Prehospital and disaster medicine: the official journal of the National Association of EMS Physicians and the World Association for Emergency and Disaster Medicine in association with the Acute Care Foundation
Background: Data on use of pre-hospital emergency medical services (EMS) by patients with cardiac... more Background: Data on use of pre-hospital emergency medical services (EMS) by patients with cardiac conditions in the Gulf region are scarce, and prior studies have suggested underutilization. Patient perception and knowledge of EMS care is critical to proper utilization of such services. Objectives: To estimate utilization, knowledge and perceptions of pre-hospital EMS services among patients with ST Elevation Myocardial Infarction in the Emirate of Abu Dhabi. Methods: We conducted a multicentre prospective study of consecutive patients admitted with STEMI in 4 government hospitals in Abu Dhabi. Semi structured interviews were conducted with patients to assess rationale for choosing their pre-hospital mode of transport and their knowledge of EMS services. Results: Of 587 patients with STEMI (age 51 ± 11 years, Male 95%), only 15% presented through EMS, and the remainder came via private transport. Over half of the participants (55%) stated that they did not know the telephone number ...
ABSTRACT Introduction Physician perceptions about emergency medical services (EMS) are important ... more ABSTRACT Introduction Physician perceptions about emergency medical services (EMS) are important determinants of improving pre-hospital care for cardiac emergencies. No data exist on physician attitudes towards EMS care of patients with ST-Elevation Myocardial Infarction (STEMI) in the Emirate of Abu Dhabi. Objectives To describe the perceptions towards EMS among physicians caring for patients with STEMI in Abu Dhabi. Methods We surveyed a convenience sample of physicians involved in the care of patients with STEMI (emergency medicine, cardiology, cardiothoracic surgery and intensive care) in four government facilities with 24/7 Primary PCI in the Emirate of Abu Dhabi. Surveys were distributed using dedicated email links, and used 5-point Likert scales to assess perceptions and attitudes to EMS. Results Of 106 physician respondents, most were male (82%), practicing in emergency medicine (47%) or cardiology (44%) and the majority (63%) had been in practice for >10 years. Less than half of the responders (42%) were “Somewhat Satisfied” (35%) or “Very Satisfied” (7%) with current EMS level of care for STEMI patients. Most respondents were “Very Likely” (67%) to advise a patient with a cardiac emergency to use EMS, but only 39% felt the same for themselves or their family. Most responders were supportive (i.e. “Strongly Agree”) of the following steps to improve EMS care: 12-lead ECG and telemetry to ED by EMS (69%), EMS triage of STEMI to PCI facilities (65%), and activation of PCI teams by EMS (58%). Only 19% were supportive of pre-hospital fibrinolytics by EMS. There were no significant differences in the responses among the specialties. Conclusions Most physicians involved in STEMI care in Abu Dhabi are very likely to advise patients to use EMS for a cardiac emergency, but less likely to do so for themselves or their families. Different specialties had concordant opinions regarding steps to improve pre-hospital EMS care for STEMI. Keywords: Emergency Medical Services, ST Elevation Myocardial Infarction, Survey
Received 25 April 2012; accepted 25 April 2012. published online 23 May 2012. ... No abstract is ... more Received 25 April 2012; accepted 25 April 2012. published online 23 May 2012. ... No abstract is available. To read the body of this article, please view the Full Text online. ... Visit SciVerse ScienceDirect to see if you have access via your institution. ... Advertisements on this site ...
The aim of this study was to compare vital signs of minimally injured and moderately injured pati... more The aim of this study was to compare vital signs of minimally injured and moderately injured patients during ambulance transport and subsequent emergency department (ED) assessment. We carried out a retrospective chart review. Patients were divided into two groups: minimally injured patients with neck pain (group 1) and moderately injured patients with a closed ankle or wrist fracture (group 2). The Wilcoxon signed-rank test was used to compare vital signs within groups during transport and ED assessment. Groups 1 and 2 included 90 and 118 patients, respectively. In group 1, systolic blood pressure was significantly lower (P=0.001, median difference 8 mmHg) and heart rate was significantly higher (P<0.01, median difference 3 beats/min) during transport than during ED assessment. There was no significant difference in respiratory rate in group 1 or any of the vital signs in group 2. We conclude that transport anxiety has minimal effect on vital signs. In trauma, clinicians should exclude tissue injury before attributing increased systolic blood pressure or heart rate to anxiety.
Prehospital and disaster medicine: the official journal of the National Association of EMS Physicians and the World Association for Emergency and Disaster Medicine in association with the Acute Care Foundation
Background: Data on use of pre-hospital emergency medical services (EMS) by patients with cardiac... more Background: Data on use of pre-hospital emergency medical services (EMS) by patients with cardiac conditions in the Gulf region are scarce, and prior studies have suggested underutilization. Patient perception and knowledge of EMS care is critical to proper utilization of such services. Objectives: To estimate utilization, knowledge and perceptions of pre-hospital EMS services among patients with ST Elevation Myocardial Infarction in the Emirate of Abu Dhabi. Methods: We conducted a multicentre prospective study of consecutive patients admitted with STEMI in 4 government hospitals in Abu Dhabi. Semi structured interviews were conducted with patients to assess rationale for choosing their pre-hospital mode of transport and their knowledge of EMS services. Results: Of 587 patients with STEMI (age 51 ± 11 years, Male 95%), only 15% presented through EMS, and the remainder came via private transport. Over half of the participants (55%) stated that they did not know the telephone number ...
ABSTRACT Introduction Physician perceptions about emergency medical services (EMS) are important ... more ABSTRACT Introduction Physician perceptions about emergency medical services (EMS) are important determinants of improving pre-hospital care for cardiac emergencies. No data exist on physician attitudes towards EMS care of patients with ST-Elevation Myocardial Infarction (STEMI) in the Emirate of Abu Dhabi. Objectives To describe the perceptions towards EMS among physicians caring for patients with STEMI in Abu Dhabi. Methods We surveyed a convenience sample of physicians involved in the care of patients with STEMI (emergency medicine, cardiology, cardiothoracic surgery and intensive care) in four government facilities with 24/7 Primary PCI in the Emirate of Abu Dhabi. Surveys were distributed using dedicated email links, and used 5-point Likert scales to assess perceptions and attitudes to EMS. Results Of 106 physician respondents, most were male (82%), practicing in emergency medicine (47%) or cardiology (44%) and the majority (63%) had been in practice for >10 years. Less than half of the responders (42%) were “Somewhat Satisfied” (35%) or “Very Satisfied” (7%) with current EMS level of care for STEMI patients. Most respondents were “Very Likely” (67%) to advise a patient with a cardiac emergency to use EMS, but only 39% felt the same for themselves or their family. Most responders were supportive (i.e. “Strongly Agree”) of the following steps to improve EMS care: 12-lead ECG and telemetry to ED by EMS (69%), EMS triage of STEMI to PCI facilities (65%), and activation of PCI teams by EMS (58%). Only 19% were supportive of pre-hospital fibrinolytics by EMS. There were no significant differences in the responses among the specialties. Conclusions Most physicians involved in STEMI care in Abu Dhabi are very likely to advise patients to use EMS for a cardiac emergency, but less likely to do so for themselves or their families. Different specialties had concordant opinions regarding steps to improve pre-hospital EMS care for STEMI. Keywords: Emergency Medical Services, ST Elevation Myocardial Infarction, Survey
Received 25 April 2012; accepted 25 April 2012. published online 23 May 2012. ... No abstract is ... more Received 25 April 2012; accepted 25 April 2012. published online 23 May 2012. ... No abstract is available. To read the body of this article, please view the Full Text online. ... Visit SciVerse ScienceDirect to see if you have access via your institution. ... Advertisements on this site ...
The aim of this study was to compare vital signs of minimally injured and moderately injured pati... more The aim of this study was to compare vital signs of minimally injured and moderately injured patients during ambulance transport and subsequent emergency department (ED) assessment. We carried out a retrospective chart review. Patients were divided into two groups: minimally injured patients with neck pain (group 1) and moderately injured patients with a closed ankle or wrist fracture (group 2). The Wilcoxon signed-rank test was used to compare vital signs within groups during transport and ED assessment. Groups 1 and 2 included 90 and 118 patients, respectively. In group 1, systolic blood pressure was significantly lower (P=0.001, median difference 8 mmHg) and heart rate was significantly higher (P<0.01, median difference 3 beats/min) during transport than during ED assessment. There was no significant difference in respiratory rate in group 1 or any of the vital signs in group 2. We conclude that transport anxiety has minimal effect on vital signs. In trauma, clinicians should exclude tissue injury before attributing increased systolic blood pressure or heart rate to anxiety.
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