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Patient Transfer
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
This remains the commonest mode of transfer; it is generally straightforward to arrange. The ambulance service has set vehicle response times; for a time-critical response the time is 8 minutes (the same as those for a community cardiac arrest or CAT 1 call).19
What Diminishes Joy
Published in Eve Shapiro, Joy in Medicine?, 2020
Say, for example, someone is in a restaurant and starts to have chest pains or what they think is a heart attack and calls 9-1-1. This is the general way things work: there’s a dispatch center within our local area that will take our call. The operators take the information: what’s going on and where we are. They pass that along to someone else in that center who will relay that information to our station, to a police station if they need it, and to a fire station if they need it to say, “At this restaurant there’s an 80-year-old man complaining of chest pain.” From there, I and whoever I’m working with get into the ambulance, start driving to wherever the call is, and when we get there do our medical assessment. Usually we do an initial assessment wherever the person is, if it’s appropriate. If not, we do it on the way to the hospital.
Special Situations
Published in Wayne E. Richenbacher, Mechanical Circulatory Support, 2020
At the time of transfer, personnel from the transplant center should travel to the referring hospital to assess the patient and aid in transfer. During transfer the requisite caregivers include a nurse, second nurse or perfusionist to assume responsibility for the VAD drive unit and a respiratory therapist if the patient is intubated. The ambulance should be of sufficient size to permit transportation of the patient, the VAD drive console, ventilator, nurses and transport personnel. Given the highly specialized hardware and physiology associated with the patient requiring mechanical circulatory support, it is best that the ambulance crew be assigned to provide access to supplies and assist the primary caregivers in this instance. Check the power requirements of the equipment to be transported. The power source available should be capable of running one or two mechanical blood pump consoles, monitors, intravenous pumps and a mechanical ventilator. Backup hand pumps or alternate power source for the VAD should be available and easily accessed in the event of a power failure. Additional medications including inotropes are readily available. During transportation the patient’s hemodynamics and VAD function are carefully monitored. The patient is admitted directly to the surgical intensive care unit upon arrival at the tertiary care center.
A decision framework model for hospital selection in COVID-19 pandemic: A FIS approach
Published in International Journal of Healthcare Management, 2023
Naveen Jain, Manish R. K. Sahu, A. R. Singh, Prateek Sharma
Further, Hunter [17] emphasized that during the pandemic outbreak the requirement of ventilators and personal protective equipment is crucial and hence identified them as major criteria for hospital selection. Chauhan, Sharma, and Sagar [18] conducted an empirical survey among the patients of private and public hospitals in India and identified quality of treatment, cleanliness, hospital reputation, and amenities like payment and food facilities as important patient choice factors [18]. Abroad countries like Australia also emphasize Public Health Insurance as criteria for the selection of public or private hospitals [19]. Hashemkhani Zolfani et al. [20] pointed out that the distance of the hospital, accessibility via roads, traffic congestion, and local regulation, are the major criteria. Also, Ambulance services of the hospitals play a major role in bringing the patients to hospitals [21]. The ambulance services should provide services to the patients with the least response time possible [16]. Another criterion in hospital selection is the availability of beds for admission during the pandemic [17]. The demand for beds in the hospital during the pandemic is uncertain and needs to be addressed very carefully [18]. Other vital criteria as reported by the authors are blood testing facilities and the blood banks in hospital [19].
The Critical Intervention Screen: A Novel Tool to Determine the Use of Lights and Sirens during the Transport of Trauma Patients
Published in Prehospital Emergency Care, 2022
Shane Urban, Heather Carmichael, Martin Moe, Andrea Kramer, Omar Al-Azzawi, Robbie Dumond, Angela Wright, Robert McIntyre, Catherine Velopulos
EMS system models vary greatly within our catchment area. Ambulances can be staffed with dual paramedics, tiered with a paramedic and EMT, or be a basic life support (BLS) unit staffed by only EMTs. In addition to the variances in EMS system models, agencies can have differences in medical direction which in turn can impact practice patterns and standard operating procedures. While practice patterns vary between agencies, the publicly available Denver Metropolitan Prehospital Protocols list 26 procedures potentially within a paramedic’s scope of practice. Amongst the 26 procedures listed are supraglottic airways, endotracheal intubation, and placement of needle thoracostomies. Of the top three EMS agencies that transport to our trauma center, all three are able to perform the aforementioned procedures.
National Characteristics of Non-Transported Children by Emergency Medical Services in the United States
Published in Prehospital Emergency Care, 2022
Caleb Ward, Anqing Zhang, Kathleen Brown, Joelle Simpson, James Chamberlain
Beyond the individual patient and EMS agency level, we found that community-level factors are associated with EMS non-transport. Non-transport was much less likely for children in areas with higher levels of child poverty. The proportion of records with missing data prevented us from analyzing individual insurance status in our study. However, our community-level finding is consistent with previous studies that describe higher rates of EMS transport for individuals with Medicaid coverage or no health insurance (36, 37). Families living in poverty and covered by Medicaid may lack transport to access care and be more reliant on EMS as a safety net health service ()(37). Individuals with private health insurance may also be more concerned about the cost of ambulance transport ()(37). Non-transport was more common for calls originating in rural and wilderness areas than urban and suburban areas. The physical distance and transport time to the nearest ED may deter families and EMS agencies from transporting children with low acuity complaints.