Abstract:
OBJECTIVE:To identify the factors that lead to increased use of emergency medical services (EMS) by patients 65 years of age and older in an urban EMS system. METHODS:Retrospective, case-control study of frequent EMS use among elderly patients transported during one year in an urban EMS system. Three distinct groups were examined for transports that took place in 1999: (1) 1-3 transports per year (low use); (2) 4-9 times per year (high use); and (3) those transported 10+ times (very high use). This frequency-use indicator variable is the primary outcome measurement. Predictors included age, gender, preexisting medical diseases, ethnicity, number of medications, number of medical problems, primary physician, psychiatric diagnosis, and homelessness. Analysis of predictors was done using ordinal logistic regression model, and a global test of interaction terms. RESULTS:Male gender, black ethnicity, homelessness, and a variety of types of medical problems were associated with increased use of EMS resources. The strongest single predictor of case status remained homelessness, which was nearly eight times as commonly associated with frequent EMS use than for the controls. The number of medical problems and medications also were significantly associated with EMS use in this patient population. There was a lack of association of alcohol, substance abuse, and psychiatric disorders with EMS use. Patients with asthma who did not have a primary care physician were more likely to use EMS services than were those who had a physician. CONCLUSIONS:This analysis highlights homelessness as being strongly associated with frequent EMS use among the elderly and downplays other associated factors, such as psychiatric disease and substance use. Medical illness severity, particularly asthma when no primary care physician is available, also appears to drive frequent EMS use. Both findings have implications in terms of targeting of public resources; providing housing to medically ill elderly and primary care to asthmatics in particular, may provide dividends not only in terms of social welfare and medical care, but in preventing frequent EMS use by the elderly.
journal_name
Prehosp Disaster Medjournal_title
Prehospital and disaster medicineauthors
Tangherlini N,Pletcher MJ,Covec MA,Brown JFdoi
10.1017/s1049023x0000813xsubject
Has Abstractpub_date
2010-05-01 00:00:00pages
258-64issue
3eissn
1049-023Xissn
1945-1938journal_volume
25pub_type
杂志文章abstract::This is a summary of the presentations and discussion of Panel 2.10, Reproductive, Mental, and Child Health of the Conference, Health Aspects of the Tsunami Disaster in Asia, convened by the World Health Organization (WHO) in Phuket, Thailand, 04-06 May 2005. The topics discussed included issues related to reproductiv...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00003058
更新日期:2005-11-01 00:00:00
abstract:OBJECTIVE:Little is known about the overall frequency of hazardous materials (HazMat) events in the United States and the nature of prehospital care for those exposed. The purpose of the current study was to perform a descriptive analysis of Emergency Medical Services (EMS) activations reported to a national EMS databa...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X1500504X
更新日期:2015-10-01 00:00:00
abstract:INTRODUCTION:Patients with respiratory failure are usually mechanically ventilated, mostly with fraction of inspired oxygen (FiO2) > 0.21. Minimizing FiO2 is increasingly an accepted standard. In underserved nations and disasters, salvageable patients requiring mechanical ventilation may outstrip oxygen supplies. STUD...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X20001016
更新日期:2020-12-01 00:00:00
abstract:INTRODUCTION:The discussions in this theme provided an opportunity to share specific experiences with disasters that occurred outside of the Asia-Pacific Rim. METHODS:Details of the methods used are provided in the preceding paper. The chairs moderated all presentations and produced a summary that was presented to an ...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00025565
更新日期:2001-01-01 00:00:00
abstract:INTRODUCTION:The esophageal detector device (EDD) recently has been found to assess endotracheal (ET) tube placement accurately. This study describes the reliability of the EDD in determining the position of the ET tube in clinical airway situations that are difficult. METHODS:This was a prospective, randomized, singl...
journal_title:Prehospital and disaster medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1017/s1049023x00042369
更新日期:1996-01-01 00:00:00
abstract::This paper discusses the need for consistency in mass-gathering data collection and biomedical reporting. Mass gatherings occur frequently throughout the world, and having an understanding of the complexities of mass gatherings is important to inform health services about the possible required health resources. Factor...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X12001288
更新日期:2012-12-01 00:00:00
abstract::The tasks required for the preservation of the health of rescuers can be accomplished with the creation of a system for medical examinations and rehabilitation that functions with commonly used methodological and organizational principles. Absence of such a common methodological platform often results in the disqualif...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:
更新日期:1999-07-01 00:00:00
abstract:INTRODUCTION:Full-scale disaster drills are complex, expensive, and may involve hundreds or thousands of people. However, even when carefully planned, they often fail to manifest the details of medical care given to the casualties during the drill. OBJECTIVE:To assess the feasibility of integrating physicians among th...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:
更新日期:1997-04-01 00:00:00
abstract::Introduction Survivors of natural disasters in the United States experience significant health ramifications. Women particularly are vulnerable to both post-disaster posttraumatic stress disorder (PTSD) and depression, and research has documented that these psychopathological sequelae often are correlated with increas...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章,评审
doi:10.1017/S1049023X16000911
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:After a major earthquake, the assignment of scarce mental health emergency personnel to different geographic areas is crucial to the effective management of the crisis. The scarce information that is available in the aftermath of a disaster may be valuable in helping predict where are the populations that ar...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X17000206
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Abuse or unintended overdose (OD) of opiates and heroin may result in prehospital and emergency department (ED) care. Prehospital naloxone use has been suggested as a surrogate marker of community opiate ODs. The study objective was to verify externally whether prehospital naloxone use is a surrogate marker ...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X15004793
更新日期:2015-08-01 00:00:00
abstract:INTRODUCTION:Mildly injured and "worried well" patients can have profound effects on the management of a mass-casualty incident. The objective of this study is to describe the characteristics and lessons learned from an event that occurred on 28 August 2005 near the central bus station in Beer-Sheva, Israel. The unique...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00004623
更新日期:2007-05-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to assess the risk of cardiopulmonary resuscitation (CPR) performed in out-of-hospital settings for chest injuries in patients with out-of-hospital cardiac arrest (OHCA). METHODS:This retrospective, observational study was conducted in an emergency critical care medical center in J...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X18000201
更新日期:2018-04-01 00:00:00
abstract:INTRODUCTION:Burnout among emergency medical personnel (EMP) is suspected, but largely unsupported in the literature. An investigation of the phenomenon of burnout and factors contributing to its existence are essential steps in designing effective interventions. RESEARCH QUESTIONS:Three research questions were propos...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:
更新日期:1999-10-01 00:00:00
abstract::Introduction Vasopressors are associated with return of spontaneous circulation (ROSC), but no long-term benefit has been demonstrated in randomized trials. However, these trials did not control for the timing of vasopressor administration which may influence outcomes. Consequently, the objective of this study was to ...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X17000115
更新日期:2017-06-01 00:00:00
abstract:INTRODUCTION:The need to manage psychological symptoms after disasters can result in an increase in the prescription of psychotropic drugs, including antidepressants and anxiolytics. Therefore, an increase in the prescription of antidepressants and anxiolytics could be an indicator of general psychological distress in ...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X12001392
更新日期:2012-12-01 00:00:00
abstract::On January 12, 2010, Port-au-Prince, Haiti, was shattered by a violent earthquake that killed or injured thousands of its citizens. Local emergency services became overwhelmed and international assistance was required. French relief teams were deployed to assist local hospitals in caring for the victims. The medical c...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X12001239
更新日期:2012-12-01 00:00:00
abstract:INTRODUCTION:On 26 December 2004, an earthquake (9.0 Richter, 10 kilometers below the sea) near Sumatra, Indonesia, triggered a tsunami, which traveled at approximately 800 km per hour to strike the Indian coastline. The disaster response at a 100-bed hospital situated on the beach front (2,028 km from the epicenter) i...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00003939
更新日期:2006-09-01 00:00:00
abstract::The tsunami disaster affected several countries in Southeast Asia in December 2004 and killed or affected many tourists, most of them from Europe. Eight Czech citizens died, and about 500 Czechs were seriously mentally traumatized. The psychosocial needs of tourists included: (1) protection; (2) treatment; (3) safety;...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:
更新日期:2006-01-01 00:00:00
abstract::Introduction Many Syrians have left their country and migrated to other countries since March 2011, due to the civil war. As of March 2016, a total of 2,747,946 Syrian refugees had immigrated to Turkey. Some Syrian refugees have been living in camps, while 2,475,134 have been living in metropolitan areas, such as Anka...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章,多中心研究
doi:10.1017/S1049023X18000134
更新日期:2018-04-01 00:00:00
abstract::In response to the International Liaison Committee on Resuscitation (ILCOR; Niel, Belgium) release of an updated recommendation related to out-of-hospital spinal immobilization (SI) practice in 2015, a systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X20000680
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:During a mass gathering, some participants may receive health care for injuries or illnesses that occur during the event. In-event first responders provide initial assessment and management at the event. However, when further definitive care is required, municipal ambulance services provide additional assess...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X16001199
更新日期:2017-02-01 00:00:00
abstract::By defining the chain of medical care and the capacities of the successive phases within this chain, an attempt is made to analyze and grade the determinants of these capacities. In this way, calculations that indicate overall disaster preparedness can be expressed in a figure ranging from 1-5. The capacity of the sys...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00037158
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND:Fibrinolysis is an acceptable treatment for acute ST-segment elevation myocardial infarction (STEMI) when primary percutaneous coronary intervention (PCI) cannot be performed within 120 minutes. The American Heart Association has recommended Emergency Medical Services (EMS) interventions such as prehospital ...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X20000801
更新日期:2020-10-01 00:00:00
abstract::Many of the problems that develop in disaster management can be avoided with good program planning. Assessment following a disaster is essential. Needs assessment is essential in the early phases of a disaster and situation assessments become more important as the disaster process continues. Both are dynamic and conti...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:
更新日期:1998-04-01 00:00:00
abstract:INTRODUCTION:On 26 December 2003, at 05:26 hours, an earthquake of magnitude 6.6 (Richter scale) caused a disaster in the Bam region of Southeastern Iran, which had a population of approximately 102,000. In this study, the clinical and laboratory features and therapeutic interventions in pediatric (three months to 14 y...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00007305
更新日期:2009-09-01 00:00:00
abstract::The use of chemical warfare agents against civilians and unprotected troops in international conflicts or by terrorists against civilians is considered to be a real threat, particularly following the terrorist attacks on 11 September 2001 against the World Trade Center in New York and against the Pentagon in Washingto...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章,评审
doi:10.1017/s1049023x00001072
更新日期:2003-07-01 00:00:00
abstract::Although the United States has been impacted by numerous devastating disasters over the last 10 years, there have been only limited efforts between the governmental and non-profit/voluntary organizations to meet the multiple disaster health and mental health needs of the community. Too often, responding organizations ...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:
更新日期:2000-10-01 00:00:00
abstract:INTRODUCTION:Accountability in the delivery of humanitarian aid has become increasingly important and emphasized by the humanitarian community. The Humanitarian Accountability Partnership (HAP) was created in 2003 in order to improve accountability in the humanitarian sector. HAP acts as a self-regulatory body to the h...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X14000673
更新日期:2014-08-01 00:00:00
abstract::The concept of protecting civilians in armed conflict is enshrined in international humanitarian law and widely acknowledged in humanitarian norms. Making this concept operational in humanitarian service delivery is a challenge. Yet, there are many ways in which humanitarian workers could learn from local people about...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00021580
更新日期:2009-07-01 00:00:00