Responding to an in-flight medical emergency.
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ABSTRACT:
SUBMITTER: Low RCH
PROVIDER: S-EPMC8801864 | biostudies-literature | 2021 May
REPOSITORIES: biostudies-literature
Publications
Responding to an in-flight medical emergency.
Low Robin Chin Howe RCH How Choon How CH
Singapore medical journal 20210501 5
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Project description:IntroductionWhile teams are a central component in health care, many professionals who function in them have had little, if any, formal training on how to develop an effective team. Medical educators and trainers have used many different approaches to teach the basic skills and knowledge of team effectiveness and how team members can best interact with each other. To make team training more realistic, experiential exercises have been used. One of the more popular categories of experiential activities is survival exercises in which team members are given a scenario and required to make decisions that ultimately decide whether the team survives the ordeal.MethodsThis activity describes a situation in which a medical professional is traveling on an airliner when a request for medical assistance occurs. Participants can include clinically experienced medical students, residents, fellows, and faculty physicians. The activity can be used as a stand-alone exercise or in conjunction with another team topic, such as communications or decision making. It has also been effective as an icebreaker for teams working together during a workshop.ResultsApproximately 100 medical students, residents, and faculty from anesthesia, family medicine, pediatrics, and internal medicine have participated in this activity. It has been very well received and generated a great deal of discussion of both medical knowledge and team-building skills.DiscussionThis activity, which can be used to examine team communications, decision making, leadership, and conflict management, is suitable for health care professionals either through intra- or interprofessional training.
| S-EPMC6342154 | biostudies-literature
Project description:IntroductionOur planet has been experiencing a huge burden of natural disasters and public health emergencies in the last three decades. Emergency medical service providers are expected to be in the frontlines during such emergencies. Yet, this system is badly understudied when it comes to its roles and performance during disasters and public health emergencies. This study is designed to enhance understanding by assessing a sample U.S EMS providers' views about working during natural disasters and disease outbreaks and explores whether they are coming to work during such conditions.MethodsThis study utilized a qualitative approach using face-to-face interviews with EMS workers from the State of Delaware, USA. Participants were asked about their views, insights, and potential behavior of working during natural disasters and disease outbreaks. Data collected were transcribed and coded using ATLAS.ti software to develop themes of the study using an inductive approach.ResultsThree themes were emerged from interviews regarding working during natural disasters; respondents expressed excitement, concern, or no real differences. For disease outbreaks, however, the two themes were concerned and no additional risk. While participants expressed varying concerns about working during disasters and pandemic conditions, everyone felt willing and obligated to come to work despite the perceived high risk for some of them to work in some conditions.ConclusionThis study helps to provide the base upon which EMS, public health, and emergency management agencies can formulate actions that emerged from the views of EMS providers concerning work during disasters and public health emergencies.
| S-EPMC7185370 | biostudies-literature
Project description:IntroductionThis study aimed to determine the impact of community socioeconomic status on emergency medical services' response time for fatal vehicle crashes.MethodsAuthors used the 2019 National Highway Traffic Safety Administration Fatality Analysis Reporting System and 2019-2020 Area Health Resource Files to obtain emergency medical services' time intervals and county socioeconomic characteristics (e.g., median household income, availability of trauma centers, and rurality), generating a study sample of 18,540 individuals involved in fatal vehicle crashes between January and December 2019. Generalized linear models with log-link and Gamma-family were used to obtain estimates, and other variables were adjusted in the model.ResultsBoth the mean time of the emergency medical service arrival to the site of the crash and the mean transport time from the crash site to hospital varied by county SES. Counties with a higher mean household income had 12% shorter emergency medical services' arrival times and up to 7% shorter emergency medical services' hospital transport times than counties with lower SES. The emergency medical services' hospital transport times by emergency medical services also varied by proximity to trauma centers and were 15% shorter in counties that had ≥2 trauma centers than in counties without trauma centers.ConclusionsThis study shows socioeconomic disparities in emergency medical service rescue time for fatal vehicle crashes. Community characteristics play a major role in emergency medical services' arrival time intervals. Prior research demonstrated a strong link between the timeliness of emergency medical service response and the likelihood of survival in fatal motor vehicle accidents. These findings showing that socioeconomically disadvantaged areas and those lacking trauma facilities had slower emergency medical service rescue times, suggest that socioeconomic status may be a predictor of mortality in fatal motor vehicle accidents. Effective emergency medical services are essential to reduce the morbidity and mortality among motor vehicle crash victims; however, disparities exist in the timeliness of these services by geographic and socioeconomic county characteristics. Further research is urgently needed to inform policy interventions.
| S-EPMC10546577 | biostudies-literature
Project description:IntroductionIn-flight medical emergencies are common occurrences that require medical professionals to manage patients in an unfamiliar setting with limited resources. Emergency medicine (EM) residents should be well prepared to care for patients in unusual environments such as on an aircraft.MethodsWe developed a simulation case for EM residents featuring a 55-year-old male passenger who suffers a cardiac arrest secondary to a tension pneumothorax. We conducted this case eight times during a 5-hour block of scheduled simulation time. Participants included EM residents of all training levels from one residency program. We arranged the simulation lab as an airplane cabin, with rows of chairs representing airplane seats and a mannequin in a window seat as the patient. Residents were expected to manage cardiac arrest and perform needle thoracostomy on the patient. Residents also evaluated and treated a flight attendant with a near syncopal episode. Throughout the case, residents were expected to practice teamwork skills, including leadership, communication, situational awareness, and resource utilization. Participants were debriefed and completed voluntary anonymous evaluations of the session.ResultsSeventeen EM residents participated in the simulation. Overall, all 17 found the simulation to be a valuable educational experience. In addition, all agreed or strongly agreed that they felt more prepared to respond to an in-flight emergency after participating in the simulation.DiscussionThis simulation was determined to be a valuable part of EM resident education. The challenges presented and skills practiced in this in-flight medical emergency simulation case are transferable to other resource-limited environments.
| S-EPMC7449573 | biostudies-literature
Project description:Background: Limited information is available covering all medical events managed by the airport-based outreach medical service. This study explores the clinical demand for emergency medical outreach services at Taoyuan International Airport (TIA), Taiwan. Methods: Electronic medical records collected from TIA medical outreach services from 2017 to 2018, included passengers' profiles, flight information, events location, chief complaints, diagnosis (using ICD-9 -CM codes), and management outcomes. Medical events distribution was stratified by location and ages, and were compared statistically. Results: Among 1,501 eligible records, there were 81.8% ground-based emergency medical events (GBME), 16.9% in-flight medical events (IFME) managed after scheduled landing, and 1.3% IFME leading to unscheduled diversion or re-entry to TIA. The top three GBME diagnoses were associated with neurological (23.3%), gastrointestinal (21.2%), and trauma-related (19.3%) conditions. The top three IFME diagnosis that prompted unscheduled landings via flight diversion or re-entry were neurological (47.4%), psychological (15.8%), and cardiovascular (10.5%). The chief complaints that prompted unscheduled landings were mostly related to neurological (42.1%), cardiovascular (26.3%), and out-of-hospital cardiac arrest (OHCA) (10.5%) symptoms. A higher frequency of IFME events due to dermatologic causes in patients aged ≤ 18 years compared with adults and older adults (19 vs. 1.5% and 0, respectively); and a higher frequency of IFME due to cardiovascular causes in adults ≥ 65 years compared with patients aged ≤ 65 (15.1 vs. 9%). Among all IFME patients, six out-of-hospital deaths occurred among passengers from scheduled landings and two deaths occurred among 18 IFME passengers who were transferred to local hospitals from flight diversion or re-entry. A statistically significant difference in outcomes and short-term follow-up status was found between patients with IFME and those with GBME (p < 0.001). Conclusion: Ground-based emergency medical events exceeded in-flight medical events at TIA. The most frequent events were related to neurological, gastrointestinal symptoms, or trauma. Results of this study may provide useful information for training medical outreach staff and preparing medical supplies to meet the clinical demand for airport medical outreach services.
| S-EPMC8342757 | biostudies-literature
Project description:Most disaster plans depend on using emergency physicians, nurses, emergency department support staff, and out-of-hospital personnel to maintain the health care system's front line during crises that involve personal risk to themselves or their families. Planners automatically assume that emergency health care workers will respond. However, we need to ask: Should they, and will they, work rather than flee? The answer involves basic moral and personal issues. This article identifies and examines the factors that influence health care workers' decisions in these situations. After reviewing physicians' response to past disasters and epidemics, we evaluate how much danger they actually faced. Next, we examine guidelines from medical professional organizations about physicians' duty to provide care despite personal risks, although we acknowledge that individuals will interpret and apply professional expectations and norms according to their own situation and values. The article goes on to articulate moral arguments for a duty to treat during disasters and social crises, as well as moral reasons that may limit or override such a duty. How fear influences behavior is examined, as are the institutional and social measures that can be taken to control fear and to encourage health professionals to provide treatment in crisis situations. Finally, the article emphasizes the importance of effective risk communication in enabling health care professionals and the public to make informed and defensible decisions during disasters. We conclude that the decision to stay or leave will ultimately depend on individuals' risk assessment and their value systems. Preparations for the next pandemic or disaster should include policies that encourage emergency physicians, who are inevitably among those at highest risk, to "stay and fight."
| S-EPMC7124291 | biostudies-literature
Project description:Spontaneous helping behavior during an emergency is influenced by the personality of the onlooker and by social situational factors such as the presence of bystanders. Here, we sought to determine the influences of sympathy, an other-oriented response, and personal distress, a self-oriented response, on the effect of bystanders during an emergency. In four experiments, we investigated whether trait levels of sympathy and personal distress predicted responses to an emergency in the presence of bystanders by using behavioral measures and single-pulse transcranial magnetic stimulation. Sympathy and personal distress were expected to be associated with faster responses to an emergency without bystanders present, but only personal distress would predict slower responses to an emergency with bystanders present. The results of a cued reaction time task showed that people who reported higher levels of personal distress and sympathy responded faster to an emergency without bystanders (Exp. 1). In contrast to our predictions, perspective taking but not personal distress was associated with slower reaction times as the number of bystanders increased during an emergency (Exp. 2). However, the decrease in motor corticospinal excitability, a direct physiological measure of action preparation, with the increase in the number of bystanders was solely predicted by personal distress (Exp. 3). Incorporating cognitive load manipulations during the observation of an emergency suggested that personal distress is linked to an effect of bystanders on reflexive responding to an emergency (Exp. 4). Taken together, these results indicate that the presence of bystanders during an emergency reduces action preparation in people with a disposition to experience personal distress.
| S-EPMC4949296 | biostudies-literature
Project description:BackgroundIn medical events, patients have to independently decide whom to contact: emergency medical services, medical on-call service or emergency department.ObjectivesAre Germans able to assess the urgency of medical events and choose the correct resource?Materials and methodsIn 2018 a nationwide anonymous telephone survey was done in Gabler-Haeder design. In all, 708 interviewees were presented with six medical scenarios. Participants were asked to rate urgency and to assess whether medical help was necessary within minutes to hours. Telephone numbers of emergency medical services and medical on-call service were inquired.ResultsUrgency of different scenarios was often misjudged: in cases with high, medium, and low urgency the misjudgement rate were 20, 50, and 27%, respectively. If medical help was rated as necessary, some participants chose the wrong service: 25% would not call an ambulance in stroke or myocardial infarction. In cases with medium urgency, more respondents chose to consult an emergency department (38%) than to call medical on-call service (46%).ConclusionsKnowledge regarding different options for treatment of medical events and competence to assess urgency seem to be too low. Beside efforts to increase health literacy, one solution might be to introduce a joint telephone number for emergency medical services and medical on-call service with a uniform assessment tool and appropriate allocation.
| S-EPMC8897349 | biostudies-literature
Project description:BACKGROUND:Little is known regarding paediatric medical emergency calls to Danish Emergency Medical Dispatch Centres (EMDC). This study aimed to investigate these calls, specifically the medical issues leading to them and the pre-hospital units dispatched to the paediatric emergencies. METHODS:We performed a retrospective, observational study on paediatric medical emergency calls managed by the EMDC in the Region of Southern Denmark in February 2016. We reviewed audio recordings of emergency calls and ambulance records to identify calls concerning patients ≤ 15 years. We examined EMDC dispatch records to establish how the medical issues leading to these calls were classified and which pre-hospital units were dispatched to the paediatric emergencies. We analysed the data using descriptive statistics. RESULTS:Of a total of 7052 emergency calls in February 2016, 485 (6.9%) concerned patients ≤ 15 years. We excluded 19 and analysed the remaining 466. The reported medical issues were commonly classified as: "seizures" (22.1%), "sick child" (18.9%) and "unclear problem" (12.9%). The overall most common pre-hospital response was immediate dispatch of an ambulance with sirens and lights with a supporting physician-manned mobile emergency care unit (56.4%). The classification of medical issues and the dispatched pre-hospital units varied with patient age. DISCUSSION:We believe our results might help focus the paediatric training received by emergency medical dispatch staff on commonly encountered medical issues, such as the symptoms and conditions pertaining to the symptom categories "seizures" and "sick child". Furthermore, the results could prove useful in hypothesis generation for future studies examining paediatric medical emergency calls. CONCLUSION:Almost 7% of all calls concerned patients ≤ 15 years. Medical issues pertaining to the symptom categories "seizures", "sick child" and "unclear problem" were common and the calls commonly resulted in urgent pre-hospital responses.
| S-EPMC5756442 | biostudies-literature
Project description:Concussions are a major cause of morbidity in pediatrics. Many concussions occur during activities with emergency medical service (EMS) providers present to determine if a higher level of care is needed. Data are limited on how capable these providers are. We assessed the ability of EMS providers to recognize pediatric concussions. Fifty-six total responses were included, 38 from EMS and 18 from our MD/RN (medical doctor/registered nurse) group. No statistical differences were found between the 2 groups when adjusted for age, gender, number of years in practice, and number of pediatric concussions managed. This first of its kind pilot study was designed to assess EMS personnel's ability to recognize and triage pediatric concussions. Our findings show EMS providers are statistically identical in their ability to recognize and triage concussions to physicians. The performance of our MD participants was lower than expected. Larger studies are needed to further investigate EMS providers' ability to recognize a concussion.
| S-EPMC5528916 | biostudies-other