Evidence-based medicine (sometimes called scientific medicine) has existed in some form since at least the 16th century, when Andreus Vesalius, the "father of human anatomy," published diagrams of the human body actually based on anatomical investigation. William Harvey's publication of the first accurate description of the cardiovascular system, the 1665 discovery of the cell by Robert Hooke, and the 19th-century revelation of the neuron as the basic unit of the brain were also critical milestones. In the 1960s, the push toward evidence-based medicine became stronger, and basic science research began..
Bystander Cardiopulmonary Resuscitation (CPR) has been recognized as a critical component in the survival of out-of-hospital cardiac arrest (OHCA); likewise, time is a factor in the effectiveness of CPR. Pre-arrival instructions (PAIs) for CPR performance by Emergency Medical Dispatchers (EMDs) increase the rate of bystander CPR and OHCA survival. While uncontrollable barriers to PAIs delivery exists, time to first compression (TTFC) remains a modifiable component of the EMD-caller interaction. To develop a model describing the impact of TTFC intervals of...
In the absence of bystander Cardiopulmonary Resuscitation (CPR), cardiac arrest survival decreases 7%-10% for every minute of delay until defibrillation. Dispatcher-assisted CPR (D-CPR) increase rates of bystander CPR and cardiac arrest survival, with chest compressions recognized as the most important component of bystander CPR. To facilitate rapid delivery of chest compressions, the Medical Priority Dispatch System (MPDS™) altered instructions for mouth-tomouth ventilation (MTMV) and removed pulse-check, plus other minor changes to the D-CPR pre-arrival instructions. However, factors beyond...
The value of dispatch in modern Emergency Medical Services (EMS) systems cannot be understated. Among many other roles, an Emergency Medical Dispatcher (EMD) is responsible for accurate response selection. Response is based on EMD-assigned dispatch codes upon completion of caller-interrogation questions in a dispatch protocol system. When two or more signs, symptoms, or situational conditions are encountered in a calltaker evaluation, but are assigned and reported as a single, dispatch-defined code descriptor during the call-taking process by an EMD, a data hiding...
Clinical call handlers at a contact center in Queensland Health, Australia, use a clinical decision support system (CDSS) called Priority Solutions Integrated Access Management (PSIAM™) (PSIAM version 3.6.1.1, 2012 release, Priority Solutions Inc., Salt Lake City, USA) to provide community members with telephonic triage, referrals, and health information. The contact center operates 24 hours a day, 7 days a week, and all calls are handled by Registered Nurses (RNs). Callers requiring emergency services, usually an ambulance attendance, are transferred to Emergency Medical...
Without bystander CPR, cardiac arrest survival decreases 7%-10% for every minute of delay until defibrillation. Dispatcher-assisted CPR (D-CPR) has been shown to increase the rates of bystander CPR and cardiac arrest survival. Other reports suggest that the most critical component of bystander CPR is chest compressions with minimal interruption. Beginning with version 11.2 of the Medical Priority Dispatch System™ (MPDS) protocols, instructions for mouthto-mouth ventilation (MTMV) and pulse-check were removed and a compressions-first pathway introduced to facilitate rapid delivery of...
9-1-1 telecommunicators are uniquely exposed to numerous occupational stressors on an ongoing basis. Yet little is known about the sources of occupational stress and symptoms of stress in these workers and even less is known about variables that can serve as stressors or buffers to stress in the 9-1-1 call center work environment. We sought to explore the inter-relationships amongst job stressors, potential risk and protective factors, and symptoms of stress in 9-1-1 telecommunicators. Our long-term goal was to use outcomes of this study to guide and...
The traffic stop began like any other. The officer radioed to dispatch with the license plate number and a National Crime Information Center (NCIC) search was conducted. The search turned up negative – showing nothing unusual about the vehicle or its owner – and the officer started a routine approach to the vehicle. The dispatcher then searched the license plate number through the Federal Bureau of Investigation's (FBI) newest System, the National Data Exchange (N-DEx). for short. Moments before the officer reached the driver's side window, dispatch returned with some relevant information...
Diabetes is a major global problem. Diabetes and pre-diabetes are risk factors for increased incidence of cardiovascular disease. In 2014, the prevalence of diabetes worldwide was estimated at 9% among adults above 18 years of age. According to International Diabetes Foundation (IDF), 381 million people in 2013 had diabetes. To study the prevalence of diabetes and pre-diabetes in patients with acute coronary syndrome (ACS). This cross-sectional study was carried out on patients admitted to the hospital (N.K.P Salve Institute of Medical Sciences and Research Centre, Nagpur city, India) with ACS...
Air ambulances are scarce and expensive assets. To be used efficiently they need to be dispatched to patients who will gain the most benefit. To identify factors associated with low standdown rates and high conveyance rates, suggesting efficient use of air ambulance resources. Eight months' call history for a single United Kingdom air ambulance (National Health Service (NHS) paramedic/doctor crew, charity-funded aircraft) covering two English counties was retrospectively analyzed. Standdown and conveyance rates were calculated for (medical, trauma, road traffic collision (RTC)) types of call...
