European journal of emergency medicine : official journal of the European Society for Emergency Medicine
-
Faster emergency response times are generally considered to have a positive effect on life expectancy of patients with a life-threatening event, leading many communities to determine response time intervals. However, worldwide, increasing urbanization and traffic congestion threatens ambulance response times. An emergency motorcycle response vehicle (MRV) can overcome these hurdles more easily than a larger ambulance. It also offers dispatch flexibility in responding to calls estimated to have a low likelihood of a patient who needs transport. The first aim of this study was to determine whether an MRV can shorten response times and impact on resuscitation outcomes in a heavily urbanized and densely populated region in the Netherlands. The second aim was to evaluate differences in dispatch and transport between MRV and ambulance. ⋯ Using motorcycles in a Dutch setting lead to better emergency medical service response times. The MRV serves a different population. Resulting in a higher treat and release rate and less transportation to hospital.
-
Participants in advanced resuscitation courses are often expected to learn to perform intraosseous access (IO). But how many learning modalities are needed to achieve procedural confidence in IO? We distributed an online questionnaire to members of emergency medicine, paediatric and anaesthesiology societies in Scandinavia. The responders without real-life experience with IO (n=322) were classified as 'not confident' or 'confident' in IO. ⋯ Confidence increased to 74.8% after one training modality, 87.9% after two modalities, 98.7% after three modalities and 100% after four modalities (P<0.0001). Of total responders 89.5% who had 'workshop or similar training with hands-on experience' as sole teaching method was confident. Confidence in IO increases with the number of learning modalities. 'Workshop or similar training with hands-on experience' as single training modality seemed as effective as the combination of two modalities.
-
Comparative Study
Comparison of the SALT and Smart triage systems using a virtual reality simulator with paramedic students.
Virtual reality systems may allow for organized study of mass casualty triage systems by allowing investigators to replicate the same mass casualty incident, with the same victims, for a large number of rescuers. The study objectives were to develop such a virtual reality system, and use it to assess the ability of trained paramedic students to triage simulated victims using two triage systems. ⋯ The virtual reality platform seems to be a viable research tool for examining mass casualty triage. A small sample of trained paramedic students using the virtual reality system was able to triage simulated patients faster and with greater accuracy with 'Smart' triage than with 'SALT' triage.
-
To determine whether vital signs in patients suffering from acute pain in the out-of-hospital setting have any association with pain severity measured using an ordinal pain scale. ⋯ An association between prehospital vital signs and pain severity has been shown using ordinal logistic regression. In adults, a respiratory rate of 25 breaths/min or more was the most important predictor of having more severe pain. Tachycardia and systolic hypertension may also be important in younger and older patients, respectively. Simple correlation fails to show clinically important associations between prehospital vital signs and pain severity.