Tuukka Puolakka1, Markku Kuisma2, Sami Länkimäki2, Jyrki Puolakka2, Juhana Hallikainen2, Kirsi Rantanen2, Perttu J Lindsberg2. 1. From the Emergency Medicine and Services (T.P., M.K., S.L., J.P., J.H.), Clinical Neurosciences and Neurology (K.R., P.J.L.), and Research Programs Unit, Molecular Neurology (P.J.L.), Helsinki University Hospital, University of Helsinki, Finland. tuukka.puolakka@hus.fi. 2. From the Emergency Medicine and Services (T.P., M.K., S.L., J.P., J.H.), Clinical Neurosciences and Neurology (K.R., P.J.L.), and Research Programs Unit, Molecular Neurology (P.J.L.), Helsinki University Hospital, University of Helsinki, Finland.
Abstract
BACKGROUND AND PURPOSE: Significant portion of the prehospital delay consists of minutes spent on the scene with the patient. We implemented a training program for the emergency medical services personnel with the aim to optimize the on-scene time (OST) and to study the impact of different elements of prehospital practice to the OST duration. METHODS: In this prospective interventional study, key operational emergency medical service performance variables were analyzed from all thrombolysis candidates transported to the Helsinki University Hospital emergency department. The catchment period was 4 months before and 4 months after the implementation. RESULTS: One hundred and forty-one patients were managed as thrombolysis candidates before and 148 patients after the training program implementation. The OST duration for the groups was 25 (20.5-31) and 22.5 (18-28.5) minutes, respectively (P<0.001). Physician consultations via telephone were associated with a longer (odds ratio 0.546 [0.333-0.893]) and advanced life support training with a shorter OST (odds ration 1.760 [1.070-2.895]). CONCLUSIONS: Implementation of the emergency medical services training program successfully decreased the OST of thrombolysis candidates by 10%. Higher expertise level of the ambulance crew was associated with shorter OST, and decisions to consult a physician via telephone were reflected by longer OST.
BACKGROUND AND PURPOSE: Significant portion of the prehospital delay consists of minutes spent on the scene with the patient. We implemented a training program for the emergency medical services personnel with the aim to optimize the on-scene time (OST) and to study the impact of different elements of prehospital practice to the OST duration. METHODS: In this prospective interventional study, key operational emergency medical service performance variables were analyzed from all thrombolysis candidates transported to the Helsinki University Hospital emergency department. The catchment period was 4 months before and 4 months after the implementation. RESULTS: One hundred and forty-one patients were managed as thrombolysis candidates before and 148 patients after the training program implementation. The OST duration for the groups was 25 (20.5-31) and 22.5 (18-28.5) minutes, respectively (P<0.001). Physician consultations via telephone were associated with a longer (odds ratio 0.546 [0.333-0.893]) and advanced life support training with a shorter OST (odds ration 1.760 [1.070-2.895]). CONCLUSIONS: Implementation of the emergency medical services training program successfully decreased the OST of thrombolysis candidates by 10%. Higher expertise level of the ambulance crew was associated with shorter OST, and decisions to consult a physician via telephone were reflected by longer OST.
Authors: Gaia T Koster; T Truc My Nguyen; Adrien E D Groot; Jonathan M Coutinho; Jan Bosch; Heleen M den Hertog; Marianne A A van Walderveen; Ale Algra; Marieke J H Wermer; Yvo B Roos; Nyika D Kruyt Journal: BMJ Open Date: 2018-06-27 Impact factor: 2.692
Authors: Karianne Larsen; Kristi G Bache; Eirik Franer; Lars H Tveit; Maren R Hov; Christian G Lund; Volker Solyga; Hans Morten Lossius Journal: Acta Anaesthesiol Scand Date: 2018-11-14 Impact factor: 2.105
Authors: Christopher I Price; Lisa Shaw; Peter Dodd; Catherine Exley; Darren Flynn; Richard Francis; Saiful Islam; Mehdi Javanbakht; Rachel Lakey; Joanne Lally; Graham McClelland; Peter McMeekin; Helen Rodgers; Helen Snooks; Louise Sutcliffe; Pippa Tyrell; Luke Vale; Alan Watkins; Gary A Ford Journal: Trials Date: 2019-02-12 Impact factor: 2.279