Emergency Medical Service Systems: A Global Perspective Shakti Kumar Gupta, Sunil Kant, Angel Rajan Singh
INDEX
ABCDEFGHIJKLMNOPQRSTUVW
Page numbers followed by f refer to figure and t refer to table, respectively
A
Acute coronary syndrome 148
Additional resources for EMS 102f
Advantages of
communication 88
information 88
technologies 88
After prehospital ECG timings by phase 122t, 123t
Agencies
involved in EMS 179t
to dispatches being made, list of 96f
ALS versus BLS-D in OHCA 117
Ambulance 20, 39
applications and RMS 92
choice 200
design and
fabrication 98
fleet management 200
distribution in
Ireland 18f
Romania 26f
layouts 159f, 160f
personnel and equipment 9
response time, causes for delay in 193f
safety 202
specifications in India 157
Antimicrobial copper 127
in emergency medical services 125
Applications and requirements 200
Area of response of HEMS 212f
Atlanta VA hospital 139
Autoinjectors 224f
Autopulse 107
Average annual growth in ED visits 67f
B
Baby with brain stem lesion 147f
Bag value mask 145f
Basic trauma and casualty care 77
Basis of BTACC course 78f
Before prehospital ECG timings by phase 122t, 123t
Bigger
tyres of DOST 208f
windshield 208f
Bioburden on copper surfaces 132f
Biological
management 101
preparedness for chemical in India 45
Bioterrorism 41
Boussignac CPAP 146f
BTACC 77
course, basis of 78f
Burden of emergencies in community 56f
C
Campaign for patient awareness 151f
Canadian study 115
Capacity development 36
Cardiac arrest 15, 115
Causes for delay in ambulance response time 193f
CBRN management 43
CCRTF reports 1997 and 1998 61f
Central interdisciplinary emergency unit 65f
Chain of
emergency medical care call and dispatch 39
patient flow 57f
survival 63f
Challenges 25
for education and training of emergency
medicine personnel in India 177
in developing quality ambulance in India 206
Changing
scenario 196
trends in emergency calls 6f
Characteristics of patients with STEMI
transferred for primary PCI 84f
treated with PPCI 85f
Chassis, choice of 201f
Chemical
agents 42
for screening in special lab, list of 103f
management 101
Choice of chassis 201f
Circulation improving resuscitation
care trial 107, 108
Classification of mass gatherings 165t
Coast guard helicopters to carry emergency
patients 18f
COE construction 207f
Collection of data 49f
Commencement of EMS (1899) 3f
Communication 29
in emergency care 88
advantages of 88
Community health clinics 57
Community-based emergency care 56
Comparison of
DCAS ambulance response time 192
EMS systems 156
Compliance to standards 206
Components of
CAD 91
EMS call 47
Computer aided dispatch systems 90
Consolidated dispatch 95
about communications 94
Constitution of PAROS 153f
Continuum of care 76
Copper in all GLP tests in bacteria 131f
Core values of Falck 37f
County wide coordination 97f
CPR process data 112t
Creativity culture 51
Critical steps 170
Crush syndrome 188f
CT scan bowels full of air 146f
Culture of continuous improvement in hospitals
and emergency medical services 134
Current situation 7
Customer requirements 206
D
Data
analysis 111
collected in EMS system 50f
entry 155
interpretation 189
management goals 138
Decrease in median door-to-balloon time 123f
Dedicated points of actions in cases of
emergencies 171f
Department front door 67
Designing helicopter interiors for air
ambulance 218
Detection capabilities for biological warfare agents
and toxins 223f
Development of prehospital emergency care in
Karachi 170f
Different phases of patient management in ED 68f
Dirty bomb 41f
Disaster
management 31
Act 31
vehicles 201f
mitigation 174
relief 174
Discussion 114
Distribution
network of helicopter emergency medical
services 5f
of EMS in cologne 101f
of oxygen 99f
District hospitals 57
DOST ambulance 207
DRDO's achievements and endeavors 221
Dubai scenario 191
E
E coli 130f
Early care and impact on disease 59f
ECG of STEMI case 149f
ECGs transmitted by month 121t
ED quality impact on overall hospital quality 199
Education and documentation 190
Effect of stopping compressions on blood flow 135f
E-learning platform supporting wider ambulance
emergency preparedness 228f
Elements of emergency response system 90f
Emergencies in community, burden of 56f
Emergency
care system–Karachi 170
core services 38f
department
and bomb blasts 170
overcrowding 58
management exercise 36
medical
care 24
response for Fukushima nuclear power plant
accident 230
services concepts in incident 101
services in
Germany 3
Ireland 17
Italy 20
Singapore 7
various countries 1
services
Indian scenario 88
operation crowded areas—mass
gatherings 165
performance indicators 79, 191
plan in cologne 101
preparedness for mass gatherings 71
system in Japan 12
system in Korea—hospital phase 28
medicine services evolution 177
physician 14f
response 31
system under national rural health
mission 181
EMRI
business model 181
timeliness 184t
type of cases moved by medical category 184
EMS
and medical care cost 14
centers in India 178f
dispatch system 13f
distribution pattern in Germany 4f
evolution in Germany 4
history in western world 39f
in Ireland 17
in numbers 13
planning 167
staffing 20
system in United States 48
EMSS in Korea
interhospital transfer 29
prehospital phase 28
EPAROS 155f
EPCR sheet 19f
Equipment 21, 145, 218, 227
Etiology of patients 14, 15f
Evaluation 228
Event planning 166
Evolution of prehospital emergency services in
India 37
Examples of challenges 206
Extrinsic motivation 51
F
Facts about HAI 126f
Financing 29
models across emergency unit 215
First responder bag 55f
Fixed wing aircraft 213f
Fleet management and funding 202
Fly eye concept 52f
Fukushima nuclear power plant 230
G
General characteristics by arm 112t
Genesis 226
Germany map 210f
Goal 202
Golden hours 214f
Good ambulance 98
Governance of PAROS 152
Government initiative towards EMS 180f
Gradual implementation of PPCI and triage of
patients 85f
GVK EMRI 174
H
H1N1 virus inactivation tests 130f, 131f
Hardware and equipment 54
Haryana Swasthya Vahan Sewa Model 181
Hazardous area response team 226
Headlamps of DOST 208f
Heartstart FR3 136
Helicopter emergency medical services
market requests 218
overview 214
Helicopter EMS floor 220f
HEMS 212
area of response of 212f
challenges 216
crew 212f
stations in Germany 211f
HGV incidents often serious 187f
Hospital consumer assessment of healthcare
providers and systems 199
I
ICT in EMS 89
Ideal STEMI system of care 151
Identification of safety risks 168
Impact 176t
on outcome 84
Importance of
emergency department's front door 67
touch 126
Improvement 63
Incident
location cases analysis 193f
response system 33, 34f
Inclusion criteria 110
Increase in paramedics 12f
India's vulnerability to disasters 31
Indianapolis
system 72
Indiana, USA 71f
Individual
physician and nurse monitoring 199
protection 224f
Infection control, multifaceted challenge 128
Information 29
advantages of 88
in emergency care 88
Initial emergency system in Romania 24f
Innovation 51, 227
Inside
Italian ambulance 21f
of ambulance 29f
view of helicopter for transportation 5f
Integrated
approach 58
computer aided dispatch system 90
emergency system 25f
Interhospital transfer 189
systems 190
Interior of DOST 209f
International regulatory guidance 216
Intraosseous 140
Intrinsic motivation 51
Introduction to American Heart Association 148
Invention 51
and innovation in emergency medical and
trauma services 51
Malaysia 52
Italian ambulance
adult and pediatric spinal board 22
stretcher 21f
transport and evacuation chair 22f
IV bottles 206
J
JAAM activities 232
Janani express business model 182
K
Korean model of financing emergency care 27
L
Legal-institutional framework 32f
Legislation 79
Limitations 123
Load distributing band 107f
CPR 108f
Loss of life per minute 59f
LSPV with booster breaks 208f
M
Maintaining clinical focus missive project
innovative of human patient simulation 227f
Major improvements 64f
Management
algorithm of trauma 64
of algorithm of trauma 65f
Map
epicenter and spread of Bhuj earthquake 173f
of Korea 27f
Mapping system 93f
Mass
casualty
event 33
incident 101
gatherings 72
classification of 165t
Material comes close to antimicrobial copper 129f
Mechanical CPR device 5f
Mechanisms
for creating blood flow during CPR 108f
of injury 187
Medical
management 224
preparedness for
CBRN 43
chemical in India 45
preparedness Indian scenario 31
Methicillin resistant Staphylococcus aureus bacteria 129
Microorganisms on touch surfaces 127f
Mini marathon 72f
Miriam hospital 139
Modern dispatch centre 9f
Monitoring of oxygen 99f
Monthly average response time with respect to
area 192f
Montreal ambulance service 92
Movement to
most competent hospital 80f
nearest hospital and regional hospitals 80f
MRSA viability on copper alloys and stainless steel at 200°C 129f
Multicenter Canadian study of prehospital trauma care 116f
Multidisciplinary
action 205
trauma team 64f
Myocardial infarction 119
N
National
disaster response force 33
equipment strategy 229
guidelines on medical preparedness and mass
casualty management 33
HART activity 227
multi agency 227
preparedness goal in context 75f
NBC
defence
preparedness 222
technologies 221
threat scenario 221f
NDRF battalions 35f
Network membership 153
Nuclear
disaster management 101
emergencies in India 41
Number of
participants of CPR course by fire department 15f
registered doctors and nurses 28t
O
Objectives of emergency response system 90
Obstructed frontal access 188f
Optimization of STEMI care 124
Optimized prehospital treatment 217
Original dispatch center 94f
Outcome to triage of patients 86f
Ownership pattern of Falck 38f
Oxygen, control of 99f
P
Pan-Asian resuscitation outcomes study 152
PAROS sites 156
Participating countries 154f
Patient
awareness, campaign for 151f
stretcher 207
trend in Singapore 58f
with STEMI
transferred for primary PCI,
characteristics of 84f
treated with PPCI, characteristics of 85f
Penetration sites 141f
People dying in terrorist related activities 169f
Percutaneous coronary intervention 82
Philips heartstart FR3 137f, 138f
Planning and design essential components of
emergency medical services system 47
Plans of PAROS 155
Post visit calls 198f
Potential
biological agents 222f
effects of reduced space per person 167t
Potentially dangerous crowd forces and
psychological pressures begin to develop 167t
Power and functions of NDMA 32
Pre-development challenges 206
Pre-fabricated ambulance construction process 100f
Prehospital 140
12-lead ECG 151
ECG transmission 119
emergency care—Five-Year plan (2009–2014) 10
pyramid model for India 40
Preparing
emergency department for victims of bomb 169
for 21st century 226
Present integrated dispatch center 95f
Primary PCI procedures per year 83
Principal structuring of EMS equipment 220
Principles in management 76
Proactive rounding 198
Problem with EMS 88
Process in emergency department 69f
Public private partnership in emergency medical
services 174
Q
Quality
and patient's safety in emergency
department 196
definition 196
improvement 196
measures 199
Quick conversion benefits 219
R
Radiation emergency medical system in
Japan 231f
Radiological
management 101
preparedness for chemical in India 45
Randomization 110
procedure 111f
Reducing door-to-balloon 119
Relationship of door-to-balloon time and
mortality 119f
Reperfusion strategies for STEMI 148
Response time 14f
Results
effectiveness endpoint 113t
mean response time and number of fire stations
and fire posts by month 9
neurologic endpoint 113t
of survey to find grassroot perspective in
EMS 180t
Retrospective quality measures 198
Rise of antibiotic resistant strains 125f
Road casualties in Germany 215f
Roadmap summary 11f
Roadside to critical care continuum of care 76
Role of
advanced life support in Asian EMS 115
central ministries and departments 32
doctors 231
S
Safety
and adaptation to environment 217f
features 207
for safety of doctors/paramedics 98f
of attendants 99f
SCDF annual call volume 1997–2010 8f
Screenshot of EMS data 102f
Secondary triage 53f
Series of
discrete steps-1 77f
very discrete steps 76f
Simulation and modeling 225
Single patient configuration 220f
Sites for IO 141f
Smart CPR 135, 136
Solutions for EMS 88
Specialized medical facilities 36
Specific reasons to
communication 194f
geographical factor 194f
ST elevation myocardial infarction program 81
Stakeholders for specifications of ambulance
interior 219f
Standards of care 19
State trauma committee and working group’s
governance arrangements 62f
State with
EMRI services 182t
government managed services 182t
local tie-ups Janini Express Model 183t
ziqitsa services 182t
STEMI based on prehospital ECGs 122t
Strategic
imperatives 10f
medical intelligence 42f, 44f
Strategies to improve quality 197
Stratified to prehospital triage 85f
Strengths 185
Stretcher for helicopter 219f
Structure and management of trauma patients
military hospital 63
Subgroup analysis 113, 113f
Subject exclusion 111
Successful systems of trauma care 60
Suggestions from guidelines 158
Suitcase nuke 42f
Synergizing 175f
System
delay and
heart failure 87f
mortality 86f
in Romania 24
of care for STEMI patients 149
prior to implementation of prehospital 12-lead
ECG 120f
T
Technologies
advantages of 88
in emergency care 88
Telemedicine 82
and field-triage of patients with STEMI for
primary PCI 82
system in emergency care in Romania 79
Tender requirements for ambulances 204
Tertiary hospitals 57
Threats—UK hazardous area response team 226
Time
in acute ST elevation 119
wise case analysis for 2011 195f
Timeliness dimension 184
Total cases transported 184t
Total emergency ambulance service calls 8f
Touch surfaces 126
replaced with copper 133f
Traditional vs alternative plant 188f
Training 227
Trauma 60
system 60
Trends of EMS calls in Dubai 191f
Triage counter 52f
Trial
data 120
phases 110f
sites 109f
Tsunami damaged FNPP 230f
Turning customer insights into meaningful
innovation 134
Turning disaster into opportunity, Gujarat
experience 173
Two-patient configuration 220f
Two-tier hospital defibrillation 138
Types of membership 154f
U
Understanding current state 68
Use of
information technology in Dubai emergency
medical services 191
self-disinfecting touch surface 125
Utstein analysis in Japan 16f
V
Variation and ED beds 197f
Vehicle level parameters 204t
Ventilation in emergency medical services 145
Victorian road trauma committee 61
W
Wait management 54f
Weaknesses 185
Workload characteristics 165
and conceptual model 166t
Workload prediction 165
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