Bakgrund: Interhospitala transporter innebär ökade risker för medicinska komplikationer för den kritiskt sjuka patienten. Inom ramen för intensivvårdsjuksköterskans kompetens ingår att kunna utföra omvårdnad till den kritiskt sjuka patienten under interhospitala transporter. Sjuksköterskor med specialistutbildning inom intensivvård kan under transport av kritiskt sjuka patienter uppleva oro. För att kunna förbättra omhändertagandet av patienten är det av intresse att ta reda på om det finns fler perspektiv och upplevelser av arbetet vid denna komplexa situation som en interhospital intensivvårdstransport innebär.Syfte: Syftet med denna studie var att beskriva intensivvårdssjuksköterskors upplevelse av att vårda kritiskt sjuka patienter under markbundna interhospitala transporter.Design: Denna studie har en kvalitativ design.Metod: Semi-strukturerade intervjuer med åtta intensivvårdssjuksköterskor spelades in och transkriberades för att sedan analyseras med tematiskt analys.Resultat: Ur analysen konstruerades tre huvudteman. Att sträva efter att ha kontroll över situationen, Betydelsen av ett bra samarbetet i teamet och Att utmanas i sin yrkeskompetens.Slutsats: Resultatet visade att transportera kritiskt sjuka patienter mellan sjukhus kan ge upphov till både negativa och positiva känslor. Uppgiften kan göra att intensivvårdssjuksköterskorna känner sig utelämnande men samtidigt självständiga och att detta kan vara kopplat till den individuella erfarenheten. Att förbereda patienten kan vara en procedur som även innebär att intensivvårdssjuksköterskorna mentalt förbereder sig själva och därmed ger dem förutsättningar att känna trygghet under transport.Relevans för klinisk praktik: Klinisk träning och simuleringsövningar i ambulans skulle kunna öka möjligheten för intensivvårdssjuksköterskor att känna sig trygga och självständiga när de transporterar kritiskt sjuka patienter mellan sjukhus. NYCKEORD: Intensivvård, Intensivvårdssjuksköterska, Interhospital transport.Tematisk analys
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Takeda, Renata Algisi. "Uma contribuição para avaliar o desempenho de sistemas de transporte emergencial de saúde." Universidade de São Paulo, 2000. http://www.teses.usp.br/teses/disponiveis/18/18137/tde-15052014-102209/.
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A rapidez na realização do atendimento às vítimas é uma das maiores necessidades de serviços de atendimento médico de urgência, e o tempo decorrido entre o instante da ocorrência da solicitação pelo serviço e o início do atendimento, denominado tempo de resposta, é um dos principais fatores que influenciam o desempenho do sistema. Este tempo depende de uma reunião de fatores como condições de tráfego, dia e período do dia, número de veículos disponíveis e suas localizações, capacitação profissional da equipe, etc. Apresenta-se neste trabalho uma análise do desempenho do serviço oferecido na cidade de Campinas-SP, tratando o problema por meio do modelo hipercubo de filas, que considera as variações aleatórias dos processos de chegadas e atendimento dos chamados. Sua aplicação produz uma ampla variedade de indicadores de desempenho para o sistema, que são comparados com os valores reais observados, para validar a hipótese de aplicação do modelo. Os resultados de sua aplicação para configurações operacionais alternativas, tais como descentralização e aumento do número de ambulâncias, mostraram uma elevação significativa do nível de serviço oferecido ao usuário. Conclui-se que o modelo constitui uma importante ferramenta de análise para este tipo de sistema, auxiliando na tomada de decisões estratégicas e operacionais do sistema.One of the major concerns of medical emergency systems is to provide the fastest possible medical attention for the victims. The time elapsed between the emergency call and the assistance, called the response time, is one of the main factors that influence the system\'s performance. This time lapse depends on traffic conditions, the day of the week and time of day, the number of available vehicles and their location, the rescue team\'s professional qualifications, etc. This work consists of an analysis of the performance of the emergency service available in Campinas, SP, and deals with the problem using the hypercube queuing model, which considers stochastic variations of the arrival and assistance processes. The application of this model produces a wide variety of system performance indicators, which are compared with the real observed values to validate the model\'s hypothetical application. Application of the model in alternative operational scenarios, such as decentralization and a greater number of ambulances, showed a significant increase in the quality of the service offered to the user. It was concluded that the model constitutes an important analytical tool for this type of system, serving as an aid for strategic and operational decision-making.
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Bernal, Nathalie. "Le transport héliporté au niveau du SAMU de Carcassonne." Montpellier 1, 1990. http://www.theses.fr/1990MON11158.
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Palacios, Alejo Raquel. "Alimentos ofrecidos ambulatoriamente y características del comprador en vehículos de una empresa de transporte público, Lima-2015." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2016. https://hdl.handle.net/20.500.12672/5564.
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Identifica los alimentos ofrecidos ambulatoriamente y características del comprador en vehículos de una Empresa de transporte Público. El estudio fue de tipo cuantitativo, descriptivo y transversal. Se realizó en Vehículos de una Empresa de transporte Público cuya ruta inicia en el distrito de Ate y finaliza en el mismo después de recorrer ocho distritos de la ciudad de Lima. Durante las mañanas y tardes de los siete días de la semana, estación verano, se observaron los alimentos ofrecidos por los vendedores y las características aparentes del comprador.Tesis
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Halt, Julia, and Strannerdahl Anders. "Anestesi- och ambulanssjuksköterskors erfarenheter av teamarbete vid interhospitala transporter : en intervjustudie." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-64411.
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Bakgrund: Interhospitala transporter ökar årligen inom Sverige. För att en interhospital transport skall utföras med god vårdkvalitet ställs höga krav på samarbete mellan de olika professionerna. Ett väl fungerande team underlättar arbetet och leder till ökad trygghet hos personalen vilket troligen kommer att påverka den vård patienten får. Det finns emellertid begränsad kunskap om hur teamarbetet fungerar vid interhospitala transporter och vad personalen har för erfarenhet av det. Syfte: Syftet med studien var att beskriva anestesi- och ambulanssjuksköterskors erfarenheter av teamarbetet vid interhospitala transporter. Metod: Studien utfördes med en kvalitativ metod där semistrukturerade intervjuer genomfördes med tolv anestesi- och ambulanssjuksköterskor vid två olika regioner i södra Sverige under våren 2017. Analysen företogs med en kvalitativ innehållsanalys enligt Graneheim och Lundman (2004). Resultat: Resultatet redovisas i fyra kategorier med underkategorier. Erfarenheterna tyder på ett överlag välfungerande teamarbete vid de interhospitala transporterna. Kommunikation, ansvarsfördelning och tidigare erfarenheter uppfattades påverka samarbetet samt den vård som patienten fick. Relationerna i teamet samt attityder hos teammedlemmarna innebär en utmaning för synergin i teamet. Slutsats: Ett välfungerande teamarbete utgörs av tydlig kommunikation, relationerna i teamet samt grundlig kompetens vilket framkallar en trygghet i teamet. Erfarenheterna av samarbetet vid interhospitala transporter är bra samtidigt som det finns ett behov och en vilja till förbättring.Background : The interhospitala transports of intensive care patients is increasing every year in Sweden. To make sure that the transport between the various units are- performed to the highest possible level of care it is vital that a high standard of co-operation is performed with all professionals involved. Well organized teamwork eases the workload and helps to give a feeling of security with all staff involved which is then likely to positively affect the care of the patient in focus. However there is still a limited knowledge about how a well functioned teamwork is interpreted between all parts involved in transportation of intensive care patients. Purpose: The purpose with this study was to describe the Nurse anesthetists and Ambulance nurses experiences of teamwork at interhospitala transports. Method: This study was implemented with a qualitative method where semi-structured interviews took place with 12 Nurse anesthetists or Ambulance nurses in two different regions in the south of Sweden during the spring of 2017. The analysis was completed with a qualitative content analysis according to Graneheim and Lundman (2004). Result: The result is presented in four categories. The experiences of those involved gave an interpretation of a mainly well-functioning teamwork. However communication, division of responsibilities and competence are main factors with recurring issues which was perceived to affect the cooperation of all professions involved and of course the treatment that the patients receive. The relations in the team as well as the attitudes of the team members funds challenges for the synergy in the team. Conclusion : A well functioning teamwork is built from clear communication, relations in the team and thorough expertise which will lead to a feeling of safety in the team. The experiences of the cooperation in interhospital transports are good, at the same time as there is a need and a will to make improvements.
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Sjöberg, Christoffer, and Martin Rosander. "Ambulanssjuksköterskans ansvarsfulla bedömning : En kvalitativ studie om ambulanssjuksköterskors upplevelser vid den prehospitala bedömningen." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-102056.
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Bakgrund: För att arbeta inom ambulanssjukvården krävs en hög medicinsk kompetens samt en förmåga att kunna fatta snabba beslut. Då antalet ambulansuppdrag har ökat skall fler patienter bedömas och hänvisas till lämplig vårdnivå. Ambulanssjuksköterskan ställs inför en ansvarsfull bedömning då patienten skall hänvisas till rätt vårdnivå, både för att optimera utnyttjandet av vårdresurserna och för patientens bästa. Syfte: Belysa ambulanssjuksköterskans upplevelser vid bedömning och hänvisning. Metod: Studien genomfördes med en kvalitativ design. För insamling av data användes ett frågeformulär med öppna frågor. Deltagarna valdes ut genom ett strategiskt urval inom två ambulansstationer i södra Sverige. För att analysera resultatet användes Graneheim och Lundmans (2004) innehållsanalys. Resultat: I resultatet framkom varierande upplevelser avseende bedömning och hänvisning. Undersökningsmöjligheter och beslutsunderlag sågs av vissa respondenter som tillräckliga och av andra som otillräckliga för att kunna göra en trygg bedömning och hänvisning. Vid undersökning av sjuksköterskans upplevelser av bedömning och hänvisning framkom även vikten av ett bra vårdmöte med patient och anhöriga. Det framkom också att ett gott samarbete med andra vårdaktörer var viktigt för att kunna göra en trygg bedömning och hänvisning. Sjuksköterskans bedömning och hänvisningen präglades av ett ansvar att alltid göra sitt yttersta för patienten, det latenta temat i resultatet blev slutligen den ansvarsfulla bedömningen. Slutsats: Sjuksköterskorna uppgav att rådande undersökningsmöjligheter och bedömningsunderlag påverkade bedömningen och hänvisningen. Även samverkan med andra vårdaktörer, patient och anhöriga var något som påverkade det prehospitala arbetet. Sjuksköterskans upplevelser av ansvar för patienten präglade bedömningen och hänvisningen, oron över att fatta fel beslut ledde många gånger till bristande hänvisning. Bristande hänvisning kunde ibland leda till att patienten inte erhöll rätt vårdnivå och att vårdresurser utnyttjades på fel sätt.
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Magy, Tania. "L' art Rom, des transports amoureux. . . : un atelier ambulant d'arts plastiques : des partages d'en-saignements, entre Tsiganes, Gadjé et autres voyageurs dans le temps." Paris 1, 2002. http://www.theses.fr/2002PA010623.
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Un art Rom, direz-vous ? Qui sont les Roma, les Gitans, entre craintes et moqueries, un peuple de poètes sans terre ? Quelles sont leurs expressions artistiques et "plastiques" ? La description d'élans, de saveurs, transports amoureux, l'éblouissement des rencontres, l'art de la foire, la foire de l'art ? Qu'en est-il vraiment de ma pratique singulière et de mon implication dans toute cette merveilleuse histoire ? Pour la suite, il s'agit d'interroger, de vivre, les thématiques "d'enseignement ambulant", "d'utopie nomade", des croisements de routes, de genres, entre norme et marge, des moments de vie, la construction et le cheminement de projets artistiques. Du suspense, de l'émotion ! Rencontrer de multiples pratiques itinérantes, des arts plastiques riches de leurs différences, grand déballage et stationnement autorisé !
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Lundgren, Kristin. "Oro och farhågor i samband med överrapportering av patienter som transporteras av ambulans mellan två vårdinrättningar : en kritisk incidentstudie av upplevelser hos sjuksköterskor inom ambulanssjukvården." Thesis, Högskolan i Borås, Akademin för vård, arbetsliv och välfärd, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-12316.
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Tidigare forskning har identifierat bristande överrapportering mellan yrkesgrupper som en av riskfaktorerna i samband med en interhospital transport. Studiens syfte var att utifrån kritiska händelser beskriva upplevelser av oro och farhågor hos sjuksköterskor inom ambulanssjukvården i samband med överrapportering av patienter som transporteras av ambulans mellan två vårdinrättningar. Metoden för studien var kritisk incidentteknik (CIT). Datainsamlingen utfördes i ett landsting i södra Sverige där sex sjuksköterskor inom ambulanssjukvård deltog. Intervjuerna transkriberades och analyserades enligt kritisk incidentteknik. I resultatet framkom fem huvudkategorier av oro och farhågor hos sjuksköterskor inom ambulanssjukvården i samband med överrapportering; Oro och farhågor för att nedgraderas till transportör, Oro och farhågor för rationalisering och slarv, Oro och farhågor för den prehospitala arbetsmiljön, Oro lindras genom att mottagande personal efterfrågar ytterligare information och Oro lindras genom tydligt medicinskt ansvar. Studien visar att oro och farhågor i samband med överrapportering av patienter som transporteras av ambulans mellan två vårdinrättningar kan relateras till ett patientansvar, yrkesrollen och arbetsmiljö. Den interhospitala transporten har en betydelsefull påverkan både på vårdrelationen till patienten och ambulanssjuksköterskans yrkesidentitet. Då sjuksköterskor inom ambulanssjukvård upplevt en adekvat och god överrapportering beskrevs det bidra till en patientsäker vård och upplevelse av lugn och trygghet i yrkesrollen. Överrapporteringen bör därför betraktas som en grundförutsättning för professionellt vårdarbete inom ambulanssjukvård.
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Calle, Vera Andrés Manuel. "Comercio ambulatorio y sentidos de reciprocidad: El caso de los vendedores en los ómnibus del transporte público de la Vía Expresa de Lima." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2012. https://hdl.handle.net/20.500.12672/15638.
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Publicación a texto completo no autorizada por el autorLa revisión de importantes autores que han abordado la explicación del fenómeno de la informalidad nos conducen a las vías sociológicas, jurídicas, económicas y antropológicas que, en el fondo privilegian lo económico, lo legal o lo cultural para tratar de explicar y descubrir los sistemas y procesos que se reproducen tras de la informalidad en un contexto de pobreza y subordinación en el que desenvuelve el país. La antropología, encuentra que, en la informalidad urbana, se manifiestan patrones culturales de conducta muy ligados en su mayoría a las tradiciones andinas enriquecidas o transformadas por la modernidad. Así, la solidaridad, el amor al trabajo, la ayuda mutua, la reciprocidad, la redistribución, etc., son los principales instrumentos que validan la dinámica entre los informales, los que a su vez se tiñen con los valores de la competencia, ganancia, lucro, ventaja, explotación, etc., propias del mercado autorregulado. Investigaciones como las de Degregori (1986), Golte (1988) y Valdivia-Adams (1991), dejan claro precedente de la mixtura y combinaciones de la informalidad, el mercado y los migrantes provincianos en Lima. Un enfoque de corte liberal y legal, señala que la causa de la informalidad en general, es el complejo y enmarañado conjunto de normas burocráticas y jurídicas que, prácticamente impiden y desaniman la formalización y capitalización del potencial empresarial y humano que posee el peruano, Hernando de Soto (1986), ha sido el principal exponente conceptual de esta orientación y, entre sus contribuciones gubernamentales se cuentan la Ley de Simplificación Administrativa, incorporada por el gobierno de García Pérez y el impulso de la Titulación de la Propiedad Informal durante el gobierno de Fujimori. Desde la historia reciente, un estado centralista y elitista, ha terminado por asfixiar el interior del país, abandonándolo en grandes vacíos y ausencias económicas y políticas. Estas condiciones, desde la década del 50, han producido consistentes oleadas migratorias sobre las ciudades de la costa, especialmente Lima. Estas nuevas condiciones, no previstas, han desbordado las capacidades y servicios instalados en las ciudades que al ver quintuplicadas las demandas de trabajo, vivienda, salud, educación; entra en un proceso de informalidad generalizada. A estas características se suman la discriminación y marginación que padecen los migrantes andinos en las grandes ciudades según observaba Quijano (1980), y con ellas la imposición de una ciudadanía inacabada y endeble, señalada por López (1995), o que el mismo autor calificaría dos años después como una “ciudadanía de segunda clase, imaginaria” (1997). Sin embargo, “unos peruanos son más ciudadanos que otros” (López, 1997:230) no todos acceden a los derechos ciudadanos en igualdad de condiciones, en tanto que los derechos civiles, políticos y sociales han quedado reducidos a la propiedad individual, a la libreta electoral y a los derechos del trabajador respectivamente. Y, por otro lado, la pobreza como expresión clara de la desigualdad social y la discriminación cultural, está fuertemente relacionada con los niveles de ciudadanía: “a medida que la pobreza aumenta, la ciudadanía disminuye, y a medida que aquella disminuye, esta aumenta” (López, 1997:459-461). Y, si la pobreza excluye o incorpora en la ciudadanía, el mercado, puede llegar a convertirse en la primera vía para acceder a ella. Tal es el caso de los migrantes étnicos que, debiendo anular o, estratégicamente postergar, parte de su activo cultural proveniente de los andes, incorporaron idioma, cultura, alimentos, vestido, etc., diferentes a precio de ser aceptados como ciudadanos e iguales (Balbi, 1997) en la dinámica comercial limeña. Por otra parte, la ciudadanía no es puramente conquistas y logros de índole material. Los aspectos de las emociones, sensaciones, de la salud, de la satisfacción con su trabajo y su nivel de preparación, de las expectativas de vida, de los valores son de igual importancia en una sociedad que promueva la justicia y la igualdad. “es necesario saber que privilegios legales y políticos disfrutan los ciudadanos, que libertades tiene para conducir sus relaciones sociales y personales. Es necesario saber cómo están estructuradas las relaciones familiares y las relaciones entre géneros” (Nussbaum_Sen, 1996:15). Si la informalidad y la ciudadanía manifiestan características que las hacen parte de un proceso social e histórico que, las ha hecho interdependientes y complementarias, el espacio público, (de nuestro interés) termina de conjugar la anterior relación. El espacio público, aquel que pertenece a todos sin ser de ninguno, es también el espacio de las contradicciones: del encuentro y del desencuentro, de la fama o del completo anonimato. En un contexto de construcción de la solidaridad y reciprocidad urbana, el espacio público es el principal lugar de los intercambios e interacciones, donde los diferentes grupos de la sub-urbe y del “lugar exclusivo” rozan permanentemente diferentes manifestaciones de cultura, de estímulos consumistas y otros valores. En las dinámicas urbanas del mercado, el espacio público es tomado, a viva fuerza o mediante negociación. Tenerlo u ocuparlo temporalmente, posibilita una renta a quien dé él se apropia (Avendaño, 1998). Los lugares de tránsito, denominados por Auge (1998:30_46) como, no lugares, carecen de identidad, de relación y de historia como signos del proceso social, aunque no de forma total, cerrada o absoluta. Así, nuestro espacio móvil, el interior de los buses; nuestro espacio de tránsito, los paraderos de los buses, retienen caracteres que equivalen en parte a los denominados no lugares, con la especial diferencia de que aun siendo espacios anónimos, presentan una agitada dinámica de vida en cada una de las historias personales que día por día se manifiestan. Nuestro espacio, entonces, se autorepresenta como lugar antropológico, el reconocido por Auge (1988:57_63) como aquel que es al mismo tiempo principio de “sentido para aquellos que lo habitan y principio de inteligibilidad para aquel que lo observa”. Se coexiste, aunque temporalmente, en un mismo lugar, siendo cada miembro un ente singular. Este hecho, va a otorgar y reproducir, relaciones de identidad compartida y configurada del espacio, produciendo un ambiente social de familiaridad y condescendencia al interior de los buses. Cada una de las explicaciones teóricas de los problemas, de las condiciones de la práctica de la solidaridad y reciprocidad urbana, de la informalidad y del espacio público son de gran valor. A estas, deben sumarse las explicaciones y experiencias que los mismos actores brindan acerca de su actividad.
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Cordoliani, Patrice. "Transports sanitaires héliportés : évolution et bilan d'activité du service d'aide médicale urgente du département du Gard." Montpellier 1, 1997. http://www.theses.fr/1997MON11011.
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Canales, Contreras Danilo. "Comercio informal urbano en Chile neoliberal: el caso de los vendedores ambulantes en el transporte público (Santiago, 1990-2017): autonomía, resistencia y continuidad histórica de una "economía popular de la calle"." Tesis, Universidad de Chile, 2017. http://repositorio.uchile.cl/handle/2250/147347.
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Vidal, Caroline. "Apport d'une mise à disposition exclusive d'un hélicoptère sanitaire au Samu 66 pendant l'été 1992 : bilan et perspectives." Montpellier 1, 1993. http://www.theses.fr/1993MON11164.
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Requena, Maisa Aparecida. ""Esse é o legítimo tá pessoal": o discurso dos vendedores informais em situação de trabalho." Pontifícia Universidade Católica de São Paulo, 2009. https://tede2.pucsp.br/handle/handle/14065.
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Previous issue date: 2009-05-07Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
The study of diversities of creative manifestations in Brazilian people has allowed us to find out personages who discovered an alternative of work to face the unemployment: to produce publicity and selling products inside the Metropolitan trains of São Paulo. It is about the discourses produced by the informal worker whose advertising does not appear in magazines, newspaper, pamphlets, outdoors etc., but have the same goals, which are to publicize, spread ideas and, mainly, to sell products. In this sense, this research has as its objective to analyze the discursive mechanism that characterize the speeches of these informal workers. The research conforms to the theoretical field developed by Dominique Maingueneau, more specifically in the conceptions of Interdiscourse, Scenography and Ethos. From the methodological point of view, we have followed these steps: (i) the observation of the work activities of the workers the discourses produced by them, (ii) field notes about the activity in work circumstances and about the discourses transmitted by the workers and (iii) transcription of some of their speech. The analysis has revealed two groups of discourse: the slogan-discourses and the advertisement-discourse. The first one has showed an enunciative scene compatible with the street market conditions, while in the second one, the developed scene was similar to the auction situation. From the scenography analysis, it has emerged the Ethos of the enunciators of both groups. In the slogan-discourse, the presented Ethos is from an agile, discreet and invisible enunciator, while in the advertisement-discourse, the presented Ethos is from a good-tempered, calm, sympathetic, agile and considerate enunciator. Thus, the workers mobilize many mechanisms in order to create a new model of publicity that aims to legitimate its discourses, generating scenographies and presenting an Ethos
A observação das diversas maneiras de manifestações criativas do povo brasileiro nos permitiu localizar pessoas que encontraram um meio diferente de trabalho para enfrentar o problema da falta de emprego: produzir publicidade e vender produtos no interior dos trens metropolitanos de São Paulo. Trata-se de discursos produzidos pelos vendedores informais cuja publicidade não aparece em revistas, jornais, panfletos, outdoors etc., mas que apresentam os mesmos objetivos, o de divulgar, de propagar idéias e, principalmente, o de vender seus produtos. Nesse sentido, a pesquisa tem por objetivo analisar os mecanismos discursivos que caracterizam a fala do vendedor informal. A investigação se enquadra na perspectiva desenvolvida por Dominique Maingueneau, mais precisamente, nas noções de interdiscurso, cenografia e ethos. Do ponto de vista metodológico, foram seguidas as seguintes etapas: (i) observação da atividade de trabalho dos vendedores e dos discursos produzidos por eles, (ii) anotações de campo sobre a atividade em situação de trabalho e sobre os discursos veiculados pelos vendedores e (iii) transcrição de algumas de suas falas. A análise revelou dois grupos de discursos: os discursos-slogans e os discursos-anúncios. Os primeiros apresentam uma cena de enunciação compatível com à de feira livre e os segundos, são semelhantes à cenografia de um leilão. A partir da análise da cenografia, emergiu o ethos dos enunciadores dos dois grupos. No discurso-slogan, o ethos é o de um enunciador ágil, discreto, invisível, enquanto no discursoanúncio, a imagem discursiva é o de um enunciador bem-humorado, calmo, simpático, ágil e atento aos chamados dos clientes
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Visser, Marlize. "Air ambulance transport in sub-Saharan Africa : challenges experienced by health care professionals." Diss., 2011. http://hdl.handle.net/2263/29781.
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Introduction Air ambulances transport patients to their home country or to centres of medical excellence when they are critically ill or injured. From stranded hikers to cancer patients, individuals worldwide use air ambulance transport when they need care that cannot be provided in the country or area where they are situated. Aim The overall aim of this study was to explore the challenges experienced by health care professionals during air ambulance transport of patients in sub-Saharan Africa. Research method A quantitative, non-experimental, descriptive, exploratory design was used. The study was conducted in three phases. Phase 1 was the planning of the questionnaire, Phase 2 was the pre-testing of the questionnaire and Phase 3 was the execution phase in which the questionnaires were distributed, and data were captured and analysed. Results The researcher used the data generated from the questionnaires to indicate short falls within air ambulance transport services in sub-Saharan Africa. Conclusion The researcher made recommendations in order to increase the level of air ambulance services in sub-Saharan Africa.Dissertation (MCur)--University of Pretoria, 2011.
Nursing Science
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Fatahi, Arsham. "Air versus Land Vehicle Decisions for Interfacility Air Medical Transport." Thesis, 2013. http://hdl.handle.net/1807/43989.
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In emergency medical transport, “time to definite care” is very important. Emergency medical services and transport medicine agencies have several possible vehicle options for interfacility transfers. Use of a land vehicle, helicopter, or fixed wing aircraft will be dependent on patient condition, distance between sending and receiving hospitals, crew configuration and capabilities, and other factors such as weather and road conditions.
This thesis lays out the complex process of patient transfers and highlights the challenges in decision making under time pressure; it then describes the behaviour of human operators in estimating time to definite care. To support the operators in choosing a transportation mode, a decision support tool was built, which provides relevant time estimates for interfacility transfers based on historical dispatch and call data. The goal is to enable operators to make evidence-based decisions on vehicle allocation. A prototype interface was generated and was evaluated through a usability study.
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Černý, Jiří. "Etické kodexy nelékařských zdravotnických profesí se zaměřením na pracovníky zdravotnické dopravy." Doctoral thesis, 2018. http://www.nusl.cz/ntk/nusl-383940.
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Ethical codes of non-medical health professions focusing on ambulance service workers ABSTRACT A sharp increase of number of the codes of ethics in all fields of human activity is the trend of current ethical education. The dissertation is oriented (focuses) on the question of the necessity or the suitability of codes of ethics for ambulance services (Emergency Ambulance Services and Non- emergency patient transport services). The introductory theoretical part defines the range of medical transport professions that are the subjects of research. There are introduce the theoretical bases of healthcare professions. The historical part of the dissertation is focused on the development of a medical transport with an emphasis on ethical principles in the work of emegency and nonemergency ambulance services. The theory that the direct precursors of code of ethics can be promises, oaths, orders, statutes, instructions, recommendations and similar written or unwritten documents containing ethical principles that include challenges to help others and the demands of collegiallity, respect, honesty or virtuous life was confirmed. In the work is also mentions some ethical problems and dilemmas in the work in the ambulance services. The content of the practical part of dissertation is research study on the question of...
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"Die interhospitaalvervoer van siek neonate." Thesis, 2015. http://hdl.handle.net/10210/13338.
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M.Cur.With reference to the question whether the interhospital transport of ill neonates in South Africa and more specifically in the Transvaal is adequate, a study was done in which the quality of the interhospital transport of ill neonates on the Witwatersrand was investigated. Criteria for the interhospital transport of ill neonates were formulated according to a literature review and they were validated. The quality of interhospital transport of ill neonates on the Witwatersrand was researched according to the formulated criteria. The case study method was used and was applied to neonates who were transported to a selected private- and provincial hospital by private- and provincial ambulance services between May 1987 and June 1987. Through the results of the study the researcher came to the conclusion that the interhospital transport of ill neonates on the Witwatersrand is inadequate. Recommendations which may contribute to the improvement of the transport system were made.
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Govender, Seenivasan. "Emergency transport of obstetric patients within the Ugu Health District." Thesis, 2011. http://hdl.handle.net/10321/688.
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Dissertation submitted in fulfillment of the requirements for the Degree of Master in
Technology: Emergency Medical Care, Durban University of Technology, 2011.Background Information regarding pre-hospital emergency medical services is limited and it is therefore challenging to determine if there is delay in emergency transport of patients. This study aimed to provide such information specifically regarding the emergency transportation of obstetric patients. Purpose The purpose of the study was to describe the transport of obstetric patients within the Ugu Health District of KwaZulu Natal, in terms of patient profiles, the response time intervals and factors that affected response times. Objectives The objectives of the study were to: determine response time intervals from the initial call to delivery of the patient to a public sector hospital; describe the types of obstetric cases being transported; describe factors that affect response times and; make recommendations on policies and procedures governing emergency obstetric patient transportation Methodology All obstetric patients transported by Emergency Medical Rescue Service (EMRS) within a 2 month time frame within the Ugu District made up the study population. The study was conducted through prospective quantitative data collection using hospital records, the EMRS information system (communications centre data base records) and the EMRS patient return forms. The data was triangulated which established reliability before descriptive analysis was conducted. vi Findings The EMRS predominantly transports obstetric patients in labour with a gravidity of 1. The mean response interval (from receipt of the call to arrival at the patient) of 1h41minutes was a result of delays in the pre-response interval (pre-response waiting time). The mean pre-response interval of 1h07 minutes was a result of delays caused by ambulance unavailability. Pearson‟s correlation showed a significant relationship between the pre-response interval and response interval i.e. delays in the pre-response interval caused delays in the response interval. The EMRS lacks Standard operating procedures governing emergency transport and this was one of the main factors that contributed to some of the causes of ambulance unavailability. The lack of standard operating procedures is therefore also partly responsible for a delayed response interval. 64.5% of the incidents achieved response time intervals of more than 1hour and has therefore failed to achieve the predetermined Department of Health target for 70% of ambulances reaching the site of the patient within 1 hour. Other factors that affect the response time intervals were the poor road conditions, shift change delays and re-routing of ambulances. Conclusion EMRS predominantly transports obstetric patients in labour, including high risk patient groups that are arguably beyond the scope of care of the Basic and Intermediate qualified Emergency Care Practitioners. Standard operating procedures for governing emergency transport are lacking and have contributed to a number of factors affecting response time intervals. Standard operating procedures therefore need to be developed taking into consideration the findings of this study as well as previous recommendations by the National Committee on Confidential Enquiries into Maternal Deaths (NCCEMD).
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Muhlbauer, Dagmar. "An analysis of patients transported by a private helicopter emergency service within South Africa." Thesis, 2015. http://hdl.handle.net/10321/1326.
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Submitted in fulfillment of the requirements for the degree of Master of Technology: Emergency Medical Care, Durban University of Technology, Durban, South Africa, 2015.Introduction: A Helicopter Emergency Medical Service (HEMS) is a specialist flying emergency service where on-board medical personnel have both the knowledge and equipment to perform complicated medical procedures. There is an absence of literature describing the types of patients treated and the clinical outcome of these patients flown by Helicopter Emergency Medical Services within South Africa. The paucity of literature on this topic poses a challenge for current aeromedical services as there is no baseline information on which to base flight criteria, staffing and policy documents. This has the potential to hamper the advancement of HEMS within South Africa. Purpose of the study: The purpose of this study was to undertake a descriptive analysis of the patients flown by the Netcare 911 HEMS over a 12 month period in both Gauteng and KwaZulu-Natal and to assess the patients’ outcomes. The objectives of the study were to analyse the clinical demographics of patients transported by the Netcare 911 HEMS operation, determine the time frames from dispatch of the helicopter to delivery of the patient to the receiving hospital and undertake a correlational analysis of crew qualifications, clinical procedures performed and their outcomes at 24 hours and 72 hours. A further objective was to make recommendations regarding the refinement of current aeromedical policies as well as the education and training requirements. Methodology: The research study was conducted utilizing a retrospective quantitative, descriptive design to undertake an analysis of patients transported by a private helicopter emergency medical service within South Africa. The records of all patients transported by the Netcare 911 HEMS operations between 01 January 2011 and 31 December 2011 were included. Results: In the 12 month study period there were a total of 547 cases. However, the final study population was made up of 537 cases as 10 cases had to be excluded due to incomplete documentation. Of the 537 cases, 82 (15.3%) were managed by the KwaZulu-Natal HEMS and 455 (84.7%) were managed by the Gauteng HEMS. Findings revealed that the majority of patients flown in both Gauteng and KwaZulu-Natal were adult males: males (n=398; 74.1%) and adults (n=437; 81.4%). Motor vehicle accidents were the most common incident type for both operations (n=193; 36%). At the 24-hour follow up, 339 (63.1%) patients were alive and stable and at the 72-hour follow up, 404 (75.3%) were alive and stable. Conclusion and recommendations The findings of this study provide valuable information that may have an impact on the current staffing and authorization criteria of South African HEMS operations.
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Ingleton, C., S. Payne, Anita R. Sargeant, and J. Seymour. "Barriers to achieving care at home at the end of life: transferring patients between care settings using patient transport services." 2009. http://hdl.handle.net/10454/6872.
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Enabling patients to be cared for in their preferred location often involves journeys between care settings. The challenge of ensuring journeys are timely and safe emerged as an important issue in an evaluation of palliative care services, which informed a service redesign programme in three areas of the United Kingdom by the Marie Curie Cancer Care 'Delivering Choice Programme'. This article explores perceptions of service users and key stakeholders of palliative care services about problems encountered in journeys between care settings during end-of-life care. This article draws on data from interviews with stakeholders (n = 44), patients (n = 16), carers (n = 19) and bereaved carers (n = 20); and focus groups (n = 9) with specialist nurses. Data were gathered in three areas of the United Kingdom. Data were analysed using a framework approach. Transport problems between care settings emerged as a key theme. Four particular problems were identified: (1) urgent need for transport due to patients' rapidly changing condition; (2) limited time to organise transfers; (3) the management of specialist equipment and (4) the need to clarify the resuscitation status of patients. Partnership working between Ambulance Services and secondary care is required to develop joint protocols of care to ensure timely and safe transportation between care settings of patients, who are near their end of life. Commissioning of services should be responsive to the complexities of patients' needs and those of their families.
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Bosembo, Ilondjo Maurice. "Évaluation des besoins et des ressources hospitalières en Afrique centrale." Thèse, 2005. http://hdl.handle.net/1866/15310.
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