Base de dados : MEDLINE
Pesquisa : N02.421.297.043 [Categoria DeCS]
Referências encontradas : 20 [refinar]
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  1 / 20 MEDLINE  
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[PMID]:29320497
[Au] Autor:Tremblay PO; Duchesne T; Cumming SG
[Ad] Endereço:Département de mathématiques et de statistique, Université Laval, Québec, Québec, Canada.
[Ti] Título:Survival analysis and classification methods for forest fire size.
[So] Source:PLoS One;13(1):e0189860, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Factors affecting wildland-fire size distribution include weather, fuels, and fire suppression activities. We present a novel application of survival analysis to quantify the effects of these factors on a sample of sizes of lightning-caused fires from Alberta, Canada. Two events were observed for each fire: the size at initial assessment (by the first fire fighters to arrive at the scene) and the size at "being held" (a state when no further increase in size is expected). We developed a statistical classifier to try to predict cases where there will be a growth in fire size (i.e., the size at "being held" exceeds the size at initial assessment). Logistic regression was preferred over two alternative classifiers, with covariates consistent with similar past analyses. We conducted survival analysis on the group of fires exhibiting a size increase. A screening process selected three covariates: an index of fire weather at the day the fire started, the fuel type burning at initial assessment, and a factor for the type and capabilities of the method of initial attack. The Cox proportional hazards model performed better than three accelerated failure time alternatives. Both fire weather and fuel type were highly significant, with effects consistent with known fire behaviour. The effects of initial attack method were not statistically significant, but did suggest a reverse causality that could arise if fire management agencies were to dispatch resources based on a-priori assessment of fire growth potentials. We discuss how a more sophisticated analysis of larger data sets could produce unbiased estimates of fire suppression effect under such circumstances.
[Mh] Termos MeSH primário: Fogo
Florestas
[Mh] Termos MeSH secundário: Alberta
Classificação
Conjuntos de Dados como Assunto
Despacho de Emergência Médica/organização & administração
Fogo/estatística & dados numéricos
Relâmpago
Modelos Logísticos
Modelos de Riscos Proporcionais
Curva ROC
Análise de Sobrevida
Tempo (Meteorologia)
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180111
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189860


  2 / 20 MEDLINE  
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[PMID]:29215827
[Au] Autor:Issacs SM; Cash C; Antar O; Fowler RL
[Ti] Título:No Need for Speed: Response and transport with red lights and siren.
[So] Source:JEMS;42(2):41-3, 2017 02.
[Is] ISSN:0197-2510
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Condução de Veículo
Serviços Médicos de Emergência/normas
Tratamento de Emergência/normas
Tempo para o Tratamento
[Mh] Termos MeSH secundário: Acidentes de Trânsito
Despacho de Emergência Médica
Seres Humanos
Iluminação
Ruído dos Transportes
Fatores de Tempo
Transporte de Pacientes
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:171208
[St] Status:MEDLINE


  3 / 20 MEDLINE  
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[PMID]:29215826
[Au] Autor:Goodloe JM; Knoles CL; McAnallen D; Cox ML; Howerton DS
[Ti] Título:When is the Need for Speed?
[So] Source:JEMS;42(2):31-8, 2017 02.
[Is] ISSN:0197-2510
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Condução de Veículo
Serviços Médicos de Emergência/normas
Tratamento de Emergência/normas
Tempo para o Tratamento
[Mh] Termos MeSH secundário: Acidentes de Trânsito
Despacho de Emergência Médica
Seres Humanos
Iluminação
Ruído dos Transportes
Fatores de Tempo
Transporte de Pacientes
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:171208
[St] Status:MEDLINE


  4 / 20 MEDLINE  
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[PMID]:29182264
[Au] Autor:Escott MEA
[Ti] Título:Healthcare Anxiety: Educate the public on when to call 9-1-1.
[So] Source:JEMS;41(9):66, 2016 09.
[Is] ISSN:0197-2510
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Emergências
Despacho de Emergência Médica/utilização
Serviços Médicos de Emergência/utilização
Educação em Saúde
Conhecimentos, Atitudes e Prática em Saúde
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE


  5 / 20 MEDLINE  
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[PMID]:28499459
[Au] Autor:Pedersen PB; Henriksen DP; Mikkelsen S; Lassen AT
[Ad] Endereço:Department of Emergency Medicine, Institute of Clinical Research, University of Southern Denmark & Odense University Hospital, Odense, C DK-5000, Denmark. peter.bank.pedersen@rsyd.dk.
[Ti] Título:Dispatch and prehospital transport for acute septic patients: an observational study.
[So] Source:Scand J Trauma Resusc Emerg Med;25(1):51, 2017 May 12.
[Is] ISSN:1757-7241
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: In order to dispatch ambulances with the correct level of urgency, the dispatch center has to balance the perceived urgency and traffic safety considerations with the available resources. As urgency is not clear in all clinical situations, some high urgency patients may end up with a suboptimal mode of transport. Patients with severe sepsis or septic shock suffer from highly time dependent conditions but they present with a wide range of symptoms, which might be difficult to identify in the dispatch system. The aim of the study is to investigate the modes of prehospital transport among acute admitted patients with sepsis, severe sepsis and septic shock. METHODS: We included all adult patients (≥15 years) presenting to an acute medical unit at Odense University Hospital with a first-time admission of community-acquired sepsis between September 2010-August 2011. Cases and prehospital ambulance transport were identified by structured manual chart review. In all cases it was registered, whether the ordinary ambulance was assisted by the mobile emergency care unit (MECU), manned by anesthesiologists. RESULTS: We included 1,713 patients median age 72 years (IQR 57-81), 793 (46.3%) male, 621 (36.3%) had sepsis, 1,071 (62.5%) severe sepsis, and 21 (1.2%) septic shock. In the group of sepsis patients, 390 (62.8%) arrived without public prehospital transport, 197 (31.7%) were transported by ambulance, and 34 (5.5%) were assisted by MECU. In the group of severe sepsis patients, the same percentage 62.8% arrived without public pre-hospital transport, a lower percentage 28.2% were transported by ambulance, and a larger percentage 9.0% were transported by MECU. Among 21 patients with septic shock, 10 arrived without public pre-hospital transport (47.7%), 7 (33.3%) were transported by ambulance, and 4 (19.0%) by MECU. The 30-day mortality hazard ratio was associated with mode of transport, with the adjusted highest hazard ratio found in the group of MECU transported patients 1.76 (95%Cl 1.16-2.66). CONCLUSIONS: A substantial proportion of patients with severe sepsis and septic shock arrive to hospital without public prehospital transport or by unspecialized ambulances.
[Mh] Termos MeSH primário: Ambulâncias/estatística & dados numéricos
Despacho de Emergência Médica/estatística & dados numéricos
Choque Séptico/epidemiologia
Choque Séptico/terapia
[Mh] Termos MeSH secundário: Doença Aguda
Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Serviços Médicos de Emergência/estatística & dados numéricos
Feminino
Seres Humanos
Masculino
Meia-Idade
Sepse/epidemiologia
Sepse/terapia
Índice de Gravidade de Doença
Transporte de Pacientes/estatística & dados numéricos
Triagem
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170921
[Lr] Data última revisão:
170921
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170514
[St] Status:MEDLINE
[do] DOI:10.1186/s13049-017-0393-x


  6 / 20 MEDLINE  
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[PMID]:28407809
[Au] Autor:Moser A; Mettler A; Fuchs V; Hanhart W; Robert CF; Della Santa V; Dami F
[Ad] Endereço:Emergency Department, Hôpital Neuchâtelois, Maladière 45, 2000, Neuchâtel, Switzerland. alexandre.moser@ssvnn.net.
[Ti] Título:Merger of two dispatch centres: does it improve quality and patient safety?
[So] Source:Scand J Trauma Resusc Emerg Med;25(1):40, 2017 Apr 13.
[Is] ISSN:1757-7241
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Dispatch centres (DCs) are considered an essential but expensive component of many highly developed healthcare systems. The number of DCs in a country, region, or state is usually based on local history and often related to highly decentralised healthcare systems. Today, current technology (Global Positioning System or Internet access) abolishes the need for closeness between DCs and the population. Switzerland went from 22 DCs in 2006 to 17 today. This study describes from a quality and patient safety point of view the merger of two DCs. METHODS: The study analysed the performance (over and under-triage) of two medical DCs for 12 months prior to merging and for 12 months again after the merger in 2015. Performance was measured comparing the priority level chosen by dispatcher and the severity of cases assessed by paramedics on site using the National Advisory Committee for Aeronautics (NACA) score. We ruled that NACA score > 3 (injuries/diseases which can possibly lead to deterioration of vital signs) to 7 (lethal injuries/diseases) should require a priority dispatch with lights and siren (L&S). While NACA score < 4 should require a priority dispatch without L&S. Over-triage was defined as the proportion of L&S dispatches with a NACA score < 4, and under-triage as the proportion of dispatches without L&S with a NACA > 3. RESULTS: Prior to merging, Dispatch A had a sensitivity/specificity regarding the use of lights and sirens and severity of cases of 86%/48% with over- and under-triage rates of 78% and 5%, respectively. Dispatch B had sensitivity and specificity of 92%/20% and over- and under-triage rates of 84% and 7%, respectively. After they merged, global sensitivity/specificity reached 87%/67%, and over- and under-triage rates were 71% and 3%, respectively CONCLUSIONS: A part the potential cost advantage achieved by the merger of two DCs, it can improve the quality of services to the population, reducing over- and under-triage and the use of lights and sirens and therefore, the risk of accidents. This is especially the case when a DC with poor triage performance merges with a high-performing DC.
[Mh] Termos MeSH primário: Despacho de Emergência Médica/normas
Segurança do Paciente
Triagem/normas
[Mh] Termos MeSH secundário: Despacho de Emergência Médica/organização & administração
Seres Humanos
Estudos Retrospectivos
Sensibilidade e Especificidade
Suíça
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170831
[Lr] Data última revisão:
170831
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170415
[St] Status:MEDLINE
[do] DOI:10.1186/s13049-017-0383-z


  7 / 20 MEDLINE  
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[PMID]:27629892
[Au] Autor:Lehm KK; Andersen MS; Riddervold IS
[Ti] Título:Non-urgent Emergency Callers: Characteristics and Prognosis.
[So] Source:Prehosp Emerg Care;21(2):166-173, 2017 Mar-Apr.
[Is] ISSN:1545-0066
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: In Denmark, calls to the Danish emergency number 1-1-2 concerning medical emergencies are received by an emergency medical communication center (EMCC). At the EMCC, health care professionals (nurses, paramedics, and physicians) decide the necessary response, depending on the level of emergency as indicated by the Danish Index for Emergency Care. The index states 37 main criteria (symptoms) and five levels of emergency, descending from A (life threatening) to E (not serious). An ambulance is not sent to emergency level-E patients (level-E patients), but they are given other kinds of help/advice. No prior studies focusing on Danish level-E patients exist, hence the sparse knowledge about them. This study aimed to characterize level-E patients in the Central Denmark Region and to investigate their progress in the health care system after the 1-1-2 call, regarding contacting 1-1-2 again, general practitioner and Emergency Department (ED) visits, hospital admission, and death. METHODS: This is a retrospective follow-up study of callers who contacted the EMCC of the Central Denmark Region and were assessed as level-E patients from August 2013 to July 2014. The study population was identified in the EMCC dispatch software, whose data were supplemented with health care data from three national registries. RESULTS: Of the 53,414 patients who called 1-1-2 over the study period, 4,962 level-E patients were included in the study. The median age was 47 years (IQR: 24.3-67.7), and 53.4% were men. The most common main criteria were extremity pain - minor wounds. Within 1 day after their 1-1-2 call, 42.1% had a subsequent contact with the health care system. Of those, 5.9% called 1-1-2 again, 24.3% contacted an ED, and 8.6% were admitted. The fatality rate was 0.1%. CONCLUSIONS: Level-E patients who contacted the EMCC of the Central Denmark Region were most frequently young adults. Almost 60% of level E-patients, who could be tracked, had no further contact with the health care system within a day after their 1-1-2 call. Of those who did, a quarter contacted an ED, indicating that level-E patients needed medical attention. The low fatality rates suggest limited undertriage, that is, level-E patients do not seem to need emergency medical service transportation. Further studies on undertriage among other things are needed.
[Mh] Termos MeSH primário: Despacho de Emergência Médica/estatística & dados numéricos
Sistemas de Comunicação entre Serviços de Emergência/estatística & dados numéricos
Triagem/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Idoso
Dinamarca/epidemiologia
Despacho de Emergência Médica/normas
Sistemas de Comunicação entre Serviços de Emergência/normas
Serviços Médicos de Emergência/normas
Serviços Médicos de Emergência/estatística & dados numéricos
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Prognóstico
Estudos Retrospectivos
Triagem/normas
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170622
[Lr] Data última revisão:
170622
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160916
[St] Status:MEDLINE
[do] DOI:10.1080/10903127.2016.1218981


  8 / 20 MEDLINE  
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[PMID]:26373555
[Au] Autor:Lee S
[Ad] Endereço:Purdue University, West Lafayette, IN, USA. lee46@purdue.edu.
[Ti] Título:A new preparedness policy for EMS logistics.
[So] Source:Health Care Manag Sci;20(1):105-114, 2017 Mar.
[Is] ISSN:1386-9620
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Response time in emergency medical services (EMS) is defined as the interval for an ambulance to arrive the scene after receipt of a 911 call. When several ambulances are available upon the receipt of a new call, a decision of selecting an ambulance has to be made in an effort to reduce response time. Dispatching the closest unit available is commonly used in practice; however, recently the Preparedness policy was designed that is in a simplistic form yet being capable of securing a long-term efficiency. This research aims to improve the Preparedness policy, resolving several critical issues inherent in the current form of the policy. The new Preparedness policy incorporates a new metric of preparedness based on the notion of centrality and involves a tuning parameter, weight on preparedness, which has to be appropriately chosen according to operational scenario. Computational experiment shows that the new policy significantly improves the former policy robustly in various scenarios.
[Mh] Termos MeSH primário: Planejamento em Desastres
Serviços Médicos de Emergência/organização & administração
Política Organizacional
[Mh] Termos MeSH secundário: Planejamento em Desastres/organização & administração
Despacho de Emergência Médica/organização & administração
Seres Humanos
Modelos Organizacionais
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171020
[Lr] Data última revisão:
171020
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150917
[St] Status:MEDLINE
[do] DOI:10.1007/s10729-015-9340-4


  9 / 20 MEDLINE  
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[PMID]:27614747
[Au] Autor:Ichiki T; Onozuka D; Kamouchi M; Hagihara A
[Ad] Endereço:Department of Cardiology, Harasanshin Hospital, 1-8 Taihakucho, Hakata-ku, Fukuoka, 812-0033, Japan. ichiki@cardiol.med.kyushu-u.ac.jp.
[Ti] Título:An association between fine particulate matter (PM ) levels and emergency ambulance dispatches for cardiovascular diseases in Japan.
[So] Source:Int Arch Occup Environ Health;89(8):1329-1335, 2016 Nov.
[Is] ISSN:1432-1246
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The aim of this study is to determine whether short-term exposure to fine particulate matter (PM ) is associated with emergency ambulance dispatches for cardiovascular diseases in Japan. METHODS: The nationwide data on emergency dispatches of ambulance for cardiovascular diseases classified as I00-I99 by International Classification of Diseases-10th revision in 30 Japanese prefectures between April 1 and December 31, in 2010 were analyzed. Data on weather variability including PM , temperature and relative humidity were acquired from ambient air pollution monitoring stations. Conditional Poisson regression models were used to estimate the prefecture-specific effects of PM on morbidity, and adjust for confounding factors. A meta-analysis was then applied to pool estimates at the 30-prefecture level. RESULTS: A total of 160,566 emergency ambulance dispatches for cardiovascular diseases were reported during the study period. The risk of emergency ambulance dispatch for cardiovascular diseases significantly increased with an increase in the exposure to PM in Fukuoka and Iwate Prefectures. However, we found no statistically significant associations between PM and emergency ambulance dispatches in the pooled analysis (odds ratio 1.00, 95 % confidence interval 0.99-1.00). Heterogeneity was not observed between prefectures (Cochran Q test, p = 0.187, I  = 18.4 %). CONCLUSIONS: Exposure to PM is not associated with overall emergency ambulance dispatches for cardiovascular diseases in Japan.
[Mh] Termos MeSH primário: Ambulâncias
Doenças Cardiovasculares/etiologia
Despacho de Emergência Médica/estatística & dados numéricos
Exposição Ambiental/efeitos adversos
Material Particulado/efeitos adversos
[Mh] Termos MeSH secundário: Despacho de Emergência Médica/métodos
Exposição Ambiental/análise
Geografia
Seres Humanos
Umidade
Japão
Tamanho da Partícula
Material Particulado/análise
Distribuição de Poisson
Análise de Regressão
Fatores de Risco
Temperatura Ambiente
Tempo (Meteorologia)
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Particulate Matter)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:171005
[Lr] Data última revisão:
171005
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160912
[St] Status:MEDLINE


  10 / 20 MEDLINE  
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[PMID]:27550497
[Au] Autor:Jung K; Huh Y; Lee JC; Kim Y; Moon J; Youn SH; Kim J; Kim TY; Kim J; Kim H
[Ad] Endereço:Division of Trauma Surgery, Department of Surgery, Ajou University School of Medicine, Suwon, Korea. jake98@daum.net.
[Ti] Título:Reduced Mortality by Physician-Staffed HEMS Dispatch for Adult Blunt Trauma Patients in Korea.
[So] Source:J Korean Med Sci;31(10):1656-61, 2016 Oct.
[Is] ISSN:1598-6357
[Cp] País de publicação:Korea (South)
[La] Idioma:eng
[Ab] Resumo:The aim of this study was to investigate the efficiency of domestic physician-staffed helicopter emergency medical service (HEMS) for the transport of patients with severe trauma to a hospital. The study included patients with blunt trauma who were transported to our hospital by physician-staffed HEMS (Group P; n = 100) or nonphysician-staffed HEMS (Group NP; n = 80). Basic patient characteristics, transport time, treatment procedures, and medical treatment outcomes assessed using the Trauma and Injury Severity Score (TRISS) were compared between groups. We also assessed patients who were transported to the hospital within 3 h of injury in Groups P (Group P3; n = 50) and NP (Group NP3; n = 74). The severity of injury was higher, transport time was longer, and time from hospital arrival to operation room transfer was shorter for Group P than for Group NP (P < 0.001). Although Group P patients exhibited better medical treatment outcomes compared with Group NP, the difference was not statistically significant (P = 0.134 vs. 0.730). However, the difference in outcomes was statistically significant between Groups P3 and NP3 (P = 0.035 vs. 0.546). Under the current domestic trauma patient transport system in South Korea, physician-staffed HEMS are expected to increase the survival of patients with severe trauma. In particular, better treatment outcomes are expected if dedicated trauma resuscitation teams actively intervene in the medical treatment process from the transport stage and if patients are transported to a hospital to receive definitive care within 3 hours of injury.
[Mh] Termos MeSH primário: Despacho de Emergência Médica/métodos
Ferimentos e Lesões/patologia
[Mh] Termos MeSH secundário: Adulto
Resgate Aéreo
Feminino
Pessoal de Saúde
Seres Humanos
Escala de Gravidade do Ferimento
Masculino
Meia-Idade
República da Coreia
Análise de Sobrevida
Centros de Atenção Terciária
Fatores de Tempo
Resultado do Tratamento
Ferimentos e Lesões/mortalidade
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170308
[Lr] Data última revisão:
170308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160824
[St] Status:MEDLINE
[do] DOI:10.3346/jkms.2016.31.10.1656



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