Browsing by keyword "*Transportation of Patients"
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Feasibility and safety of emergency interhospital transport of patients during early hours of acute myocardial infarctionThe transfer of patients with acute myocardial infarction from community hospitals to tertiary care facilities for further intervention has become increasingly more frequent due to the emerging role of thrombolytic therapy and percutaneous transluminal coronary angioplasty. To assess the feasibility and safety of early transfer, a prospective analysis of 57 patients who were transported by ground ambulance or helicopter to the University of Massachusetts Medical Center, Worcester, for acute intervention during the early hours of myocardial infarction was conducted. Before transport, the majority (46 [81%]) of patients were having chest discomfort, 13 (23%) were hypotensive, and 12 (21%) were electrically unstable (defined as high-grade ventricular ectopia or nonsustained ventricular tachycardia). During transport, the majority (41 [72%]) continued to have some chest discomfort; however, only two (4%) remained hypotensive. Although five patients (9%) were electrically unstable during transport, the instability was considered noncritical. The distance traveled or the mode of transportation did not adversely impact on these clinical complications. All patients survived transport, and 53 patients (93%) were eventually discharged from the receiving hospital.
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Knowledge and Beliefs of EMS Providers toward Lights and Siren TransportationINTRODUCTION: The use of warning lights and siren (WLS) increases the risk of ambulance collisions. Multiple studies have failed to demonstrate a clinical benefit to the patients. We sought to investigate the degree to which providers understand the data and incorporate it into their practice. METHODS: The authors distributed an anonymous survey to prehospital providers under their medical direction at staff and quality assurance meetings. The surveys asked the providers' degree of agreement with four statements: transport with lights and siren shortens transport times; transport with lights and siren improves patient outcome; transport with lights and siren increases the risk of collision during transport; and transport with lights and siren reduces the utilization of "mutual aid" service. We compared responses between providers who had been in prior ambulance collisions and those who had not. RESULTS: Few responses reached statistical significance, but respondents tended towards agreement that WLS use shortens transport times, that it does not improve outcomes, and that it increases the risk of collision. Despite the overall agreement with the published literature, respondents report > 80% of transports are conducted using WLS. CONCLUSION: The data demonstrate the surveyed providers are aware of the risk posed by WLS to themselves, their patients, and the public. Nevertheless, their practice in the absence of rigid protocols suggests they disregard this knowledge. Despite a large number of prior ambulance collisions among the surveyed group, a high number of transports are conducted using WLS.
