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Coplen, Chris Rolland. "Emergency medical service training for California peace officers." CSUSB ScholarWorks, 1989. https://scholarworks.lib.csusb.edu/etd-project/438.
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Thor, Danielle Claire. "Ethics in Emergency Medical Services: A Contextual Analysis." Master's thesis, Temple University Libraries, 2019. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/592304.
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Urban BioethicsM.A.
The modern concept of Emergency Medical Services (EMS) has grown from its humble volunteerism origins to a multidisciplinary enterprise, outstretched into the realms of both healthcare and public service. As the American EMS community continues to assume greater responsibilities and further develop its professional standards, the moral foundations of this field open themselves to more thorough scrutiny. Upon examination, the major deficit in the ethical structuring of EMS becomes glaringly obvious: it exists as a piecemeal collection of its medical and militaristic counterparts unified by theoretical generalizations that avoid its inherently unique structure. If EMS wishes to matriculate into complete professionalism, or even continue its assumption of critical responsibilities surrounding the health and safety of others, then it must also develop and maintain its own individual ethical framework from which it operates. In doing so, an urban bioethical approach rooted in context-driven analysis and pragmatic solutions may provide the best guidance and protections for all those who interact with the EMS system while respecting the values of this distinctively prideful service.
Temple University--Theses
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Tan, Huiyi. "A study on prehospital emergency medical service system status in Guangzhou /." View the Table of Contents & Abstract, 2007. http://sunzi.lib.hku.hk/hkuto/record/B38479886.
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Zhang, Xiang. "Efficiency in Emergency medical service system : An analysis on information flow." Thesis, Växjö University, School of Mathematics and Systems Engineering, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:vxu:diva-1620.
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In an information system which includes plenty of information services, we are always seeking a solution to enhance efficiency and reusability. Emergency medical service system is a classic information system using application integration in which the requirement of information flow transmissions is extremely necessary. We should always ensure this system is running in best condition with highest efficiency and reusability since the efficiency in the system directly affects human life.
The aim of this thesis is to analysis emergency medical system in both qualitative and quantitative ways. Another aim of this thesis is to suggest a method to judge the information flow through the analysis for the system efficiency and the correlations between information flow traffic and system applications.
The result is that system is a main platform integrated five information services. Each of them provides different unattached functions while they are all based on unified information resources. The system efficiency can be judged by a method called Performance Evaluation, the correlation can be judged by multi-factorial analysis of variance method.
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Barley, Kim Wayne. "The development of a marketing plan for an emergency medical service." Thesis, Port Elizabeth Technikon, 2002. http://hdl.handle.net/10948/120.
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The research problem addressed in this study was to develop a comprehensive marketing plan that would help an emergency medical service (EMS) in the Nelson Mandela Metropolitan Municipality (NMMM), capture a significant market share and gain a competitive advantage over competitors. To achieve this object, a literature study to determine the key components of a marketing plan was undertaken and used as a theoretical model in developing an actual marketing plan. In addition to the literature study, an empirical study was conducted to identify the key issues critical to the development of a marketing plan for the EMS. The survey method used, based on the key components gained from the literature study, consisted of an in-depth scan of the macro-environment and thorough market investigation of the target industry. The investigation involved the general management and senior personnel from the local emergency medical industry, medical aid schemes and private hospitals and clinics delimited in the study. The results of the above literature study were finally combined with the results of the empirical study and a marketing plan for an emergency medical service was developed. This study concludes with recommendations applicable for the implementation of the actual marketing plan.
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Tan, Huiyi, and 譚惠儀. "A study on prehospital emergency medical service system status in Guangzhou." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2007. http://hub.hku.hk/bib/B40052163.
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Kondapalli, Swetha. "An Approach To Cluster And Benchmark Regional Emergency Medical Service Agencies." Wright State University / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=wright1596491788206805.
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Paschal, Beverly J. "16PF® Traits as Predictors of Emergency Medical Service Worker Tenure." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2226.
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The United States is experiencing a severe shortage of Emergency Medical Service (EMS) paramedics. The job outlook for paramedics (EMT-P) for the years 2012-2022 is predicted to increase by 23%-33%, which is much faster than the 4% average increase of other first-response professions. The average tenure of paramedics is less than 4 years. There is a significant gap in the literature concerning paramedic personality traits and tenure. The primary objective of the current study is to provide empirical data on the personality traits possessed by long-term paramedics (5+ years), and compare them to those with shorter tenure (< 5 years). Using Allport's Trait Theory, I predicted that personality would affect paramedic longevity. The 6 personality traits tested were warmth, reasoning, emotional stability, liveliness, social boldness and openness to change. A socio-demographic questionnaire, determined the length of their EMS career, while the 16PF® Assessment, tested their personality traits. Using t tests, Mann-Whitney U tests, and a set of regression analyses, data were examined to determine if length of career and personality traits predicted paramedic tenure. The research sample consisted of long term paramedics and former paramedics. The results showed that of the 6 personality traits, only warmth was a significant predictor of paramedic tenure. A logistic regression showed for every additional point in warmth, the odds of leaving EMS prior to 5 years increased by a factor of 2.77. This study provides support for positive social change by helping EMS to learn how to increase recruitment and tenure. It also helps by advising EMS agencies to attend to the mental and emotional health of their paramedics by being aware of the level of their warmth personality trait.
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Johnston, Janice Mary. "Ambulatory care: a comparison of event and episode utilisation patterns." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1998. http://hub.hku.hk/bib/B31237125.
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Gibson, Nicholas P. "The epidemiology of acute asthma managed by ambulance paramedics in the prehospital setting in Western Australia /." Connect to this title, 2006. http://theses.library.uwa.edu.au/adt-WU2007.0142.
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Bentley, Melissa. "A National Assessment of Ideal Cardiovascular Health among Emergency Medical Service Professionals." The Ohio State University, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=osu1480456097279235.
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Kling, Michael Patrick. "Needs Assessment for Mental Health Support Towards Emergency Medical Service (EMS) Personnel." Thesis, Regent University, 2021. http://pqdtopen.proquest.com/#viewpdf?dispub=27961789.
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Understanding and assessing the needs of Emergency Medical Service (EMS) personnel and other first responders is crucial for providing these individuals with the resources needed within their community. The literature discusses how EMS personnel are at risk for psychological impairment due to routine exposure to traumatic events and occupational stressors within EMS organizations. Additionally, the research has supported the importance of positive coping abilities, organizational belongingness, and social support within the lives of EMS personnel to enable them to resiliently handle the occupational stress of their job. This study investigated the occupational needs of EMS providers to determine if they are receiving resources within their organization to cope with occupational stressors. Participants for this study comprised (n=153) paramedics and fire-fighters from the Tidewater EMS Council organization. A needs assessment was conducted to explore correlations between quality of life, resiliency, years of service, level of education, burnout, secondary traumatic stress, interpersonal support, positive and negative religious coping, and the occupational needs of EMS personnel. The results revealed that burnout (r=4.27**) and secondary traumatic stress (r.215*) were important factors for determining occupational turnover among EMS personnel. Furthermore, EMS providers reported occupational needs such as easier access to mental health, improved staff relations, adequate staffing, and improved shift hours are needed within their organization. Future research should explore differences in occupational needs with EMS providers among EMS organizations in metropolitan and rural communities. Keywords: Emergency Medical Services (EMS), Burnout, Occupational Stress, Traumatic Critical Incidents
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Stedman, Robert W. "An evaluation of the level of service and delivery costs of fire and emergency medical service in Waukesha County, Wisconsin." Online version, 2000. http://www.uwstout.edu/lib/thesis/2000/2000stedmanr.pdf.
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Roberts, Craig Brendan. "The judgement of risk in traumatised and non-traumatised emergency medical service personnel." Thesis, Stellenbosch : Stellenbosch University, 2000. http://hdl.handle.net/10019.1/51990.
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Thesis (MA) -- University of Stellenbosch, 2000.ENGLISH ABSTRACT: Judgement of risk for negative events in certain situations was investigated in a group of emergency medical service (EMS) personnel with a diagnosis of posttraumatic stress disorder (PTSD; n = 27) and a group without PTSD (n = 74). Participants completed the PTSD Symptom Scale: Self-Report version (Faa, Riggs, Dancu, & Rothbaum, 1993), an EMS work experiences questionnaire, the Beck Depression Inventory (Beck, Rush, Shaw, & Emery, 1979), and an event probability questionnaire designed to assess judgement of risk. Participants with PTSD overestimated amount of risk involved in comparison to participants without PTSD, thereby demonstrating a judgement bias for risk related events. The present study found that the judgement bias in PTSD participants extended to include not just external harm related events but also general negative events (without potential threatening/harmful consequences), negative social events, and negative workrelated events. Of the posttraumatic symptomatology assessed, avoidance symptomatology was found to be the best predictor of judgement bias. The results of the present study are discussed in terms of the cognitive clinical psychology theories of PTSD, which predict the manifestation of judgement bias in PTSD, and cognitive experimental psychology explanations of the effect of negative emotional states on judgement processes.
AFRIKAANSE OPSOMMING: Oordeeloor risiko vir negatiewe gebeurtenisse in sekere situasies is ondersoek by "n groep mediese nooddienspersoneel met "n diagnose van posttraumatiese stresversteuring (PTSV; n = 27) en "n groep sonder PTSV (n = 74). Deelnemers het die PTSD Symptom Scale: Self-Report version (Foa, Riggs, Dancu, & Rothbaum, 1993), "n mediese nooddiens werkservaringe-vraelys, die Beck Depression Inventory (Beck, Rush, Shaw, & Emery, 1979), en "n gebeurtenis-waarskynlikheidsvraelys wat opgestel is om oordeeloor risiko te meet, voltooi. Deelnemers met PTSV het die mate van risiko betrokke oorskat in vergelyking met deelnemers sonder PTSVen sodoende "n beoordelingsydigheid vir risiko-verbandhoudende situasies gedemonstreer. In die huidige studie is gevind dat beoordelingsydigheid by PTSV deelnemers nie beperk was tot eksterne skade-verbandhoudende gebeurtenisse nie, maar dat dit ook veralgemeen het na algemene negatiewe gebeurtenisse (sonder potensieel skadelike gevolge), negatiewe sosiale gebeurtenisse, en negatiewe werksverwante gebeurtenisse. Daar is gevind dat, wat PTSV-simptomatologie betref, vermyding die beste voorspeller van beoordelingsydigheid was. Die resultate van die huidige studie word bespreek in terme van kognitiewe klinies-sielkundige teorieë van PTSV, wat die aanwesigheid van beoordelingsydigheid voorspel, en kognitiewe eksperimentele-sielkunde verklarings van die effek van negatiewe emosionele toestande op beoordelingsprosesse.
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Muza, Matej. "Development of a Spatial Decision Support System for Emergency Medical Service Facility Siting." Thesis, Virginia Tech, 2011. http://hdl.handle.net/10919/42583.
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Improved strategic location of an Emergency Medical Service (EMS) facility can significantly increase EMS efficiency. Urban planners need to consider a location that satisfies multiple criteria in order to make an informed decision about a future EMS facility site. Apart from basic criteria such as parcel value and size, decision-makers need to consider area and population coverage from potential parcels. Geographic Information Systems (GIS) provide an adequate analysis environment for EMS facility siting as many considered criteria are of a spatial nature. However, urban planners making decisions about an EMS facility site often lack the necessary expertise to make full use of challenging GIS tools.
In order to help urban planners in the analysis process, this research developed a Spatial Decision Support System (SDSS) for EMS facility siting. The system was developed in ESRI ArcGIS (9.3) using the Visual Basic for Applications (VBA) programming environment. The objective of the system was to integrate spatial data, analysis, and visualization in a single system to help users evaluate a facility siting problem. The systemâ s performance was tested using data for the Town of Blacksburg, VA. In addition, the system was evaluated by local planners and GIS staff with experience in EMS facility siting. Planners agreed the system enables more comprehensive and straightforward use of GIS for EMS facility siting analysis than other available siting tools. Potential improvements include a simpler user interface, synthesis of geoprocessing techniques, reduction of analysis time through automation, and better decision-making by improved visualization of results.Master of Science
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Kahle, Jurgen Werner. "A 12-month retrospective, descriptive study of Hout Bay Volunteer Emergency Medical Service, Cape Town, South Africa." Master's thesis, Faculty of Health Sciences, 2019. http://hdl.handle.net/11427/31424.
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Background
There is a growing need for Emergency Medical Services (EMS) globally and in Africa, as health services develop. The establishment and continued operation of volunteer ambulance services might assist with this need. This study provides a comprehensive overview of the operational activities of a volunteer ambulance service and forms a first step for further studies of this and other volunteer ambulance services.
Objectives
This study describes and quantifies the operational activities of Hout Bay Volunteer Emergency Medical Service (Hout Bay EMS) a volunteer ambulance service in Cape Town, South Africa for a one year period from 1 January to 31 December 2016.
Methods
This retrospective study describes call-outs, shifts and service demographics of Hout Bay EMS for 2016, using Provincial EMS dispatch data and shift records from Hout Bay EMS. Performance comparisons are drawn between Hout Bay EMS and Provincial EMS.
Outcomes
In the study period, there were 682 call-outs involving Hout Bay EMS, a total mission time of 951 hours worked over 119 shifts by 31 active members in 2016. Assault was the leading call-out type (18.40%); 58.24% of call-outs were Priority 2 (less urgent), and 39.30% of call-outs ended in no patient transport. Response times to Priority 1 call-outs were generally shorter for Hout Bay EMS than those of Provincial EMS within the Hout Bay area. Members largely preferred night shift to day shift by a factor of 4:1; the majority of shifts were worked by Basic Life Support (28.57%) and Intermediate Life Support (57.98%) qualified members compared to the relatively few shifts (13.44%) worked by Advanced Life Support members. This study shows that a small volunteer ambulance service mostly active on weekends can successfully complement the efforts of the larger, full-time provincial ambulance service it is dispatched by. This model could be replicated elsewhere to meet the growing need for emergency medical services.
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Sikora, Kamila Janetta. "Acceptability of Seasonal Influenza Vaccines Among Low-Risk Adults In An Urban Emergency Department." Yale University, 2010. http://ymtdl.med.yale.edu/theses/available/etd-03042010-205527/.
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Emergency departments (EDs) are the only source of medical care for many adults and have been found to be feasible venues for vaccinating high-risk patients against seasonal influenza. Since the CDC guidelines expanded in 2008 to include any adults wishing to protect themselves and those around them from the flu, the vaccination of low-risk patients in the ED has not been evaluated. This study sought to assess the acceptability among adult patients of all ages for vaccinating against seasonal influenza in the Urgent Care area of an urban ED, which treats primarily healthy adults. A convenience sample of adult patients in the Urgent Care area was surveyed in November 2009. Subjects were asked about their vaccination history, as well as their perceived need and potential acceptance of a vaccine in the ED. Demographic data obtained included age, race, education, insurance status, medical history, access to primary care and contact with high-risk individuals. 381 patients were approached, of whom 352 completed the survey (92.4%; 56% male, 44% female; mean age 36 years, Standard Deviation 12.4), and 349 were vaccine-eligible. 250 (72%) denied any significant medical history. While 169 patients (48.4%) had an influenza vaccination history, only 69 (20%) were vaccinated in 2009. Of the 280 not vaccinated this year, 179 (64%) would have accepted the vaccine in the ED. Factors associated with increased odds of vaccine acceptance in the ED included: age younger than 50 years (Odds Ratio [OR] 3.28, 95% Confidence Interval [CI] = 1.74 to 6.21, p<0.01), Latino/Hispanic ethnicity (OR 2.89, 95% CI = 1.52 to 5.51, p<0.01), and close contact with high-risk individuals (OR 2.28, 95% CI = 1.33 to 3.92, p<0.01). These results suggest that the majority of relatively healthy adult patients would accept the seasonal influenza vaccine in the ED. Although a shortage of vaccines and increased vigilance during a concurrent H1N1 outbreak may have influenced overall acceptability, we conclude that influenza vaccinations during the ED patient encounter would generally be acceptable to patients as a means to improve their overall health, and indirectly the health of their high-risk close contacts.
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Atyeo, Simon Vincent, and simon atyeo@defence gov au. "An Intelligent System for the Pre-Mission Analysis of Helicopter Emergency Medical Service Operations." RMIT University. Aerospace, Mechanical and Manufacturing Engineering, 2009. http://adt.lib.rmit.edu.au/adt/public/adt-VIT20090508.102128.
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The Helicopter Emergency Medical Service (HEMS) accident rate has driven operators from around the world to address the management of risks inherent to their operations. In-flight decision-making, pre-flight planning, failure to follow standard operating procedures, delayed remedial actions, and misinterpretation of environmental cues are all areas that need to be addressed for safe HEMS operations. HEMS operations are complex, being a joint exercise between the flight crew, paramedics and supporting agencies. Operations occur around-the-clock, in all-weather conditions, and often with no fore-warning. In a time critical operation, where precious minutes may cost lives, operators must decide which cases warrant a HEMS response and if so, whether the conditions are safe to conduct the mission. Intelligent systems are an emerging field offering benefits to a multitude of applications. This research forms a comprehensive investigation of the application of 'intelligent systems' to the pre-mission analysis of HEMS operations. The research has resulted in the development of a prototype decision support system capable of assisting in the pre-mission analysis of HEMS operations. The prototype system is capable of supporting flight coordinators and crew in the decision-making processes prior to HEMS operations and can potentially improve emergency medical services to the community.
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Sun, Xiaoduan. "Flying capacities, optimal fleet sizes, break-even flight charges for helicopter medical emergency service /." The Ohio State University, 1994. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487858106117557.
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Wrentz-Hudson, Debra Ann. "Emergency Medical Service Worker Knowledge of and Compliance with Occupational Exposures to Infectious Diseases." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1953.
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Firefighter Emergency Medical Service (EMS) responder personnel are at a high risk for occupational exposures to bloodborne and airborne infectious pathogens due to their unpredictable work duties in the pre-hospital environment. Not much is known about the compliance with Universal Precautions (UP) among firefighter EMS responders' personnel with regards to occupational exposures to infectious diseases. The purpose of this cross-sectional research study was to determine the relationship between compliance with UP, knowledge of UP, attitudes towards UP, occupational practices, and occupational exposures to bloodborne and airborne pathogens to prevent transmission of infectious disease among firefighter EMS responder personnel in the pre-hospital environment. A convenience sample (n = 246, 99% response) was gathered from the 6 career fire service departments in Miami-Dade County Florida. The participants completed a 40-question, self-administered survey questionnaire. Research questions and related hypotheses were evaluated with Pearson's product moment correlation, t test, analysis of variance, and linear regression models. In this study, the correlation between knowledge and compliance with UP was statistically significant (p = 0.005). This suggest that the compliance with UP among firefighter EMS responder participants increased with increase in knowledge. However, firefighter EMS personnel are not consistently complying with UP to prevent exposures to infectious diseases in the pre-hospital work environment. This research contributed to positive social change by increasing innovative knowledge that will allow the firefighter EMS responders to improve occupational practices and compliance with universal precautions.
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Belotto, Michael Joseph. "Emergency Medical Service Career Longevity: Impact of Alignment Between Preemployment Expectations and Postemployment Perceptions." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3281.
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The purpose of this qualitative study was to investigate whether there were differences between the preconceived notions of emergency medical technicians and paramedics prior to entering the profession and their notions of the vocation after facing the realities of the job. The contribution of alignment or misalignment to job satisfaction and the intention to leave the profession was also further investigated. This research is important as there currently is a gap in the literature pertaining to the factors affecting career longevity of emergency medical service (EMS) professionals. The degree of fit between individual and occupational characteristics guided this phenomenological study according to Lowman's theoretical model of career assessment and counseling. Study participants (n = 10) were recruited from organizations providing EMS training courses and ambulance service providers in New York State. Data were collected from semistructured interviews and the information was coded into themes. Key findings indicated aligned expectations and experiences of altruism led to satisfaction, physical challenges not considered prior to employment were associated with intent to leave the profession, and a perception of EMS as a transient career. This study's implications for positive social change are that its results will likely aid organizations in developing strategies to retain prehospital service workers, resulting in improved responses to the medical emergencies of communities and improvements in the care provided to society's sick and injured.
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To, Wing-chow Raphael. "Emergency ambulance service in Hong Kong : a study of continuity and change /." Hong Kong : University of Hong Kong, 1999. http://sunzi.lib.hku.hk/hkuto/record.jsp?B21037899.
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Maher, Matthew J. "Service Length and Resilience as They Contribute to Burnout in Volunteer Emergency Service Personnel| A Quantitative Analysis." Thesis, Capella University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10977163.
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The topic of the study was burnout amongst volunteer emergency service personnel in a Northeastern state. An understanding of the role burnout plays in emergency service professionals exists in the literature; however, the current research expanded the understanding by focusing on volunteers. Years of experience and resilience were studied to determine if a relationship exists with burnout. Data analysis consisted of multiple regression analyses conducted for each subscale of the Maslach Burnout Inventory – Human Services Survey (emotional exhaustion, depersonalization, and personal achievement) (Maslach, Jackson & Leiter, 1996). Results concluded that resilience, as measured by the Resilience Scale (Wagnild & Young, 1993), was found to be statistically significant in its ability to predict emotional exhaustion and personal achievement, at the p < .05 significance level. Resilience significantly predicted emotional exhaustion subscale scores of the Maslach Burnout Inventory – Human Services Survey, β= -.25, t(82) = -4.36, p < .001. Resilience and length of service when considered together also explained a significant proportion of variance in emotional exhaustion scores R2 = .92, F(2,82) = 9.65, p < .001. Resilience significantly predicted the personal accomplishment subscale, β = .21, t(82) = 5.19 p < .001. Resilience and length of service when considered together also explained a significant portion of the variance in personal exhaustion scores, R2 = .25, F(2,82) = 13.91, p < .001. Results concluded that resilience was not a statistically significant predictor of the depersonalization subscale; β = - .07, t(82) = -1.72, p = .090. Length of service was not considered to be a statistically significant predictor for the subscales (emotional exhaustion, depersonalization, and personal achievement) at the .05 alpha level. Resilience and length of service when considered together did not explain a significant portion of the variance in depersonalization scores; R2 = .04, F(2, 82) =1.90, p=.157. The regression analysis demonstrated that there was a low correlation between predictor variables of resilience, as measured by The Resilience Scale and length of service, r = .123. A stepwise regression analysis was also conducted and confirmed that the predictor variable of resilience held a greater control over the outcome variables in each regression analysis with a significant outcome. Study implications centered around a recognition that volunteer emergency service personnel can be affected by the work they perform in many similar ways as their paid counterparts. Further research is recommended to increase understanding of the relationship that other demographics and factors may play in the depletion of resilience and development of burnout in related professionals.
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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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Bam, Zina. "An exploratory survey: experiences and perceptions of community members who have accessed pre-hospital Emergency Medical Service in Langa, Cape Town." Master's thesis, Faculty of Health Sciences, 2019. http://hdl.handle.net/11427/31165.
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Background: Calling an ambulance is the first line for citizens in dealing with many healthcare emergencies. It is crucial for the caller to convey correct information regarding the patient’s emergency and on-scene location to the emergency services, resulting in prompt dispatch of correct emergency resources to the exact location. Although there is a good deal of focus on emergency medicine time parameters and outcomes, little is known about the experiences, perceptions and satisfaction level from those who have accessed pre-hospital Emergency Medical Services. Methods: A telephonic survey was conducted on individuals who had recently called for an ambulance, from the urban township of Langa, Cape Town. Surveys were conducted in the caller’s home language, using a standardized tool for collecting quantitative data around the call process, caller satisfaction, outcomes of the call, and issues experienced. Results: During June 2018, 50 callers completed the survey (69% response rate). Most callers (88%) used a personal mobile phone, and 83% called predominantly for medical problems in the daytime. Callers accessed the service by dialling a variety of emergency phone numbers. Callers were largely satisfied with the call (66%), and there were fewer language mismatches than expected. A need for better communication regarding ambulance status and over the phone medical advice was identified. A substantial number of inconsistencies were reported between callers’ outcomes and those from emergency communication centre which require further analysis. These inconsistencies, pointed into gaps within the emergency communication centre’s collecting and database system Conclusion: The study provided the first insight into pre-hospital emergency caller experiences and perceptions, highlighting important aspects perhaps not revealed through other metrics. Measurement of caller satisfaction can be a useful quality improvement tool, and would seem feasible without substantial resources. Further investigation into data capturing system and identification of call outcomes are recommended.
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Hêche, Félicien. "Risk-sensitive machine learning for emergency medical resource optimization and other applications." Electronic Thesis or Diss., Bourgogne Franche-Comté, 2024. http://www.theses.fr/2024UBFCD048.
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L'augmentation significative de la demande de soins médicaux d'urgence au cours des dernières décennies exerce une pression considérable sur les Services d'Aide Médicale Urgente (SAMU), entraînant de nombreux effets indésirables. Motivée par les résultats remarquables obtenus par les algorithmes d'apprentissage automatique modernes, cette thèse explore initialement l'utilisation de ces modèles afin d'optimiser les ressources du SAMU dans l'espoir de relever certains défis auxquels ce système de santé est confronté. La première contribution de cette thèse consiste à introduire un nouvel algorithme d'apprentissage par renforcement, appelé Latent Offline Distributional Actor-Critic (LODAC), spécialement conçu pour satisfaire des critères clés visant à assurer une gestion sûre et efficace des ressources pré-hospitalières. Ensuite, plusieurs expériences sont menées afin d'identifier les variables essentielles à inclure dans notre représentation d'état. Les résultats montrent que le temps est le seul facteur influençant significativement l'occurrence des urgences. Ces expériences plaident pour l'utilisation de méthodes stochastiques plutôt que des algorithmes d'apprentissage automatique. Suite à cette conclusion, de nouvelles méthodes pour l'allocation et la relocalisation des ressources du SAMU, basées sur des processus de Poisson inhomogènes, sont developpées. Finalement, les résultats obtenus avec LODAC suggèrent le potentiel de l'apprentissage par renforcement distributionnel dans des environnements stochastiques complexes. Pour étudier ce potentiel plus en détail, la composante distributionnelle de LODAC est isolée et testée dans un autre contexte: le négoce de contrats à terme de gaz naturel. Les résultats obtenus confirment le potentiel des algorithms distributionnels dans de tels environnementsThe significant increase in demand for emergency medical care over the last decades places considerable strain on Emergency Medical Services (EMS), leading to several undesirable effects. Motivated by the remarkable results obtained by modern Machine Learning (ML) algorithms, this thesis primarily explores the use of ML for optimizing EMS resources, aiming to address some of the challenges faced by this healthcare system. The first contribution of the thesis introduces a new Reinforcement Learning (RL) algorithm, called Latent Offline Distributional Actor-Critic (LODAC), specifically designed to satisfy key criteria essential for ensuring safe and effective behavior in the management of EMS resources. Following that, several experiments are conducted to identify the most important features that need to be incorporated into our state representation. Findings suggest that only the time significantly affects the occurrence of emergencies. These results argue for the use of stochastic methods rather than ML to optimize pre-hospital resources. Following these conclusions, new methods for EMS resource allocation and relocation based on inhomogeneous Poisson processes are developed. Finally, results obtained with LODAC suggest the potential of distributional RL in stochastic environments. To further investigate this avenue, we isolate the central distributional component of LODAC and conduct a series of experiments with this algorithm in another challenging stochastic context: natural gas futures trading. The outcomes of these experiments underscore the effectiveness of distributional RL in such environments
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Burke, Jan. "Prehospital advanced airway management practices by advanced life support providers: A retrospective observational study of emergency medical service providers in South Africa." Master's thesis, Faculty of Health Sciences, 2021. http://hdl.handle.net/11427/32596.
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Introduction: The skill of endotracheal intubation to achieve a definitive airway for critically ill and injured patients in the prehospital setting is frequently performed by advanced life support providers. Several methods may be utilised, including intubation without the use of medication, the use of sedatives or a rapid sequence intubation. There is a paucity of data available that assesses prehospital advanced airway intubation practices in South Africa. The aim of this study is to describe the advanced airway management practices of advanced life support providers across South Africa. Methods: A retrospective, observational study method was used (chart review). Electronic patient care records were sourced from private and public emergency medical services companies and collated accordingly. Results: A total of 704 cases were included. Intubation during cardiac arrest was the most common approach to airway management (n=280, 40%) followed by rapid sequence intubation (n=202, 28%), medication-facilitated intubations (n=152, 22%) and a nomedication approach (n=70, 10%). Successful intubation using an endotracheal tube was reported in 197 (98%) of rapid sequence intubation cases, 134 (88%) of the medication facilitated cases, 61 (87%) of no-medication cases and 228 (81%) of cardiac arrest cases. A first-pass success rate was described in 260 (79%) cases, with the cardiac arrest group having a first-pass success of 85%, followed by the rapid sequence intubation group (83%), the nomedication group (71%) and the medication facilitated group (61%). Hypotension and cardiac arrest were the most common adverse events. A total of 496 (70%) patients were alive at hospital handover. The average scene time and transportation time was 42 minutes and 24 minutes respectively for the rapid sequence intubation group, 42min and 27min for the medication facilitated group, 44min and 25min for the no-medication group and 57min and 16min for the cardiac arrest group. Discussion: The study described the prehospital airway management practices by advanced life support providers in South Africa. Rapid sequence intubation had the highest endotracheal intubation success rate overall and the lowest prevalence of adverse events. There was no statistical difference in survival between the rapid sequence intubation, medication facilitated and no-medication group. Due to a lack in standardised treatment guidelines, differences in fluid administration, post-intubation care, confirmation of placement and ventilation were noted. No standard approach to record keeping was found, with the quality of patient care records being variable. A standardised advanced airway management report would be beneficial as it would improve the quality of data recorded and allow for better comparisons to be made.
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Lukies, Rhonda. "Examination of prevalence rates of psychopathology and coping styles in a community sample of emergency service job candidates /." [St. Lucia, Qld.], 2006. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe19313.pdf.
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Forsberg, Lars. "Hazardous or harmful alcohol use in emergency care : early detection, motivation to change and brief intervention /." Stockholm, 2003. http://diss.kib.ki.se/2003/91-7349-547-6.
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Beniuk, Kathleen. "Integrating evidence-based medicine and service design : a study of emergency department crowding." Thesis, University of Cambridge, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.610514.
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Boldt, Faith Joy. "The Relationship between Personal Factors, Work Factors, PTSD, and Suicide Ideation in Emergency Medical Service Providers." TopSCHOLAR®, 2016. http://digitalcommons.wku.edu/theses/1625.
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EMS providers work in a high-stress environment and are routinely exposed to critical incidents. Many providers are left to deal with the chronic stress on their own, either because of lack of effective employer-based programs or a culture that discourages its use. The extent to which these factors -- as well as personal characteristics such as resilience, PTG, and coping skills -- influence PTSD and suicide ideation among EMS providers has not been well studied among EMS providers. An online survey was administered to a convenience sample of EMS providers. Of the 2,683 respondents, more than one quarter (27.7%) met the PTSD criteria of 50 or higher on the PCL-M. Close to half of the respondents (42.0%) reported having contemplated suicide in the last six months. Of those who had contemplated suicide in the last 30 days, nearly one third (27.1%) thought about suicide 10 or more days in the last 30 days. EMS culture and resilience were negatively associated with PTSD, while positive associations were found with some coping styles. PTSD scores and suicide ideation frequency were highest when post-incident services were not available in the workplace. No significant relationships were found between personal factors and suicide ideation.
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Stein, Christopher Owen Alexander. "Emergency medical service response system performance in an urban South African setting: a computer simulation model." Doctoral thesis, University of Cape Town, 2014. http://hdl.handle.net/11427/9523.
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Includes bibliographical references.This study investigated the effects of different response strategies, vehicle location strategies and vehicle numbers on response times in a simulated Emergency Medical Services system. The simulation was a computer model using discrete-event simulation and the model was based on Western Cape Emergency Medical Services operations in Cape Town. The study objectives were to (i) create the simulation model, (ii) determine the best-performing combination of explanatory factors and (iii) determine the effect of increasing vehicle numbers on response time performance. The simulation model took into account incident arrival rates, incident and hospital spatial distributions, vehicle numbers and dispatch practices in the modelled system. Verification and validation of the simulation model utilised a combination of quantitative and qualitative methods. The validated simulation model was changed in two ways: (i) the response strategy was changed to either single or two-tier (the response model factor) and (ii) the vehicle location strategy was changed to either dynamic or static (the vehicle location factor). This yielded four individual models each representing one combination of these factors. Each simulation model was run for a simulated period of seven days. Output data were analysed using multivariate analysis of variance in order to identify differences in response time between the factor combinations. A single-tier model using dynamic vehicle locations produced the best response performance. This model was run repeatedly, increasing vehicle numbers incrementally with each run to assess the effect of increased vehicle numbers on response time performance. A doubling of vehicle numbers resulted in an 14% increase in the number of responses meeting the national performance target for high acuity incidents, while a seven-fold increase in vehicle numbers increased this to 15%. No further performance increases were seen beyond this with increased vehicle numbers. A 2% performance increase for lower acuity incidents was seen with the same increase in vehicle numbers. In the system modelled, increasing vehicle numbers should not be expected to realise anything more than small improvements in response time performance, at a high operational cost. Fine-grained dynamic deployment of vehicles in anticipation of system demand appears to be a more important determinant of response performance than vehicle numbers alone.
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Andersson, Sanna, and Sandra Stålhult. "Hospitals exposed to flooding in Manila City, Philippines : GIS analyses of alternative emergency routes and allocation of emergency service and temporary medical centre." Thesis, Karlstads universitet, Fakulteten för humaniora och samhällsvetenskap (from 2013), 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-33042.
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Every year the Philippines get affected by a number of typhoons, which cause severe damage, sometimes due to flooding. The capital, Manila, is located on a flood plain that is partly at, and even below sea level and with several rivers crossing the area. These are some of the factors that contribute to that Manila often is affected by severe flooding. During ten weeks of the spring semester in 2014, this thesis was conducted as a completion of the bachelor program Geographic Information System (GIS) at Karlstad University, Sweden. Eight weeks were spent in Manila in the Philippines at the University of the Philippines Diliman, School of Urban and Regional Planning (UP SURP). The aim of the study was to investigate how hospitals in Manila City get affected during flooding. GIS was used to perform network analyses, in order to calculate the shortest route for the emergency service to travel from a station via a barangay to a hospital. The shortest alternative route during a 5-year flood was also calculated in order to compare the distance differences that might be due to flood. During a 100-year flood another type of analysis was performed, where suggestions for suitable locations for placing emergency service and temporary medical centre were presented. These suggestions on suitable locations were placed in an area that will not be affected during a 100-year flood. Results from the analyses showed that Manila City is a very exposed area during flood. During a 5-year flood some parts of Manila City will be highly exposed and about 1/4 of the population will be affected. The shortest alternative route for the emergency service to use during flood will generally be longer than in normal situations. Some hospitals cannot be accessed from some barangays due to impassable roads. During a 100-year flood the area gets gravely affected, almost 2/3 of the population will be affected and many roads become impassable, which limits the accessibility in Manila City.
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許耀元. "Research on Survey of National Emergency Medical Resources and Efficiency of Emergency Medical Service." Thesis, 2018. http://ndltd.ncl.edu.tw/handle/9ukp57.
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碩士輔仁大學
科技管理學程碩士在職專班
106
The national emergency medical service case has been increased year by year, hoping emergency medical tasks are used in the people who real need to send medical emergency service, please cherish the emergency medical resources and respect the emergency profession.After the emergency medical judgment and evaluation,the patient send to the nearest hospital.In addition due to the limited resources for first aid in all counties and cities ,therefore,non-emergency injuries, it is suggested to take transportation to the clinic by themsleves or to a specific hospital for treatment, leaving emergency medical resources to the most in need. In this study, the methods of literature analysis, expert interviews, secondary data analysis, data envelopment analysis (DEA) and analytic hierarchy process (AHP) were further using questionnaire to investigate the efficiency of emergency medical resources in every county and city. Firstly,in this study, DEA was used to assess the emergency medical efficiency of the fire department. Based on its characteristics, the DEA was constructed to evaluate the efficiency and fairness of the fire department. The other processes, through the literature, expert interviews and a series of input and output of the test, the final empirical analysis concludes as follows: (1) By reducing the investment, downsizing the overall sizes, will enable the diminishing scale of return to appropriate scale; (2) In the analysis of variance variables, the variables of unit balance with relative efficiency are all zero; (3) In the analysis of the sensitivity of the inputs and outputs ,the highest of sensitivity is first aid; (4) The application of the AHP method , to weight-limited DEA mode found that the overall average efficiency of the reduced efficiency phenomenon ;(5)Through the input and output value ratio, to assess whether the management is efficient.
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王書政. "Mobile Data Communication in Emergency Medical Service." Thesis, 1999. http://ndltd.ncl.edu.tw/handle/25434155037869999485.
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碩士中原大學
醫學工程學系
87
The goal of thesis is to establish a emergency medical service system, which can be used in the ambulance or any stable sites without interference by the landforms or buildings. For the increasing demand with emergency medicine, the advanced communication and computer technologies were used to improve the telemedicine system which can avoid the time delay of saving patients, reduce the cost of curing and promote the quality of medicine. The cable network communication technology has been used in the telemedicine system, however, few disadvantages such as: the difficulty of cable mounting, low mobility, and high cost need to be solved in those systems. The system can be divide into three parts: the data transmission system of the transmit site, the monitor system of the receive site, and the case report database system. The communication mediums are the GSM mobile phone and the wireless local area network (LAN) equipment. The transmission information included different combinations of immediate biosignals, the still image, texts and speech. The communication protocol is TCP/IP and the communication interface program is written with the Winsock. The Paradox and the Sybase structure query language (SQL) Server were used as the database system and a database combination system was built to simulate the data processing and the medical case report database. The Borland Database Engine (BDE) is adopted in this system as the database combination interface, and the standard SQL language is used to do the data accessing. Some tests which including the influence of the movement of the mobile phone to the transmission speed, the transmission effects, the transmission reliable degree, the convenience and the expanding possibility and the electromagnetic noise factor, were used to evaluate the performance of this system. The results show that the movement of mobile phone is up to 100 km/hr or across to the station, the transmission speed is still not influenced. Transmission delays of the mobile phone and the wireless LAN equipment are within 3 seconds and 1 second, respectively. The transmission reliable degree of the biosignals, texts and images is 100%, and the quality of the transmission speech is also very clear. The equipment of this system is handy and convenient to carry and use. Moreover, the expanding and transposing possibility of the hardware and the software are good. There is no interference between this system and other wireless communication system. A emergency medical service system which have overcame the disadvantages of the inherent microwave antenna system was established. This wireless system can break the limitation of the old wire system. This system uses the inherent medical database in the laboratory and imitates to combine with the real medical information system. In the future, we hope this system can have some contribution in improving the emergency medical service system, promoting the medicine quality and endure the cost of the medicine after some improvements.
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Allen, Mark. "An analysis of the practical experiences and confidence in performing emergency medical skills in South African medical interns." Thesis, 2014. http://hdl.handle.net/10539/15295.
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Thesis (M.Sc.(Med.) Emergency Medicine--University of the Witwatersrand, Faculty of Health Sciences, 2014.This study was designed to investigate how confident South African medical interns are to perform emergency medical procedures and to investigate how their experiences or demographic differences might influence these confidences. A transverse descriptive study using a cross sectional questionnaire was undertaken. A combination of the paper-based and electronic questionnaires were distributed to doctors currently performing their internship in South Africa. The data were analysed using a Fishers exact test and applying a Bonferroni correction where necessary. The study showed a high level of confidence in the majority of procedures studied and identified some points of influence on this confidence. The confidence of South African interns compares favourably with international colleagues at a similar qualification level.
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Jin-Jia, Chang, and 張晉嘉. "A GIS study of Freeway Emergency Medical Service Network." Thesis, 1993. http://ndltd.ncl.edu.tw/handle/84410735586265832417.
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碩士國立成功大學
交通管理(科學)學系
81
This study constructs a system of emergency delivery and med- ical service network for Sun Yat-Sen National Freeway. By using Geographic Information System (GIS), it can display the shortest path for ambulance delivery and analyze a hospital''s service zone . This study applies Revised Trauma Score (RTS) to distinguish the situation of patient and to decide a patient should be sent to what kind of hospital. In GIS application, the results of this study can be concluded: (1) There are 23 hospitals invited by National Freeway Bureau. These hospitals are divided into two levels. The first level includes 5 hospitals (2 medical centers and 3 regional hospi- tals). The other hospitals are set to level 2 ( 18 hospitals) . Patients with severe or intermediate scaled injury should be sent to level 1 hospitals. (2) In service zone analysis, Hospital Chan- Gan (Linkou) is more important in saving mild, intermediate or severe patients. Hospital Chi-Zen is also important in saving mild/light inju- red patients. (3) It takes longer time to deliver patients if they were injured on freeway in Taoyuan ( from 55 to 73 Km ). National Freeway Bureau should invite other hospitals such as medical center or regional hospital to join the emergency medical service network. (4) Between Keelung and Yangmei, driving in northbound direction on freeway is more dangerous than in southbound direction.The most dangerous section is on Taishan toll station zone ( from 35 to 36 Km) in northbound direction. The accident number and ETAN ( Equivalent - Traffic - Accident - Number ) are highest (42, 671.5) than other sections. It should be the number one section to be improved.
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Chou, Chang-Chi, and 周昌圻. "Emergency Medical Service Response Actions in Mass Casualty Incidents." Thesis, 2017. http://ndltd.ncl.edu.tw/handle/zd59fg.
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碩士國立臺灣大學
土木工程學研究所
105
Emergency Medical Service (EMS) responses are directly related to the survival rate of casualties in Mass Casualty Incidents (MCI). This study aims to assist EMS response actions in MCIs. In general, EMS response actions position the time of casualty arrival at a hospital (TAH) as the top priority. However, restricted by the finite number of ambulances, medical personnel, and other medical resources, the TAH should not be the only performance indicator in MCIs. The performance of hospitals and ambulances should also be taken into consideration. Therefore, the termination time of hospital treatment is a crucial performance indicator to EMS responses in MCIs. This study aims to establish a casualty assignment system with considering the operational condition of hospitals and traffic circumstance features to diminish the casualty rate in MCIs. In this work, a nonlinear model, composed of a cell transmission model and the impedance function representing the potential congestions in hospitals, is proposed. A Lagrangian heuristics is also developed to divide the original problem into two sub-problems: a linear one and the other nonlinear one. The nonlinear sub-problem is solved by gradient projection, optimizing EMS response actions. Numerical experiments and a series of analyses were conducted to verify the computational efficiency of the proposed model.
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"Analysis of accident and emergency services in Hong Kong: the level of inappropriate utilization and why?" Thesis, 2004. http://library.cuhk.edu.hk/record=b6075018.
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Objectives: This study has been conducted to determine the levels of inappropriate use of the A&E for conditions that could be treated by GPs, the nature of the morbidity pattern of those conditions, the reasons why primary care services were not being utilized, and also examined the validity (i.e. sensitivity and specificity) of patient classifications undertaken by nurses at the time of admission within this local context. Study design and setting: A cross sectional study was conducted over a one year period and subjects were randomly selected from four A&E departments located across the four principle geographic regions of Hong Kong by stratified, two-stage sampling. Main outcome measure: The gold standard in differentiating true emergency cases and GP cases was based on a retrospective record review conducted independently by a panel of emergency physicians. A random sub-sample of those classified as GP cases was interviewed and compared to a matched (via morbidity status) sample of primary care patients who had attended a hospitals' GOPC in order to determine factors distinguishing these two patient groups. Multiple Logistic Regression was used to distinguish the difference between GP cases and matched GOPC primary care patients on significance and odds ratios of the variables. The morbidity pattern according to ICPC was tabulated and analysed for the 'true' A&E cases and non-urgent cases. Sensitivity, specificity and positive predictive values were computed for both non-weighted and weighted conditions. Results: The level of GP cases was found to be 57% with a significant higher proportion of patients in younger age group, and late evening. The morbidity pattern of those top 10 diagnoses of non-urgent cases was very similar to the Hong Kong general practice morbidity pattern for self limiting conditions. Closure of the clinic was the main reason for GP cases attending A&E. Other major reasons were deterioration of symptoms, GPs' inability to diagnose efficiently and patients' wish to continue medical treatment in the same hospital. Affordability was the most pronounced reason for utilising the GOPC, but did not apply to the A&E GP patients. The most accurate weighted nurses' triage classification had the average sensitivity of 75%, specificity of 65.7%, and positive predictive value of 54%. The most accurate weighted patients' self-triage classification yielded a sensitivity of 43.3%, specificity of 49.2%, and a positive predictive value of 38.6%. Conclusion: The reasons for high level of utilisation of A&E services are complex and reflect problems of delivery of GP services. There is an urgent need for the GPs to set up a network system to provide out of hours services, and also for a better interfacing between primary and secondary care, and between public and private sectors, so that patients can be referred back to GPs. The design and measures chosen for this study will help provide A&E policy makers and planners with relevant information for better addressing practical solutions.Albert Lee.
Source: Dissertation Abstracts International, Volume: 73-01, Section: B, page: .
Thesis (M.D.)--Chinese University of Hong Kong, 2004.
Includes bibliographical references (leaves 137-151).
Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [201-] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Appendix 4 in Chinese.
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Huang, Chun-I., and 黃君毅. "An Approach to Cross-Hospital Emergency Medical Service Support System." Thesis, 2004. http://ndltd.ncl.edu.tw/handle/51078799723055945458.
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碩士國立臺灣科技大學
資訊工程系
92
For emergency medical services, it is important to have the patient’s vital medical information, such as identification, medical records, and allergy conditions ready for emergency physician’s use. In order to achieve this, we design a medical information exchange mechanism, so that hospitals can perform secure information exchange efficiently with privacy protection before patients are sent to the emergency hospital. We propose building a secure cross-hospital information exchange mechanism, which makes use of wireless networks, the Healthcare Certification Authority digital certificate mechanism by Department of Health, HL7, and other Internet technologies to facilitate the timely and secure information transfer.
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Soares, Rui Guilherme Machado. "Optimizing the Network of the Emergency Medical Service in Hanoi." Master's thesis, 2016. https://repositorio-aberto.up.pt/handle/10216/85553.
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(10947207), Susanna S. George. "EMERGENCY MEDICAL SERVICE EMR-DRIVEN CONCEPT EXTRACTION FROM NARRATIVE TEXT." Thesis, 2021.
Find full textAbstract:
Being in the midst of a pandemic with patients having minor symptoms that quickly
become fatal to patients with situations like a stemi heart attack, a fatal accident injury,
and so on, the importance of medical research to improve speed and efficiency in patient
care, has increased. As researchers in the computer domain work hard to use automation
in technology in assisting the first responders in the work they do, decreasing the cognitive
load on the field crew, time taken for documentation of each patient case and improving
accuracy in details of a report has been a priority.
This paper presents an information extraction algorithm that custom engineers certain existing extraction techniques that work on the principles of natural language processing like metamap along with syntactic dependency parser like spacy for analyzing the sentence structure and regular expressions to recurring patterns, to retrieve patient-specific information from medical narratives. These concept value pairs automatically populates the fields of an EMR form which could be reviewed and modified manually if needed. This report can then be reused for various medical and billing purposes related to the patient.
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George, Susanna Serene. "Emergency Medical Service EMR-Driven Concept Extraction From Narrative Text." Thesis, 2021. http://dx.doi.org/10.7912/C2/68.
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Indiana University-Purdue University Indianapolis (IUPUI)Being in the midst of a pandemic with patients having minor symptoms that quickly become fatal to patients with situations like a stemi heart attack, a fatal accident injury, and so on, the importance of medical research to improve speed and efficiency in patient care, has increased. As researchers in the computer domain work hard to use automation in technology in assisting the first responders in the work they do, decreasing the cognitive load on the field crew, time taken for documentation of each patient case and improving accuracy in details of a report has been a priority. This paper presents an information extraction algorithm that custom engineers certain existing extraction techniques that work on the principles of natural language processing like metamap along with syntactic dependency parser like spacy for analyzing the sentence structure and regular expressions to recurring patterns, to retrieve patient-specific information from medical narratives. These concept value pairs automatically populates the fields of an EMR form which could be reviewed and modified manually if needed. This report can then be reused for various medical and billing purposes related to the patient.
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Tang, Hui-Ping, and 唐惠屏. "The Study on the Remote Districts of Emergency Medical Service." Thesis, 2016. http://ndltd.ncl.edu.tw/handle/43548668042908906425.
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碩士國立交通大學
工學院產業安全與防災學程
104
Currently, there are sixty-five remote districts totally in Taiwan. and there, in general, they have characteristics of less population, a lot of scattered houses, narrow and rigid roads and expense shortage, etc. As a result, they lead to shortage of emergency medical service equipment. So it is an important issue for how to promote quality of emergency medical service there. Nan-jwon, Miaoli County, was the investigation district for this theory. We discovered and discussed the characteristic of emergency medical service there by collecting related data and information. And we analyzed the cases of emergency rescue over the past years and realized the execution of emergency rescue task there. We interviewed some experts to find out the current problems and difficulties that people encountered there for emergency medical service. We concluded the experts interview and made the investigation poll and analyzed the problems of local residents there and the reaction of executing emergency medical service for firefighters and volunteer firefighters. Therefore, we gave in how to cope with and improving ideas. Research showed that we wanted to promote quality of emergency medical service there. Beside promoting communication quality and building complete road map and information, establishing basic rescue facilities in the public places and increasing emergency medical service spots for sightseeing areas during the key period, we should enhance rescue concept and self-rescue ability for local residents. We anticipate that our government authorities can enhance hardware facilities of emergency medical service in the remote districts and start doing emergency rescue training for local residents. We hope to completely promote quality of emergency medical service there and protect people's safety of life.
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Ning, Chu, and 朱甯. "The Feasibility Estimation of Helicopter Emergency Medical Service in Taiwan." Thesis, 2013. http://ndltd.ncl.edu.tw/handle/49678353933438966728.
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碩士開南大學
空運管理學系
101
For the time being, the air medical service in Taiwan focuses mainly on aerial rescue or transfer to and from the outlying islands. Once crucial diseases, illnesses or injuries take place in the outlying islands, the emergent aerial rescues are necessary to transfer the patients to the appropriate medical centers. This research will take the helicopter aerial emergent rescue systems in Norway, Switzerland, Australia, Canada, The Netherlands, USA, Japan, Hong Kong, Germany, France, The United Kingdom, New Zealand, Italy, Portugal, Greece, Czech Republic, Slovakia, Hungary and South Africa as examples. It draws a comparison between these countries’ practice and methods and calculates the practical benefits for Taiwan based on the statistics in Japan. The research analyses the status quo of aerial rescues in the countries, including the comparisons of aerial rescue methods and relevant analysis of HEMS. It also clarifies the differences between aerial emergent rescues and aerial transfers so as to understand details related to aerial rescues. Feasibility analysis is used for relative comparative analysis. Cost-effectiveness is involved to analyze costs for respective items in order to understand the general impact done to health insurance. This research reveals that patients in 53% of the emergent cases in Taiwan can be transferred by ambulances to hospitals offering intensive medical care for treatment within one hour. Since the landscape in Taiwan is highly mountainous, it is extremely difficult to transfer patients to the appropriate hospitals within the Golden Hour (one hour) in case of emergencies. Many countries with a GDP at a similar level as Taiwan have already developed the optimal HEMS system, which makes it possible to transfer patients to the medical centers at the speed of 50km/15 min. Taiwan has still much space for the development of HEMS. According to this research, the average costs for double-engine helicopters over the span of 20 years should be 540 million NTD, while the average costs for single-engine helicopters over the span of 20 years should be 260 million NTD. If HEMS can provide Taiwan with 700 flights yearly according to the proportion raised by Doctor Heli in Japan, 27 more lives could have been saved than ambulances every year and the social costs can be reduced by 17.82 million NTD. Having been transferred by HEMS due to traffic accidents, there are 269 patients have cured completely and return to the society earlier, the number is much more than what ambulances on the ground can do. Their number of hospitalization days over the span of 20 years implies a saving of 1.73 million NTD approximately, while the saving on medical expenses should be 6.82 million NTD. The total saving would be 8.55 million NTD and the loss related to social costs may be 3.5 billion NTD.
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Sadrawi, Muammar, and 莫哈馬. "Intelligent Systems Applied to Anesthesia, Emergency Medical Service and Arrhythmia." Thesis, 2018. http://ndltd.ncl.edu.tw/handle/m4mz3t.
Full textAbstract:
博士元智大學
機械工程學系
106
Human physiological signals are critical in human body system. Bio-potential signals are produced by the electrochemical function. This signal can be electrocardiography (ECG) and electroencephalography (EEG). However, the raw ECG and EEG are mostly noisy and have hidden materials. Initially, the filtering algorithm need to be applied to the original signal. It is very important order to extract the information from the signal before the further evaluations. The empirical mode decomposition (EMD) filtering is utilized as the filtering algorithm. The fast Fourier transform (FFT) is one of the most evaluator for the signal processing. In further, the time frequency evaluation based-on the FFT can be one utilized for the short-time investigation. Other algorithms are entropy and detrended fluctuation analysis (DFA). Meanwhile, the DFA evaluates the integrated of the original signal to its local trends. In order to evaluate the given signal from our human body to the corresponding conditions, the classification algorithms should be selected. This thesis implemented these algorithms to the several applications related the human physiological system. The first application is the anesthesia. This evaluation is conducted using the 63 patient surgical data. In this study, the EMD filter is applied for filtering the EEG signal and the sample entropy is used as the feature extraction algorithm. This sample entropy is combined to the intermittent 5-second data to train the artificial neural network (ANN) with the output from averaged consciousness level given by 5 doctors. The main achievement of this application is the important of the electromyography (EMG) signal from the sensitivity analysis. This also help the classification result. The second application is the evaluation of the cardiopulmonary resuscitation (CPR) in the emergency medical system (EMS). This investigation is conducted from about a thousand asystole patient data. The EMD is used for the initial stage for the filtering of the CPR signal. The time frequency evaluation is utilized to display the corresponding signal to its frequency in a time axis evaluation. This application also uses the sample entropy, multiscale entropy and complexity index (CI) in order to evaluate the quality of the CPR given to the asystole patients. From this application, we found that the CI provides a significant difference result from the younger patients. This result may be applied for designing the automated CPR machine with the dynamic force. The third application from this study is the arrhythmia evaluation in wearable device. This research is conducted using four PhysioNet databases and is evaluated using the wearable device and the smartphone. The evaluated classes are the atrial premature complex (APC), ventricular premature complex (VPC), atrial fibrillation (AF) and ventricular fibrillation (VF) based on ANSI/AAMI EC57:2012. The APC and VPC are the beat-based arrhythmia. Meanwhile, AF and VF are the rhythm-based arrhythmia. From this study, a less complexity algorithms are selected in order to fit the device and the smartphone specifications. For this application, we conclude that our integrated algorithm detection can achieve a good accuracy in comparison to other previous studies. The last application is ensemble genetic fuzzy neuro model applied for the emergency medical service via unbalanced data evaluation. The raw data after the first filter is used consists of 4,408,187 patient datapoints. A linguistic algorithm is applied to evaluate the input and output relationship, namely Fuzzy c-Means (FCM), which is applied as a clustering algorithm for the majority class to balance the minority class data. Each cluster is used to train several ANN models. Different techniques are applied to generate an ensemble genetic fuzzy neuro model (EGFNM) in order to select the models. The first ensemble technique, the intra-cluster EGFNM, works by evaluating the best combination from all the models generated by each cluster. Another ensemble technique is the inter-cluster model EGFNM, which is based on selecting the best model from each cluster. The accuracy of these techniques is evaluated using the receiver operating characteristic (ROC) via its area under the curve (AUC). For the result, this study achieved improved results by performing the EGFNM method compared with the unbalanced training. This study concludes that selecting several best models will produce a better result compared with all models combined. In summary, for bio-signal processing, the EMD-filter is important to raw physiological signal purification. ANN, one of the intelligent systems, produces an acceptable result for some applications of the bio-signal processing. In further, the feature extraction methods, entropy-based algorithms, DFA and FFT, display some characteristics from the signal that may helpful for the classification or further evaluation. Meanwhile, for the unbalanced data modelling, EGFNM is developed for the model evaluation. This method is useful for the ensemble technique in selecting a set of the models for the future detection.
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Soares, Rui Guilherme Machado. "Optimizing the Network of the Emergency Medical Service in Hanoi." Dissertação, 2016. https://repositorio-aberto.up.pt/handle/10216/85553.
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Holgate, Robyn. "The opinion of emergency medical service personnel regarding safety in pre-hospital emergency care practice." Thesis, 2015. http://hdl.handle.net/10539/18678.
Full textAbstract:
A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of
Master of Science in Medicine in Emergency Medicine
Johannesburg, 2015The pre-hospital setting poses a potential threat to safety as emergency care takes place in a dynamic, uncontrolled and ever-changing environment. In addition Emergency Medical Services (EMS) personnel are generally overworked. All these factors translate to possible errors which may well compromise the health conditions of the patients. This study reflects the opinions of pre-hospital personnel regarding safety and as such the perception of the current state of safety in South African EMS. A prospective, descriptive and cross-sectional online survey was utilised to obtain opinions from respondents regarding pre-hospital safety in their work environment. Results A total of 610 electronic requests to partake in the survey were sent with a yield of 26.9% (n=164). A variety of questions relating to personal safety, patient safety and organisational safety culture were posed to the respondents. The typical respondent was a white (84%, n=134), male (69%, n=109), Advanced Life Support Paramedic (55%, n=86), between the age of 31 and 40 years (44%, n=69), who has between 11 and 15 years of EMS experience and works in in the private sector (62.5%, n=65). Concerns included management support, fatigue, vehicle accidents and interpersonal violence. The majority have been exposed to vehicle accidents (54.2%, n=84) and it is believed that management could do more to ensure vehicle safety. Interpersonal violence should not be considered an anomaly in the EMS. The perceived incidence of violence towards the respondents is 56% (n=88), which is lower than that experienced by their international EMS colleagues. This workplace interpersonal violence was deemed the most important safety concern. Most respondents did not seem to think that medical adverse events were particularly prevalent in their work environment, but appeared more comfortable admitting to having witnessed others making errors. Limitations include a convenience sample which does not represent all EMS, and it is recommended that a representative study be completed. Conclusion Contributing factors towards safety concerns include lack of management support, poor communication from management, fatigue, interpersonal violence and inadequate staffing. There is evidence of a focus on a patient safety culture within the EMS.
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Cheng, Wen-Pin, and 鄭文萍. "Exploring the satisfaction on the service quality of the Emergency Medical Technician among emergency nurses." Thesis, 2018. http://ndltd.ncl.edu.tw/handle/ee582m.
Full textAbstract:
碩士樹德科技大學
會展管理與貿易行銷碩士學位學程
106
Background and purpose: The study mainly explored emergency nurses satisfaction on the pre-hospital emergency service quality of Emergency Medical Technicians. Usually Emergency Medical Technician is the first responder of an emergency medical event, the quality of pre-hospital emergency medical care has accordingly become rather crucial. Therefore, the study aims at improving the quality of the future emergency medical service by focusing on emergency nurses initial assessment of the performance of Emergency Medical Technician. Method: Sampling by analyzing the situation between emergency nurses of Kaohsiung regional or higher class Medical Institutions and Emergency Medical Technicians of fire departments. 202 samples have been acquired and used to implement the analysis. Statistics software SPSS 20 was adopted to perform reliability analysis, descriptive statistics, analysis of variance (ANOVA); post-hoc comparison analysis (LSD) was applied to explain the influences between every variance. Result: The result has shown that “ER seniority” of emergency nurses gave the highest rating to Emergency Medical Technicians on the overall satisfaction and professional attitude. Emergency nurses with different “ER seniority” provide different rating of overall satisfaction and professional attitude to Emergency Medical Technicians, and new emergency nurses with less than one year or emergency nurses with more than five-year experiences gave the highest rates. “Professional ability” of emergency nurses also had an impact on the professional attitude performed by Emergency Medical Technician, and particularly the new emergency nurses with less than one year experience gave the highest rating. In terms of the “Medical institution” of emergency nurses, E-DA Cancer Hospital gave the highest rates in regard to professional skills of Emergency Medical Technician and overall satisfaction. Conclusion: Upgrading the consistency of pre-hospital and post-hospital emergency medical service will ensure the rights of the ones who call for help. Having more practical training and enhancing the essential ability will enable the Emergency Medical Technician to provide the patients better service quality from accident scene to emergency room.
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Chang, Hsuan-Huan, and 張炫煥. "Influence Factors of Emergency Medical Service Training Achievements for the Army." Thesis, 2010. http://ndltd.ncl.edu.tw/handle/6exgju.
Full textAbstract:
碩士國立臺北科技大學
商業自動化與管理研究所
98
The government has legislated and promulgated the emergency medical service law since 1995, in order to set forth the emergency medical aid to be a new milestone in our country. The national emergency medical service units have faced an oncoming era of Knowledge Economics, that the managing level urges to realize that the most important core resources will be only Knowledge, by having completion of the concepts of knowledge management and educational training, so as to have all the units’ innovational value achieved, enhancing their working efficiency. This research will take various kinds of possible causes into consideration, influencing the army service units’ working efficiency, in a course of justifying the educational training system for the related personnel and improvements of the army emergency medical service. This research has rendered by having modules of quantification and necessary procedures, in which, the reviewing results of literature discussion is variable that the appropriate questionnaire Form were designed, after getting through the Instructors’ guidance to integrate the interior uniformity and then delivering a total of 632 copies of the questionnaires, namely 562 copies returned (in addition to 539 valid copies submitted by 253 doctors, 139 officers and 147 soldiers, excluding 23 invalid copies due to incomplete answers). At a rate of 88.9% questionnaire forms retrieved, as a matter of statistics, analyzing all the valid Samples by clarifying each characteristic, knowledge management, training plans, professional capability, etc., for the purpose of justifying different categories of educational training records. Basing on the evidence of the empirical analysis results, we have implanted the concepts of knowledge management and first aid technique as well as functions, by inviting experts to offer class lectures and/or speeches in order to obtain most of the professional information, but also induce much more interests to do so and comply with the basic requirements of the training achievements. The medical rescue personnel should get accustomed to learn about knowledge management, so that they can be provided with motive power to up-to-date their new learning packages, even much better emergency medical service technique for the various management behaviors to be gained、accumulated、shared and applied, then the army emergency medical service training system could be fully achieved. In short, the enhancement of the army personnel are willing to study more about emergency medical service training, to emphasize the importance of training plans, to make up the insufficient of the existing training programs, to increase the trainees’ satisfaction of the training system. Further more, the advanced technique and professional applications could make a great effort to increase the first aid service quality, in order to reach an ideal of macro achievements of the army emergency medical service efficiencies.