BACKGROUND Casinos are often exempted from legislation mandating smoke-free environments, potentially putting employees and patrons at risk for adverse events triggered by secondhand smoke exposure. METHODS AND RESULTS We used an interrupted time series analysis of ambulance calls not originating and originating from casinos in Gilpin County, Colorado, a rural Colorado county with a large cas...

BACKGROUND Acute asthma is a common reason for patients to seek care from ambulance services. Although better care of acute asthma can prevent avoidable morbidity and deaths, there has been little research into ambulance clinicians' adherence to national guidelines for asthma assessment and management and how this might be improved. Our research aim was to explore paramedics' attitudes, percept...

BACKGROUND A shift from a predominantly emergency service, towards one where a wide range of conditions are managed and treated on scene presents numerous challenges for ambulance services and clinicians. The effective management of a broad range of patients and conditions in the ambulance setting will have an impact on other parts of the health service including emergency departments and prima...

OBJECTIVE Since March 1992, intravenous nalbuphine hydrochloride has been used prehospital by paramedics in the Plymouth area. This study assesses the impact of this intervention. METHODS A prospective study of the parenteral analgesic requirements of 1000 consecutive patients arriving by ambulance at the accident and emergency (A&E) department of a large district general hospital. Where pare...

OBJECTIVE Access block refers to the situation where patients in the emergency department (ED) requiring inpatient care are unable to gain access to appropriate hospital beds within a reasonable time frame. We systematically evaluated the relationship between access block, ED overcrowding, ambulance diversion, and ED activity. METHODS This was a retrospective analysis of data from the Emergen...

OBJECTIVES The study aimed to analyze ambulance transportations to Emergency Departments (EDs) in New South Wales (NSW) and to identify temporal changes in demographics, acuity, and clinical diagnoses. METHODS This was a retrospective analysis of a population based registry of ED presentations in New South Wales. The NSW Emergency Department data collection (EDCC) collects patient level data ...

Use of telecommunication technologies for remote, continuous monitoring of patients can enhance e‚ectiveness of emergency ambulance care during transport from rural areas to a regional center hospital. However, the communication along the various routes in rural areas may have wide bandwidth ranges from 2G to 4G; some regions may have only lower satellite bandwidth available. Bandwidth ƒuctuati...

OBJECTIVES To estimate the lifesaving potential of interventions to accelerate the administration of intravenous thrombolysis for myocardial infarction. METHODS Data were analysed from a prospective, observational study of all patients transported to hospital by ambulance, who subsequently received intravenous thrombolysis at 20 hospitals and two ambulance services in Victoria, Australia (n =...

OBJECTIVES In 2006, Médecins sans Frontières (MSF) established an emergency obstetric and neonatal care (EmONC) referral facility linked to an ambulance referral system for the transfer of women with obstetric complications from peripheral maternity units in Kabezi district, rural Burundi. This study aimed to (i) describe the communication and ambulance service together with the cost; (ii) exam...

AIM To describe the relative impact on survival of the delay from estimated time of collapse to call for an ambulance among patients who suffer from a bystander witnessed out of hospital cardiac arrest of a cardiac aetiology. METHODS A majority of all ambulance organizations in Sweden (covering 85% of Sweden inhabitants) participate in a National survey of out of hospital cardiac arrest. RE...