Articles: emergency-medical-services.
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When a study showed that a hospital had enough beds for its service area but that one growing segment of this area needed faster access to emergency care, the Ambulatory Care Center/Emergency Services System (ACCESS) was established. Through its program and facility, ACCESS provides immediate ambulatory and emergency care in its community and, through referrals to the hospital's ED, ensures the provision of more extensive emergency or inpatient care, as needed. Telecommunications, coordination with the county rescue services and the hospital's ED, and cooperation with local private practitioners are vital elements of the program.
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The increasing prevalence of terrorist attacks and natural disasters has mandated that more emphasis be placed on emergency disaster planning. The report focuses on the 1976 Courthouse bombing in Boston, which generated 20 casualties. Ambulance response by Boston's Emergency Medical Service system was made in 2.5 minutes and all victims were transported from the scene within 20 minutes. ⋯ These include the initial medical response, staging at the scene, and hospital notification. Additionally, the concept of triage as an integral part of disaster planning is explained with examples of the on-site medical stabilization and treatment of casualties. The importance of these concepts in practice and the necessity of close coordination of ambulance response and the responses of other emergency agencies, i.e., Police and Fire, were clearly demonstrated in the disaster which resulted from the Courthouse bombing.
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The present paper explores the rationale for the development of severity indices and the role such indices can play in various research and evaluation situations. Concrete examples from Emergency Medical Services research and evaluation settings are used to illustrate the potential shortcomings of designs that fail to incorporate measures of severity. A short critical review of existing indices is presented, and the ways that the indices can be refined and improved, and better used to evaluate emergency care, are summarized.