In 2008, our center introduced the UK MicroVent emergency respiratory system (machine) for first-aid of breathing anomaly, which achieved good effects, including saving emergency treatment time, finding the cause of diseases and reducing complications.
Emergency Medical Services ; methods ; Ventilators, Mechanical

The National Capital District (NCD) is unique within Papua New Guinea in having a professional ambulance service which provides emergency care during transfer to hospital. This service has been run by St John Ambulance, who have maintained records of their work during their first ten years of operation. To review the operation of the service and to consider its potential for other parts of Papua New Guinea these records were transferred to a database and analyzed. The results of this analysis, together with relevant background, are presented and some of the issues which emerge are discussed. There have been heavy demands on the ambulance service to provide a taxi service for transferring patients between health facilities. Cancelled calls have also been a heavy drain on the service. Pregnancy-related requests for transport, including home deliveries, constitute the major group of emergency calls. Requests for transfer of patients with an acute medical or surgical condition requiring skilled attention provide an important part of the nonobstetrical work of the service, though this group makes up only 10% of the total number of requests. Trauma contributed 26% of the nonobstetrical emergency work of the service. The rate of requests for the population of the NCD has decreased and it is suggested that this is due to greater access to private vehicles rather than a decrease in demand for emergency transport. It is apparent that a skilled ambulance service cannot be provided cheaply, although for 1993 at 15 kina per request, or 30 kina if only the emergency requests are considered, the service is clearly efficient. Providing a similar service to other parts of Papua New Guinea with lower population densities and less sealed road would be very much more expensive. It is unlikely that the health services could approximate a similar degree of cost-efficiency to that of St John.
Emergency Medical Services - methods ; Emergency Medical Services - statistics & ; numerical data

OBJECTIVETo evaluate the technical characteristics and application of mass casualty incident (MCI) primary triage (PT) methods applied in China.

DATA SOURCESChinese literature was searched by Chinese Academic Journal Network Publishing Database (founded in June 2014). The English literature was searched by PubMed (MEDLINE) (1950 to June 2014). We also searched Official Websites of Chinese Central Government's (http://www.gov.cn/), National Health and Family Planning Commission of China (http://www.nhfpc.gov.cn/), and China Earthquake Information (http://www.csi.ac.cn/).

STUDY SELECTIONWe included studies associated with mass casualty events related to China, the PT applied in China, guidelines and standards, and application and development of the carding PT method in China.

RESULTSFrom 3976 potentially relevant articles, 22 met the inclusion criteria, 20 Chinese, and 2 English. These articles included 13 case reports, 3 retrospective analyses of MCI, two methods introductions, three national or sectoral criteria, and one simulated field testing and validation. There were a total of 19 kinds of MCI PT methods that have been reported in China from 1950 to 2014. In addition, there were 15 kinds of PT methods reported in the literature from the instance of the application.

CONCLUSIONSThe national and sectoral current triage criteria are developed mainly for earthquake relief. Classification is not clear. Vague criteria (especially between moderate and severe injuries) operability are not practical. There are no triage methods and research for children and special populations. There is no data and evidence supported triage method. We should revise our existing classification and criteria so it is clearer and easier to be grasped in order to build a real, practical, and efficient PT method.

PURPOSE: This study examined the factors affecting the precaution and request of medical direction for prehospital emergency treatment of major trauma patients by 119 rescue services. METHODS: Medical records and prehospital run reports of major trauma patients with an Injury Severity Score (ISS) above 15 were reviewed. In total, 123 patients who were transferred by 119 rescue services to the Emergency Department of one hospital from December 1, 2010 to February 28, 2013 were enrolled. A total of 123 patients with major trauma satisfied the ISS criterion. Excluding 26 patients with missing data, 97 patients were included in this study. Out of these 97 patients, 72 patients were male and the mean age was 46+/-16.1 years. The statistical methods used in the analysis were the Receiver-Operating Characteristic curve and Fisher's exact test. RESULTS: Between the hospital precaution group and non-precaution group, the only significant difference was in the RTS score (p=0.007). In total, 52 patients (39 male patients; mean age 49.52+/-16.14 years) with major trauma were transferred during the medical direction period. Between groups that requested medical direction and groups that did not, the only significant difference was the time interval from the call to hospital arrival (p=0.032). CONCLUSION: Within the variables we examined, transport of major trauma patients, in addition to low incidence of precaution and request for medical direction by 119 rescue services, only a few were considered.
Emergencies* ; Emergency Medical Services ; Emergency Treatment* ; Humans ; Incidence ; Injury Severity Score ; Male ; Medical Records ; Methods

PURPOSE: This study examined the factors affecting the precaution and request of medical direction for prehospital emergency treatment of major trauma patients by 119 rescue services. METHODS: Medical records and prehospital run reports of major trauma patients with an Injury Severity Score (ISS) above 15 were reviewed. In total, 123 patients who were transferred by 119 rescue services to the Emergency Department of one hospital from December 1, 2010 to February 28, 2013 were enrolled. A total of 123 patients with major trauma satisfied the ISS criterion. Excluding 26 patients with missing data, 97 patients were included in this study. Out of these 97 patients, 72 patients were male and the mean age was 46+/-16.1 years. The statistical methods used in the analysis were the Receiver-Operating Characteristic curve and Fisher's exact test. RESULTS: Between the hospital precaution group and non-precaution group, the only significant difference was in the RTS score (p=0.007). In total, 52 patients (39 male patients; mean age 49.52+/-16.14 years) with major trauma were transferred during the medical direction period. Between groups that requested medical direction and groups that did not, the only significant difference was the time interval from the call to hospital arrival (p=0.032). CONCLUSION: Within the variables we examined, transport of major trauma patients, in addition to low incidence of precaution and request for medical direction by 119 rescue services, only a few were considered.
Emergencies* ; Emergency Medical Services ; Emergency Treatment* ; Humans ; Incidence ; Injury Severity Score ; Male ; Medical Records ; Methods

PURPOSE: This research was done to identify the hospital arrival rate and factors related to prehospital delay in arriving at an emergency medical center within the golden time after symptom onset in patients with acute myocardial infarction (AMI). METHODS: Data used in the research was from the National Emergency Department Information System of the National Emergency Medical Center which reported that in 2014, 9,611 patients went to emergency medical centers for acute myocardial infarction. Prehospital time is the time from onset to arrival at an emergency medical center and is analyzed by subdividing arrival and delay based on golden time of 2 hour. RESULTS: After onset of acute myocardial infarction, arrival rate to emergency medical centers within the golden time was 44.0%(4,233), and factors related to prehospital delay were gender, age, region of residence, symptoms, path to hospital visit, and method of transportation. CONCLUSION: Results of this study show that in 2014 more than half of AMI patients arrive at emergency medical centers after the golden time for proper treatment of AMI. In order to reduce prehospital delay, new policy that reflects factors influencing prehospital delay should be developed. Especially, public campaigns and education to provide information on AMI initial symptoms and to enhance utilizing EMS to get to the emergency medical center driectly should be implemented for patients and/or caregivers.
Caregivers ; Education ; Emergencies ; Emergency Medical Services ; Emergency Service, Hospital ; Humans ; Information Systems ; Methods ; Myocardial Infarction* ; Transportation

BACKGROUND: Team-based learning is known for its effective and satisfying education methods in the study of various medical schools. This study was prepared to confirm the satisfaction of applying this team-based learning to the training course of emergency medical technician.METHODS: A total of 165 new members of the course of second grade National Emergency medical technician at 2019 were finally enrolled in the study. Data were collected with a self-administered questionnaire. The team-based learning method was organized with eight students per group to conduct pre-learning and then proceed to open book to encourage active discussion among individuals. The questionnaire consisted of questions about the satisfaction of the discussion process, such as whether the knowledge gained from the discussion was appropriate, and whether collaboration between colleagues was successful during the discussion, and about the benefits of team-based learning, how well knowledge transfer compared to existing lectures, and the replacement of existing lectures. The questionnaire used a Likert 5 point scale, and the data obtained were analyzed using the SPSS version 22.0.RESULTS: The overall rating of team-based learning was 7.8 ± 1.5 out of 10. Many students answered positively (88.5%) for benefits, while 87.9% responded positively to whether the knowledge transfer effect was better compared to existing lectures. In addition, the satisfaction of team-based learning was generally high, with more than 90 percent of education students giving positive answers to the replacement of other lectures with team-based learning.CONCLUSION: The learners gave positive answers to the satisfaction, usefulness and learning effects of team-based learning. Team-based learning is a discussion-based study, so it is a good way to improve communication skills. Since communication and teamwork are important in first aid activities, the characteristics of team-based learning could lead to improvements in first aid services, leading to high-quality emergency medical services.
Cooperative Behavior ; Education ; Emergencies ; Emergency Medical Services ; Emergency Medical Technicians ; First Aid ; Humans ; Learning ; Lectures ; Methods ; Schools, Medical

Disaster Planning ; organization & administration ; Emergencies ; Emergency Medical Services ; organization & administration ; Humans ; Public Health ; methods

Emergency physicians in the field are sometimes confronted with cases wherein patients cannot be intubated and ventilated. In some cases, cricothyrotomy, the method of choice for securing an emergency airway, may not have a successful outcome. We report a rare case of a 35-year-old male patient with avulsion of the larynx and a comminuted fracture of the jawbone, due to entrapment in a dung excavator. Prehospital tracheotomy was successfully performed. In cases with crush injuries to the larynx, anatomic structures, including the ligamentum conicum, are destroyed. In addition, massive subcutaneous emphysema blurs the anatomical key structures; hence, only a tracheotomy can prevent a lethal outcome.
Adult ; Emergencies ; Emergency Medical Services ; Fractures, Cartilage ; Fractures, Comminuted ; Humans ; Larynx ; Male ; Methods ; Subcutaneous Emphysema ; Tracheotomy

OBJECTIVE: This study examined the characteristics of suicidal attempters, including pre-hospital patients and those who visited the emergency department. METHODS: Suicidal attempters who had been reported to the 119 call center were selected between July 2015 and June 2016. Sex, age, place, methods of suicidal attempt, season, time, and suicide success rate were reviewed in the fire center records. RESULTS: A total 961 suicide attempters were enrolled. Among them, 53.6% were males who had an approximately 2.6 times higher mortality than that of females (9.2%). The most preferred place to commit suicide was the home in both sexes (68.0% in male, 82.8% in female) and the most preferred methods was drug intoxication, particularly pesticide. The method with the highest mortality was hanging and the lowest was self-harm. The season of the highest mortality was spring. The success of suicide and the time variation were similar. Most of the un-transferred patients also selected fatal suicide attempts compared to transfer patients. CONCLUSION: Unlike previous studies, this study includes information on un-transferred patients. Overall, the probability of death was highest as more than 50 years men chose hanging as a method, which had an influence on the un-transferred patients group.
Emergency Medical Services ; Emergency Service, Hospital ; Female ; Fires ; Gangwon-do* ; Humans ; Male ; Methods ; Mortality ; Seasons ; Suicide* ; Treatment Refusal