The EMS, ED, neurology, radiology, nursing, laboratory, and pharmacy departments are integral parts of the stroke team system. These are the key departments responsible for the support of the stroke team, or nucleus, ...
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The EMS, ED, neurology, radiology, nursing, laboratory, and pharmacy departments are integral parts of the stroke team system. These are the key departments responsible for the support of the stroke team, or nucleus, which emanates from the departments of neurology and emergency medicine in the author's medical center. In the same way that cardiac victims are treated for "heart attack," so stroke victims should be treated for "brain attack." The emphasis on public awareness to community outreach and senior citizens groups through the aid of the public affairs department of the institution, the American Heart Association, and the National Stroke Association (NSA) has been a tremendous lift in this, the decade of the brain. The Public Broadcasting System and other television channels have helped enormously in publicizing stroke signs and symptoms, new treatment of stroke, and concurrent risk factors. New clinical research for thrombolytics and neuro-protective agents are now in progress to determine the best treatment for the damaged brain. The emphasis is changing: Time is brain. We hope to change the expenditure attributable to rehabilitation and managed care after stroke to the more hopeful prospects of prevention, early treatment, and fast recovery. We can then see that our friends and family members, as victims of stroke, may proceed to independence rather than long-term care facilities or nursing homes. This will be possible only if hospitals and medical centers nationwide adequately gear themselves for the treatment of ischemic stroke through the creation of a core stroke team, finely-honed interdepartmental cooperation, and the development of an efficient ED team that is fully immersed in the ethics and protocol of "brain attack."
We studied all patients attending a free-standing minor accident and treatment service (MATS) run by emergency nurse practitioners (ENPs). In a six-month period, 5563 patients were seen in the MATS, of whom 2843 (51%)...
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We studied all patients attending a free-standing minor accident and treatment service (MATS) run by emergency nurse practitioners (ENPs). In a six-month period, 5563 patients were seen in the MATS, of whom 2843 (51%) were new attenders. A teleconsultation was carried out with 150 of these patients (2.7% of all cases). The most common reason (39%) was to discuss a radiograph with an accident and emergency consultant. The accuracy of the telemedicine-assisted radiographic diagnosis was checked subsequently by a review panel. The ENPs' working diagnoses (made by viewing the films) had a sensitivity of 90% and a specificity of 96%;this was improved by telemedicine assistance to 97% and 99%, respectively. The telemedicine patients were also surveyed several months after being seen in the MATS;their replies indicated that the telemedicine diagnoses had been correct.
This research considers the problem of relating Emergency Medical Services (EMS) to patient outcome. The hypothesis is that response time alone may be misleading as an EMS performance criterion. This research uses met...
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This research considers the problem of relating Emergency Medical Services (EMS) to patient outcome. The hypothesis is that response time alone may be misleading as an EMS performance criterion. This research uses methods for approximating multiattribute utility functions to consider both response time and on-the-scene care. The final result is an optimization problem where the response time and desired personnel requirements are decision variables. These are important inputs in the planning for Emergency Medical Services.
Facility siting models known as location covering techniques have proven to be useful particularly for emergency medical services (EMS) planning, given the importance of ambulances responding to demand within some max...
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Facility siting models known as location covering techniques have proven to be useful particularly for emergency medical services (EMS) planning, given the importance of ambulances responding to demand within some maximum time constraint. These models represent a set of methods which focus the health planner's attention on the access of people to health care, since they attempt to “cover” people in need of service within some specified time standard. This research develops a technique for the locational planning of sophisticated EMS systems, characterized by multiple levels of emergency health services. Specifically, a two-tiered system with “basic life support” and “advanced life support” capabilities is modeled as a goal program. By applying location covering techniques within a goal programming framework, this study develops a method for the siting of multilevel EMS systems so that (1) each service level maximizes coverage of its own demand population, and (2) “back-up” coordination between levels is assured. The usefulness of this goal program as a health planning tool is evidenced in the model's explicit articulation of EMS policy objectives and its ability to link system levels in terms of “goal-directed behavior”. The working of this multilevel covering model is demonstrated by reference to EMS planning scenarios and related numerical examples.
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