The impact of an emergency motorcycle response vehicle on prehospital care in an urban area

Pols, Hans van der; Mencl, Francis; Vos, Rien de

doi:10.1097/mej.0b013e32834624e8

Cited by 14 publications

(18 citation statements)

References 4 publications

(9 reference statements)

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“…A variety of initial complaints and conditions was described [9, 29, 34, 38, 40, 45, 52, 56, 57, 61–63, 65, 74, 77–79, 85]. Most often, we found initial complaints and conditions classified as VI- diseases of the nervous system ( n = 16) or category XX - External causes of morbidity and mortality ( n = 16).…”

Section: Resultsmentioning

confidence: 80%

“…Non-conveyance rates for general patient populations ranged from 3.7% up to 93.7% [28, 30, 31, 33–35, 37, 38, 40–43, 45, 46, 49, 51, 52, 57, 60, 61, 64, 68, 77, 81]. Seventeen studies reported non-conveyance rates for specific patient populations.…”

Section: Resultsmentioning

confidence: 99%

“…Most often, we found initial complaints and conditions classified as VI- diseases of the nervous system ( n = 16) or category XX - External causes of morbidity and mortality ( n = 16). For category VI the proportion of patients with these complaints and conditions ranged from 1.0%–29.0% [9, 29, 34, 38, 40, 45, 52, 56, 57, 61, 63, 65, 77–79, 85], for category XX the proportion ranged from 11.0%–68.5% [9, 29, 38, 40, 45, 52, 56, 57, 61–63, 65, 77–79, 85]. …”

Section: Resultsmentioning

confidence: 99%

“…3–2 . 5)∗ vs. ED-dischargeVan der Pols (2011) The Netherlands [77]• Repeat access general healthcare – GPMotorcycle response vehicles with one ambulance nurse with additional training ( n = 468) compared to regular ambulance ( n = 1196): • referral to GP 138/468 (29.5%) vs 167/1196 (14.0%) RR 2.11 (95%CI 1.73–2.58)Vilke (2002) USA [78]• Repeat access general healthcare – GP• Repeat access general healthcare – walk-in clinic• Repeat access emergency healthcare – ED• Repeat access emergency healthcare – EMS (call or EMS run)71/121 (58.7%) follow-up was obtained: • 27/71 (38.0%) visited family physician • 25/71 (35.2) visited urgent care facility • 9/71 (12.7%) second EMS call and transported to ED • 9/71 (12.7%) transport to ED by private vehicle • 1/71 (1.4%) second EMS call and treated at sceneZachariah (1992) USA [55]• Repeat access general healthcare – GP• Patient outcome – hospitalization93/158 (58.9%) follow-up was obtained: • 60/93 (64.5%) sought care from a physician: ◦ 15/60 (25.0%) were admitted to hospital. …”

Section: Resultsmentioning

confidence: 99%

“…Repeated access to the GP is measured in thirteen studies [8, 26, 38, 55–57, 62, 65–67, 75, 77, 78]. For general patient populations, the follow-up periods ranged from <48 h up to <7 days, and repeated access percentages varied from 13.0% (<24 h), 36.8–50.0% (<72 h) up to 46.2% (<7 days).…”

Section: Resultsmentioning

confidence: 99%

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A patient-safety and professional perspective on non-conveyance in ambulance care: a systematic review

Ebben

Vloet

Speijers

et al. 2017

Scand J Trauma Resusc Emerg Med

143

208

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BackgroundThis systematic review aimed to describe non-conveyance in ambulance care from patient-safety and ambulance professional perspectives. The review specifically focussed at describing (1) ambulance non-conveyance rates, (2) characteristics of non-conveyed patients, (3) follow-up care after non-conveyance, (4) existing guidelines or protocols, and (5) influencing factors during the non-conveyance decision making process.MethodsWe systematically searched MEDLINE, PubMed, CINAHL, EMBASE, and reference lists of included articles, in June 2016. We included all types of peer-reviewed designs on the five topics. Couples of two independent reviewers performed the selection process, the quality assessment, and data extraction.ResultsWe included 67 studies with low to moderate quality. Non-conveyance rates for general patient populations ranged from 3.7%–93.7%. Non-conveyed patients have a variety of initial complaints, common initial complaints are related to trauma and neurology. Furthermore, vulnerable patients groups as children and elderly are more represented in the non-conveyance population. Within 24 h–48 h after non-conveyance, 2.5%–6.1% of the patients have EMS representations, and 4.6–19.0% present themselves at the ED. Mortality rates vary from 0.2%–3.5% after 24 h, up to 0.3%–6.1% after 72 h. Criteria to guide non-conveyance decisions are vital signs, ingestion of drugs/alcohol, and level of consciousness. A limited amount of non-conveyance guidelines or protocols is available for general and specific patient populations. Factors influencing the non-conveyance decision are related to the professional (competencies, experience, intuition), the patient (health status, refusal, wishes and best interest), the healthcare system (access to general practitioner/other healthcare facilities/patient information), and supportive tools (online medical control, high risk card).ConclusionsNon-conveyance rates for general and specific patient populations vary. Patients in the non-conveyance population present themselves with a variety of initial complaints and conditions, common initial complaints or conditions are related to trauma and neurology. After non-conveyance, a proportion of patients re-enters the emergency healthcare system within 2 days. For ambulance professionals the non-conveyance decision-making process is complex and multifactorial. Competencies needed to perform non-conveyance are marginally described, and there is a limited amount of supportive tools is available for general and specific non-conveyance populations. This may compromise patient-safety.Electronic supplementary materialThe online version of this article (doi:10.1186/s13049-017-0409-6) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 80%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

A patient-safety and professional perspective on non-conveyance in ambulance care: a systematic review

Ebben

Vloet

Speijers

et al. 2017

Scand J Trauma Resusc Emerg Med

143

208

View full text Add to dashboard Cite

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Optimizing Operation Time and Travel Distance for Motorcycle Ambulances in Emergency Medical Services

Apiratwarakul

Phungoen²,

Cheung³

et al. 2022

Prehosp. Disaster med.

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Introduction: The motorcycle ambulance is used for quick access to patients. The response time to reach the patient takes less time than with a van ambulance. Moreover, accidents involving ambulances tend to be higher. However, at present, there is no study regarding the appropriate situation used of motorcycle ambulances in Emergency Medical Services (EMS) in Thailand. Study Objective: This study aims to optimize the travel distance and the operation time of motorcycle ambulances used. Methods: This study was a prospective, randomized controlled study at the EMS unit of Srinagarind Hospital, Thailand. The data collection period was from November 2021 through May 2022. All data involving dispatch of both ambulances in need were collected. Results: A total of 2,398 cases of EMS operation were examined. The mean age of the patients in the motorcycle ambulance group was 42.5 (SD = 6.5) years, and 51.3% (n = 616) were male. The response time for motorcycle ambulances and van ambulances during the operation time between 6:00am-9:00am was 6.2 minutes and 9.1 minutes, respectively. The response times for motorcycle ambulances and van ambulances regarding distance traveled from 0-5km were 4.2 minutes and 7.5 minutes, respectively (P <.001); distance traveled from 5-10km were 6.3 minutes and 8.2 minutes, respectively (P = .010). Conclusion: The motorcycle ambulance can reach patients faster than the ambulance at the operation time from 6:00am-9:00am and 3:00pm-6:00pm. This study focused on the distance less than 10 kilometers.

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Solo emergency care by a physician assistant versus an ambulance nurse: a cross-sectional document study

Bloemhoff

Schoonhoven

Kreek

et al. 2016

Scand J Trauma Resusc Emerg Med

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BackgroundThis study compares the assessment, treatment, referral, and follow up contact with the dispatch centre of emergency patients treated by two types of solo emergency care providers in ambulance emergency medical services (EMS) in the Netherlands: the physician assistant (PA), educated in the medical domain, and the ambulance registered nurse (RN), educated in the nursing domain. The hypothesis of this study was that there is no difference in outcome of care between the patients of PAs and RNs.MethodsIn a cross-sectional document study in two EMS regions we included 991 patients, treated by two PAs (n = 493) and 23 RNs (n = 498). The inclusion period was October 2010-December 2012 for region 1 and January 2013-March 2014 for region 2. Emergency care data were drawn from predefined and free text fields in the electronic patient records. Data were analysed using descriptive statistics. We used χ2 and Mann-Whitney U tests to analyse for differences in outcome of care. Statistical significance was assumed at a level of P <0.05.ResultsPatients treated by PAs and RNs were similar with respect to patient characteristics. In general, diagnostic measurements according to the national EMS standard were applied by RNs and by PAs. In line with the medical education, PAs used a medical diagnostic approach (16 %, n = 77) and a systematic physical exam of organ tract systems (31 %, n = 155). PAs and RNs provided similar interventions. Additionally, PAs consulted more often other medical specialists (33 %) than RNs (17 %) (χ2 = 35.5, P <0.0001). PAs referred less patients to the general practitioner or emergency department (50 %) compared to RNs (73 %) (χ2 = 52.9, P <0.0001). Patient follow up contact with the dispatch centre within 72 h after completion of the emergency care on scene showed no variation between PAs (5 %) and RNs (4 %).ConclusionsIn line with their medical education, PAs seemed to operate from a more general medical perspective. They used a medical diagnostic approach, consulted more medical specialists, and referred significantly less patients to other health care professionals compared to RNs. While the patients of the PAs did not contact the dispatch centre more often afterwards.

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The impact of an emergency motorcycle response vehicle on prehospital care in an urban area

Abstract: Using motorcycles in a Dutch setting lead to better emergency medical service response times. The MRV serves a different population. Resulting in a higher treat and release rate and less transportation to hospital.

Cited by 14 publications

References 4 publications

A patient-safety and professional perspective on non-conveyance in ambulance care: a systematic review

A patient-safety and professional perspective on non-conveyance in ambulance care: a systematic review

Optimizing Operation Time and Travel Distance for Motorcycle Ambulances in Emergency Medical Services

Solo emergency care by a physician assistant versus an ambulance nurse: a cross-sectional document study

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