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1.
Int Emerg Nurs ; 62: 101170, 2022 05.
Article in English | MEDLINE | ID: covidwho-1804221

ABSTRACT

INTRODUCTION: Emergency Department (ED) nurses and Emergency Medical Services (EMS) Staff are faced with several stressors daily, such as the COVID 19 pandemic situation, which affects the health and the quality of services to patients. Spiritual coping with stress is an attempt to overcome the stress on the basis of what is transcendent. The use of spiritual coping strategies helps a person to overcome tensions caused by the work environment. OBJECTIVE: The current study aimed to investigate occupational stress and its relationship with spiritual coping among ED nurses and EMS staff. MATERIALS AND METHODS: This study was descriptive-correlational research. Using convenience sampling methods, 516 ED nurses and EMS staff were enrolled in the study. The study instruments included demographic information, HSE Occupational Stress, and spiritual coping questionnaires. Data were analyzed using SPSSv.22 software and the descriptive statistics, Pearson correlation test, t-test, ANOVA, and multiple linear regression. RESULTS: The highest and lowest levels of occupational stress were the dimensions of "demand" (2.96 ± 0.65) and "role" (3.89 ± 0.81) respectively. Multiple linear regression analysis showed that positive spiritual coping, negative spiritual coping, workplace, service location, type of employment, and work position were important factors affecting the occupational stress of ED nurses and EMS staff, which accounted for 0.34% of the variance. CONCLUSION: The findings showed the need to improve the work environment for ED nurses and EMS staff, including changes in physical working conditions, salaries, and better employment conditions. Training programs are recommended to reduce stress through the use of positive spiritual coping strategies.


Subject(s)
COVID-19 , Emergency Medical Services , Occupational Stress , Adaptation, Psychological , Cross-Sectional Studies , Emergency Service, Hospital , Humans , Surveys and Questionnaires
2.
Journal Européen des Urgences et de Réanimation ; 2022.
Article in English | ScienceDirect | ID: covidwho-1796514

ABSTRACT

Résumé En Île-de-France, le SAMU Zonal conformément au dispositif ORSAN assure la coordination et notamment le renfort réciproque des 8 SAMU de la région qui est aussi la Zone de Défense. À ce titre, il a été mobilisé au cours de plusieurs situations sanitaires exceptionnelles (SSE) depuis 2014 telles que les attentats terroristes de 2015 et la crise COVID. Son objectif était d’harmoniser la réponse médicale et d’optimiser l’utilisation des ressources existantes au sein des SAMU d’IDF. Il a établi les moyens de communication et les organisations nécessaires à la gestion de la crise notamment la mise en place des structures transitoires et dédiées de régulation médicale. Summary In Île-de-France (IDF), the SAMU Zonal in accordance with the ORSAN plan, ensures the coordination and in particular the reciprocal reinforcement of the 8 SAMU of the region which is also the Defense Zone. As such, it has been mobilized during several exceptional health situations since 2014 such as the 2015 terrorist attacks and the COVID. Its objective was to harmonize the medical response and optimize the use of existing resources within the SAMU of IDF. It has established the means of communication and the organizations needed to manage the crisis, in particular temporary and dedicated structures for medical regulation.

3.
Vaccines (Basel) ; 10(3)2022 Mar 09.
Article in English | MEDLINE | ID: covidwho-1792382

ABSTRACT

(1) Background: The COVID-19 vaccination has caused uncertainty among employees and employers regarding vaccination reactions and incapacitation. At the time of our study, three vaccines are licensed in Germany to combat the COVID-19 pandemic (BioNTech/Pfizer (Comirnaty), AstraZeneca (Vaxzevria), and Moderna (Spikevax). We aim to assess how often and to what extent frontline healthcare workers had vaccination reactions after the first and second vaccination. The main focus is on the amount of sick leave after the vaccinations. (2) Methods: We create a web-based online questionnaire and deliver it to 270 medical directors in emergency medical services all over Germany. They are asked to make the questionnaire public to employees in their area of responsibility. To assess the association between independent variables and adverse effects of vaccination, we use log-binomial regression to estimate prevalence ratios (PR) with 95% confidence intervals (95%CI) for dichotomous outcomes (sick leave). (3) Results: A total of 3909 individuals participate in the survey for the first vaccination, of whom 3657 (94%) also provide data on the second vaccination. Compared to the first vaccination, mRNA-related vaccine reactions are more intense after the second vaccination, while vaccination reactions are less intense for vector vaccines. (4) Conclusion: Most vaccination reactions are physiological (local or systemic). Our results can help to anticipate the extent to which personnel will be unable to work after vaccination. Even among vaccinated HCWs, there seems to be some skepticism about future vaccinations. Therefore, continuous education and training should be provided to all professionals, especially regarding vaccination boosters. Our results contribute to a better understanding and can therefore support the control of the pandemic.

4.
IAF Space Exploration Symposium 2021 at the 72nd International Astronautical Congress, IAC 2021 ; A3, 2021.
Article in English | Scopus | ID: covidwho-1782250

ABSTRACT

The Astrobotic M1 mission, as the first mission of NASA s Commercial Lunar Payload Services (CLPS) program, is scheduled to land in the Lacus Mortis region of the Moon in early 2022. Among its payloads it will carry the Peregrine Ion Trap Mass Spectrometer (PITMS), an instrument supplied by NASA GSFC that is dedicated to the investigation of the lunar exosphere, and which includes as its core component the ESA-provided Exospheric Mass Spectrometer (EMS). EMS was developed under an ESA contract by an academic/industrial consortium led by Open University (UK) using a fast track development approach that aimed at delivery of a Proto-Flight Model (PFM) instrument with drastically reduced development time. The chosen development approach and the demanding project schedule (18 months from contract start to flight hardware delivery) posed a number of specific project management challenges for successful development of the instrument within the ESA flight hardware development framework and under constraints imposed by the Covid-19 pandemic. With an as-built envelope of HWD of 168 149 127mm, a mass of 1.48kg and a typical power consumption during measurement not exceeding 9.5 Watts the instrument has modest resource requirements. EMS can be re-used in different future application scenarios, including investigations of the lunar exosphere, analysis of gases evolved from acquired samples, and monitoring aspects of the environmental impact of landers and robotic and human activities on the lunar environment. © 2021 International Astronautical Federation, IAF. All rights reserved.

5.
Front Public Health ; 10: 841013, 2022.
Article in English | MEDLINE | ID: covidwho-1776047

ABSTRACT

Background: In the Euregio-Meuse-Rhine (EMR), cross-border collaboration is essential for resource-saving and needs-based patient care within the emergency medical service (EMS) systems and interhospital transport (IHT). However, at the onset of the novel coronavirus SARS-COV-2 (COVID-19) pandemic, differing national measures highlighted the fragmentation within the European Union (EU) in its various approaches to combating the pandemic. To assess the consequences of the pandemic in the EMR border area, the aim of this study was to analyze the effects and "lessons learned" regarding cross-border collaboration in EMS and IHT. Method: A qualitative study with 22 semi-structured interviews was carried out. Experts from across the EMR area, including the City of Aachen, the City region of Aachen, the District of Heinsberg (Germany), South Limburg (The Netherlands), and the Province of Limburg, as well as Liège (Belgium), took part. The interviews were coded and analyzed according to changes in cross-border collaboration before and during the pandemic, as well as lessons learned and recommendations. Results: Each EU member country within the EMR area, addressed the pandemic individually with national measures. Cross-border collaboration between regional actors was hardly or not at all addressed at the national level during political decision- or policymaking. Previous direct communication at the personal level was replaced by national procedures, which made regular cross-border collaboration significantly more difficult. The cross-border transfer regulations of patients with COVID-19 proved to be complex and led, among other things, to patients being transported to hospitals far outside the border region. Collaboration continues to be seen as valuable and Euregional emergency services including hospitals work well together, albeit to different degrees. The information and data exchange should, however, be more transparent to use resources more efficiently. Conclusion: Effective Euregional collaboration of emergency services is imperative for public safety in a multi-border region with strong economic, cultural, and social cross-border links. Our findings indicate that existing (pre-pandemic) structures which included regular meetings of senior managerial staff in the region and a number of thematic working groups were helpful to deal with and to compensate for the disruptions during the crisis. Regional cross-border agreements that are currently based on mutual but more or less informal arrangements need to be formalized and better promoted and recognized also at the national and EU level to increase resilience. The continuous determination of synergies and good and best practices are further approaches to support cross-border collaboration especially in preparation for future crises.


Subject(s)
COVID-19 , Emergency Medical Services , COVID-19/epidemiology , European Union , Expert Testimony , Humans , SARS-CoV-2
6.
Prehosp Disaster Med ; : 1-5, 2022 Mar 03.
Article in English | MEDLINE | ID: covidwho-1758068

ABSTRACT

BACKGROUND: The Middle East and North Africa (MENA) region has been, like many parts of the world, a hotbed for terrorist activities. Terrorist attacks can affect both demand for and provision of health care services and often places a unique burden on first responders, hospitals, and health systems. This study aims to provide an epidemiological description of all terrorism-related attacks in the Middle East sustained from 1970-2019. METHODS: Data collection was performed using a retrospective database search through the Global Terrorism Database (GTD). The GTD was searched using the internal database search functions for all events which occurred in Iraq, Yemen, Turkey, Egypt, Syria, West Bank and Gaza Strip, Israel, Lebanon, Iran, Saudi Arabia, Bahrain, Jordan, Kuwait, United Arab Emirates, North Yemen, Qatar, and South Yemen from January 1, 1970 - December 31, 2019. Primary weapon type, primary target type, country where the incident occurred, and number of deaths and injuries were collated and the results analyzed. RESULTS: A total of 41,837 attacks occurred in the Middle East from 1970-2019 accounting for 24.9% of all terrorist attacks around the world. A total of 100,446 deaths were recorded with 187,447 non-fatal injuries. Fifty-six percent of all attacks in the region occurred in Iraq (23,426), 9.4% in Yemen (3,929), and 8.2% in Turkey (3,428). "Private Citizens and Properties" were targeted in 37.6% (15,735) of attacks, 15.4% (6,423) targeted "Police," 9.6% targeted "Businesses" (4,012), and 9.6% targeted "Governments" (4,001). Explosives were used in 68.4% of attacks (28,607), followed by firearms in 20.4% of attacks (8,525). CONCLUSION: Despite a decline in terrorist attacks from a peak in 2014, terrorist events remain an important cause of death and injuries around the world, particularly in the Middle East where 24.9% of historic attacks took place. While MENA countries are often clustered together by economic and academic organizations based on geographical, political, and cultural similarities, there are significant differences in terrorist events between countries within the region. This is likely a reflection of the complexities of the intricate interplay between politics, culture, security, and intelligence services unique to each country.

7.
Dissertation Abstracts International Section A: Humanities and Social Sciences ; 83(4-A):No Pagination Specified, 2022.
Article in English | APA PsycInfo | ID: covidwho-1717539

ABSTRACT

COVID-19 pandemic has brought unprecedented strain on the health care system around the world and challenged it like never before in the recent history. The impacts of disasters including pandemics are not limited to the headlines and news reports of number of affected people and costs. The short and long-term effects of disasters on Emergency Medical Services (EMS) providers are often overlooked. The needs and concerns of EMS providers are usually neglected. A rich data exists in the literature regarding disasters including pandemics. Yet, a significant gap related to EMS providers working during pandemics was revealed through the literature. Few studies have addressed the personal and professional impacts of role conflict on EMS providers' and their willingness to respond.This qualitative constructivist study provides important insights invaluable as to the work-family conflict phenomena amongst EMS providers during one of the worst pandemics in modern history. Specifically, the purpose of this study was to critically evaluate the sources of work-family conflict among EMS providers who responded during COVID-19 pandemic. Role theory with the work-family conflict pressure model were used to advance the study. The research questions that guided this study was What are the sources of work-family conflict among EMS providers during COVID-19? In-depth semi-structured interviews carried out with 30 EMS providers from 20 different states within the United States. Moreover, the ATLAS.ti qualitative analysis software was used during analysis to code data and develop themes and subthemes. The findings demonstrated several unique challenges and concerns for EMS providers during COVID-19. The analysis revealed three major themes with their subthemes of work-family conflict sources of: 1) strain-based conflict with subthemes including: 1.1) fears and concerns, 1.2) role ambiguity, 1.3) inadequate resources (lack of PPE and inadequate education and training 1.4) lack of confidence in the employer, 2) time-based conflict with subthemes included: 2.1) increased workload, 2.2) Mandatory overtime 2.3) decreased time spent with family , and 3) behavior-based conflict with subtheme included: 3.1) implement excessive precautionary measures, 3.2) obsessive behaviors, 3.3) negative emotions, and 3.4) limited interaction with family members. The knowledge gained from this study will inform EMS education, research, and practice, as well as health policy related to the care of responders and their loved ones and create balance between work and family before, during, and after disasters. Hence, enhance the development of disaster response plans and policies and the effectiveness of care provided. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

8.
J Am Coll Emerg Physicians Open ; 3(2): e12687, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1718290

ABSTRACT

OBJECTIVES: The COVID-19 pandemic has had an impact on emergency medical services (EMS) and its guidelines, which aid in patient care. This study characterizes state and territory EMS office recommendations to EMS statewide operational and clinical guidelines and describes the mechanisms of distribution and implementation during the COVID-19 pandemic. METHODS: A mixed-methods study was conducted in 2 phases. In phase 1, changes and development of COVID-19 guidance and protocols for EMS clinical management and operations were identified among 50 states, the District of Columbia, and 5 territories in publicly available online documents and information. In phase 2, structured interviews were conducted with state/territory EMS officials to confirm the protocol changes or guidance and assess dissemination and implementation strategies for COVID-19. RESULTS: In phase 1, publicly available online documents for 52 states/territories regarding EMS protocols and COVID-19 guidance were identified and reviewed. Of 52 (33/52) states/territories, 33 had either formal protocol changes or specific guidance for the pandemic. In phase 2, 2 state and territory EMS officials were interviewed regarding their protocols or guidance for COVID-19 and the dissemination and implementation practices they used to reach EMS agencies (response rate = 65%). Of the 34 state/territory officials interviewed, 22 had publicly available online COVID-19 protocols or guidance. Of the 22 officials with online COVID-19 protocols, all reported providing operational direction, and 19 of 22 officials reported providing clinical direction. CONCLUSIONS: Most states provided guidance to EMS agencies and/or updated protocols in response to the COVID-19 pandemic.

9.
Int J Ind Ergon ; 88: 103260, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1704443

ABSTRACT

INTRODUCTION: In April 2020, novel coronavirus SARS-CoV-2 (COVID-19) produced an ongoing mass fatality event in New York. This overwhelmed hospital morgues necessitating emergent expansion of capacity in the form of refrigerated trucks, trailers, and shipping containers referred to as body collection points (BCPs). The risks for musculoskeletal injury during routine and mass fatality mortuary operations and experiences of decedent handlers throughout the "first wave" of COVID-19 are presented along with mitigation strategies. METHODS: Awareness of the high rates of musculoskeletal injury among health care workers due to ergonomic exposures from patient handling, including heavy and repetitive manual lifting, prompted safety walkthroughs of mortuary operations at multiple hospitals within a health system in New York State by workforce safety specialists. Site visits sought to identify ergonomic exposures and ameliorate risk for injury associated with decedent handling by implementing engineering, work practice, and administrative controls. RESULTS: Musculoskeletal exposures included manual lifting of decedents to high and low surfaces, non-neutral postures, maneuvering of heavy equipment, and push/pull forces associated with the transport of decedents. DISCUSSION: Risk mitigation strategies through participatory ergonomics, education on body mechanics, development of novel handling techniques implementing friction-reducing aides, procurement of specialized equipment, optimizing BCP design, and facilitation of communication between hospital and system-wide departments are presented along with lessons learned. After-action review of health system workers' compensation data found over four thousand lost workdays due to decedent handling related incidents, which illuminates the magnitude of musculoskeletal injury risk to decedent handlers.

10.
Prehosp Disaster Med ; 37(2): 269-272, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1692722

ABSTRACT

BACKGROUND: Hesitancy towards the coronavirus disease 2019 (COVID-19) vaccine has been a topic of considerable concern in recent months. Studies have reported hesitancy within the general population and specific facets of the health care system. Little evidence has been published about vaccine hesitancy among Emergency Medical Services (EMS) providers despite them having played a frontline role throughout the pandemic. METHODS: A 27-question survey examining vaccination decisions and potential influencing factors among EMS providers was created and disseminated. Responses from providers who declined a COVID-19 vaccine were compared with responses from providers who did not decline a COVID-19 vaccine. RESULTS: Across 166 respondents, 16% reported declining a COVID-19 vaccine. Providers who self-identified as men, providers who reported conservative or conservative-leaning beliefs, and providers surrounded by environments where the vaccine was discussed negatively or not encouraged are significantly more likely to decline a vaccine (P <.01). Providers who have declined a vaccine reported significantly greater levels of concern about its safety, effectiveness, and development (P <.01). CONCLUSION: This study answers key questions about why some EMS providers might be declining COVID-19 vaccinations. Initiatives to improve vaccination among EMS providers should focus on the areas highlighted, and further studies should continue to examine vaccine hesitancy among EMS providers as well as in other populations.


Subject(s)
COVID-19 , Emergency Medical Services , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/therapeutic use , Humans , Male , Motivation , SARS-CoV-2 , United States/epidemiology , Vaccination
11.
Cent Eur J Oper Res ; : 1-52, 2021 Sep 18.
Article in English | MEDLINE | ID: covidwho-1653542

ABSTRACT

Emergency services worldwide face increasing cost pressure that potentially limits their existing resources. In many countries, emergency services also face the issues of staff shortage-creating extra challenges and constraints, especially during crisis times such as the COVID-19 pandemic-as well as long distances to sparsely populated areas resulting in longer response times. To overcome these issues and potentially reduce consequences of daily (medical) emergencies, several countries, such as Sweden, Germany, and the Netherlands, have started initiatives using new types of human resources as well as equipment, which have not been part of the existing emergency systems before. These resources are employed in response to medical emergency cases if they can arrive earlier than emergency medical services (EMS). A good number of studies have investigated the use of these new types of resources in EMS systems, from medical, technical, and logistical perspectives as their study domains. Several review papers in the literature exist that focus on one or several of these new types of resources. However, to the best of our knowledge, no review paper that comprehensively considers all new types of resources in emergency medical response systems exists. We try to fill this gap by presenting a broad literature review of the studies focused on the different new types of resources, which are used prior to the arrival of EMS. Our objective is to present an application-based and methodological overview of these papers, to provide insights to this important field and to bring it to the attention of researchers as well as emergency managers and administrators.

12.
Médecine de Catastrophe - Urgences Collectives ; 2022.
Article in French | ScienceDirect | ID: covidwho-1634507

ABSTRACT

Résumé La gestion des flux de patients pendant la pandémie COVID-19 a conduit les établissements de santé à s’entraider de façon à diminuer la charge de travail et le manque de lits de réanimation dans certaines régions de France, dont l’Ile de France. Cet article décrit le rationnel des prises de décision et leur déclinaison en termes d’organisation des transports aériens avec la création d’un centre médical d’évacuation (CME) sur un aéroport. Summary The management of patient flows during the COVID-19 pandemic led health care institutions to help each other in order to reduce the workload and the lack of resuscitation beds in some regions of France, including the Ile de France. This article describes the rationale for decision-making and its application in terms of the organization of air transport with the creation of an evacuation medical center (CME) at an airport.

13.
Child Abuse Negl ; 125: 105482, 2022 03.
Article in English | MEDLINE | ID: covidwho-1616418

ABSTRACT

BACKGROUND: Emergency Medical Services (EMS) use for children is correlated with areas of resource deprivation as well as child maltreatment. Households using EMS may have more social needs and be willing to accept services. OBJECTIVE: To compare social service needs and willingness to accept services in families arriving to a pediatric emergency department (ED) via EMS vs non-EMS, before and during COVID-19. PARTICIPANTS AND SETTING: Caregivers of children 0-5 years old in a quaternary pediatric ED, with a 1:1 ratio of EMS vs non-EMS arrivals. METHODS: Participants completed a survey of demographics, social service needs, and willingness to accept services, before and during COVID-19. RESULTS: Of 220 participants, 84 were enrolled before COVID-19. The EMS group reported less full-time employment (34.6% vs 51.8%, p < 0.05) and more social service needs (2.47 vs 1.76 needs, p < 0.05). Mean score for willingness to accept a service provider in the home was 3.62 for EMS and 3.19 for non-EMS (p = 0.09). Mean score for accepting a phone referral was 3.84 for EMS and 3.40 for non-EMS (p = 0.07). COVID-19 impacted needs for both groups (20.9% EMS vs 30.3% non-EMS). For all subjects presenting to the ED, COVID-19 was associated with decreased food insecurity (28.6% vs 15.4%) and children with a chronic medical condition (31.0% vs 12.5%). CONCLUSIONS: The EMS group had more social service needs. There was no difference in social services acceptance. COVID-19 affected both groups' needs. Future interventions may use EMS systems to mitigate social service needs which may be risk factors for child abuse.


Subject(s)
COVID-19 , Emergency Medical Services , Child , Child, Preschool , Emergency Service, Hospital , Humans , Infant , Infant, Newborn , SARS-CoV-2 , Social Work
14.
Am J Emerg Med ; 53: 1-5, 2022 03.
Article in English | MEDLINE | ID: covidwho-1588529

ABSTRACT

OBJECTIVE: To explore trends and patterns of laypeople's activity for seeking telephone number of emergency medical services (EMS) based on analysis of online search traffic, including changes of the search activity with onset of the coronavirus disease 2019 (COVID-19) outbreak, in five countries - the United States of America (USA), India, Brazil, the United Kingdom (UK) and Russia. METHODS: Google Trends (GT) country-level data on weekly relative search volumes (RSV) for top queries to seek EMS number were examined for January 2018-October 2021, including a comparison of RSVs between pre-COVID-19 period (January 2018-October 2019) and COVID-19 period (January 2020-October 2021), and evaluation of temporal associations of RSVs with weekly numbers of new COVID-19 cases. RESULTS: The countries demonstrated diverse patterns of the search activity with significantly different mean RSVs (the USA 1.76, India 10.20, Brazil 2.51, the UK 6.42, Russia 56.79; p < 0.001). For all countries excepting the USA mean RSVs of the COVID-19 period were significantly higher compared with the pre-COVID-19 ones (India +74%, Brazil +148%, the UK +22%, Russia +9%; p ≤ 0.034), and exhibited positive correlations with numbers of new COVID-19 cases, more pronounced for 2021 (India rS = 0.538, Brazil 0.307, the UK 0.434, Russia 0.639; p ≤ 0.045). CONCLUSION: Laypeople's activity for seeking EMS telephone number greatly varies between countries. It clearly responds to the spread of COVID-19 and could be reflective of public need for obtaining emergency help. Further studies are required to establish the role of GT for conducting real-time surveillance of population demand for EMS.


Subject(s)
COVID-19/psychology , Emergency Medical Services/statistics & numerical data , Hotlines/statistics & numerical data , Information Seeking Behavior , Brazil , COVID-19/therapy , Emergency Medical Services/methods , Hotlines/methods , Humans , India , Russia , United States , Web Browser/statistics & numerical data
15.
Int J Environ Res Public Health ; 18(23)2021 11 26.
Article in English | MEDLINE | ID: covidwho-1561654

ABSTRACT

(1) Background: Shortage of skilled workers is a relevant global health care problem. To remain competitive with other professions, job satisfaction is a critical issue; however, to date, there are no data available on the German EMS. This study aims to perform a statistical analysis of job satisfaction and performance orientation and to identify risk factors for low job satisfaction of paramedics in the German EMS. (2) Methods: Data were collected from 2590 paramedics through a nationwide cross-sectional survey, using the job satisfaction questionnaire by Neuberger and Allerbeck and the performance orientation questionnaire by Hippler and Krüger. Descriptive and regression statistical analysis were performed. (3) Results: The participants scored significantly lower than the reference sample on job satisfaction, with "organization and management" and "payment" being the lowest rated subscales. Around 9% of employees feared losing their jobs. While work attitude toward performance and success enhancement was high, fear of failure was also common. (4) Conclusions: Job satisfaction of paramedics in the German EMS is below that of the reference sample. Discontent with payment and organizational issues is common. Performance orientation is high, but fear of failure is frequent. Current and future efforts that aim at an attractive working environment should reflect on these findings.


Subject(s)
Emergency Medical Services , Emergency Medical Technicians , Allied Health Personnel , Cross-Sectional Studies , Humans , Job Satisfaction , Surveys and Questionnaires
16.
Australas Emerg Care ; 2021 Nov 30.
Article in English | MEDLINE | ID: covidwho-1540378

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has prompted many changes. Revised cardiopulmonary resuscitation (CPR) recommendations were issued including increased requirement for personal protective equipment (PPE) during CPR and isolation rooms. We hypothesized that these changes might have affected transport times and distance. Accordingly, we investigated any differences in transport time and distance and their effect on patient neurologic outcomes at hospital discharge. METHODS: This retrospective study was conducted among patients who experienced cardiopulmonary arrest and were admitted to an emergency department during specific periods - pre-COVID-19 (January 1 to December 31, 2019) and COVID-19 (March 1, 2020, to February 28, 2021). RESULT: The mean transport distance was 3.5 ± 2.1 km and 3.7 ± 2.3 km during the pre-COVID-19 and COVID-19 periods, respectively (p = 0.664). The mean total transport time was 30.3 ± 6.9 min and 35.6 ± 9.3 min during the pre-COVID-19 and COVID-19 periods, respectively (p < 0.001). The mean activation time was 1.5 ± 2.2 min and 2.9 ± 4.5 min during the pre-COVID-19 and COVID-19 periods, respectively (p = 0.003). The mean transport time was 9.3 ± 3.5 min and 11.5 ± 6 min during the pre-COVID-19 and COVID-19 periods, respectively (p = 0.001). CONCLUSION: Total transport time, including activation time for out-of-hospital cardiac arrest patients, increased owing to increased PPE requirements. However, there was no significant difference in the neurological outcome at hospital discharge.

17.
Public Health Rep ; 136(1_suppl): 72S-79S, 2021.
Article in English | MEDLINE | ID: covidwho-1495836

ABSTRACT

OBJECTIVE: Traditional public health surveillance of nonfatal opioid overdose relies on emergency department (ED) billing data, which can be delayed substantially. We compared the timeliness of 2 new data sources for rapid drug overdose surveillance-emergency medical services (EMS) and syndromic surveillance-with ED billing data. METHODS: We used data on nonfatal opioid overdoses in Kentucky captured in EMS, syndromic surveillance, and ED billing systems during 2018-2019. We evaluated the time-series relationships between EMS and ED billing data and syndromic surveillance and ED billing data by calculating cross-correlation functions, controlling for influences of autocorrelations. A case example demonstrates the usefulness of EMS and syndromic surveillance data to monitor rapid changes in opioid overdose encounters in Kentucky during the COVID-19 epidemic. RESULTS: EMS and syndromic surveillance data showed moderate-to-strong correlation with ED billing data on a lag of 0 (r = 0.694; 95% CI, 0.579-0.782; t = 9.73; df = 101; P < .001; and r = 0.656; 95% CI, 0.530-0.754; t = 8.73; df = 101; P < .001; respectively) at the week-aggregated level. After the COVID-19 emergency declaration, EMS and syndromic surveillance time series had steep increases in April and May 2020, followed by declines from June through September 2020. The ED billing data were available for analysis 3 months after the end of a calendar quarter but closely followed the trends identified by the EMS and syndromic surveillance data. CONCLUSION: Data from EMS and syndromic surveillance systems can be reliably used to monitor nonfatal opioid overdose trends in Kentucky in near-real time to inform timely public health response.


Subject(s)
Analgesics, Opioid/poisoning , Drug Overdose/epidemiology , Emergency Medical Services/statistics & numerical data , Opioid-Related Disorders/epidemiology , Population Surveillance/methods , Public Health Surveillance/methods , Sentinel Surveillance , Analgesics, Opioid/administration & dosage , COVID-19/epidemiology , Drug Overdose/prevention & control , Emergencies/epidemiology , Emergency Medical Services/trends , Humans , Kentucky/epidemiology , Pandemics , Public Health , SARS-CoV-2
18.
IJID Reg ; 1: 79-81, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1466395

ABSTRACT

Objectives: The spread of COVID-19 has affected the incidence of other infectious diseases, but there are no reports of studies using comprehensive regional population-based data to evaluate the impact of COVID-19 on influenza incidence. We attempted to evaluate the impact of COVID-19 on influenza using the population-based ORION (Osaka Emergency Information Research Intelligent Operation Network) registry. Methods: The ORION registry of emergency patients treated by emergency medical service (EMS) personnel was developed by the Osaka Prefecture government. From ORION, we included emergency patients with influenza using the ICD (International Statistical Classification of Diseases and Related Health Problems) 10 codes. Influenza incidence rate ratio (IRR) and associated 95% CI were calculated. Results: The number of influenza patients transported by EMS decreased during the COVID-19 pandemic. The IRR showed a substantial decrease in influenza patients in 2020 (IRR 2020/2018 0.39, 95% CI 0.37-0.41). Conclusions: A comprehensive regional analysis using the population-based ORION registry confirmed that from January 2020, when the first confirmed cases of COVID-19 infection were reported in Osaka, Japan, the number of influenza patients transported by EMS decreased dramatically.

19.
Int J Environ Res Public Health ; 18(19)2021 09 22.
Article in English | MEDLINE | ID: covidwho-1463628

ABSTRACT

The spatial accessibility of prehospital EMS is particularly important for the elderly population's physiological functions. Due to the recent expansion of aging populations all over the globe, elderly people's spatial accessibility to prehospital EMS presents a serious challenge. An efficient strategy to address this issue involves using geographic information systems (GIS)-based tools to evaluate the spatial accessibility in conjunction with the spatial distribution of aging people, available road networks, and prehospital EMS facilities. This study employed gravity model and empirical Bayesian Kriging (EBK) interpolation analysis to evaluate the elderly's spatial access to prehospital EMS in Ningbo, China. In our study, we aimed to solve the following specific research questions: In the study area, "what are the characteristics of the prehospital EMS demand of the elderly?" "Do the elderly have equal and convenient spatial access to prehospital EMS?" and "How can we satisfy the prehospital EMS demand of an aging population, improve their spatial access to prehospital EMS, and then ensure their quality of life?" The results showed that 37.44% of patients admitted to prehospital EMS in 2020 were 65 years and older. The rate of utilization of ambulance services by the elderly was 27.39 per 1000 elderly residents. Ambulance use by the elderly was the highest in the winter months and the lowest in the spring months (25.90% vs. 22.38%). As for the disease spectrum, the main disease was found to be trauma and intoxication (23.70%). The mean accessibility score was only 1.43 and nearly 70% of demand points had scored lower than 1. The elderly's spatial accessibility to prehospital EMS had a central-outward gradient decreasing trend from the central region to the southeast and southwest of the study area. Our proposed methodology and its spatial equilibrium results could be taken as a benchmark of prehospital care capacity and help inform authorities' efforts to develop efficient, aging-focused spatial accessibility plans.


Subject(s)
Emergency Medical Services , Quality of Life , Aged , Ambulances , Bayes Theorem , China , Humans
20.
Anaesthesist ; 70(8): 655-661, 2021 Aug.
Article in German | MEDLINE | ID: covidwho-1453678

ABSTRACT

BACKGROUND: During the peak of the COVID-19 pandemic in spring 2020, the entire emergency rescue system was confronted with major challenges. Starting on 15 March, all tourists were asked to leave the State of Tyrol, Austria. The main goal of the efforts was to ensure the usual quality of emergency medical care while reducing the physical contact during emergency interventions on site. METHODS: The Austrian Emergency Medical Service is physician-based, meaning that in addition to an ambulance team, an emergency physician (EP) is dispatched to every potential life-threatening emergency call. In Tyrol and starting on 17 March 2020, 413 types of emergency call dispatches, which were addressed with an ambulance crew as well as an EP crew before COVID-19, were now dispatched only with an ambulance crew. This procedure of dispatching differently as well as the general development of emergency calls during this period were analyzed from 15 March to 15 May 2020 and compared to the data from the same time period from 2017 to 2019. RESULTS: Despite the reduction of the population of around 30% because of absent tourists and foreign students staying in Tyrol, emergency calls with the operational keyword "difficulty in breathing/shortness of breath" rose by 18.7% (1533 vs. 1291), while calls due to traffic incidents decreased by 26.4% (2937 vs. 2161). Emergency calls with the dispatch of teams with an EP were reduced by 38.5% (1511 vs. 2456.3), whereby the NACA scores III and IV were the ones with the significant reduction of 40% each. For the reduced dispatchs, the additional dispatch of an EP team by the ambulance team amounted to 14.5%; however, for the keywords "unconscious/fainting" and "convulsions/seizures" the additional dispatch was significantly higher with over 40% each. DISCUSSION: There was an overall reduction of emergency calls. Considering, that the reduced dispatches would have led to an EP team dispatch the overall emergency doctor dispatches would have been higher than in the years before. Our study was not able to find the reasons for this increase. Only considering the additional dispatching of EPs, was this reduction in dispatching EP teams highly accurate, except for the symptoms of "unconscious/fainting" and "convulsions/seizures"; however, the actual diagnoses that the hospitals or GPs made could not be collected for this study. Therefore, it cannot be said for sure that there was equality in the quality of emergency medical care. CONCLUSION: It was possible to achieve the primary goal of reducing the physical contact with patients; however, before keeping these reductions of the dispatching order regarding. EPs for the routine operation, adaptions in these reductions as well as deeper evaluations under consideration of the data from hospitals and GPs would be necessary. Also, different options to reduce physical contact should be evaluated, e.g. building an EMT-led scout team to evaluate the patient's status while the EP team is waiting outside.


Subject(s)
Ambulances , COVID-19 , Emergency Medical Services , Austria , Emergency Medical Services/statistics & numerical data , Humans , Pandemics , Physicians , Triage
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