1,038 research outputs found

    Changing Role of EMS -Analyses of Non-Conveyed and Conveyed Patients in Finland

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    Abstract Background: Emergency Medical Services (EMS) and Emergency Departments (ED) have seen increasing attendance rates in the last decades. Currently, EMS are increasingly assessing and treating patients without the need to convey patients to health care facility. The aim of this study was to describe and compare the patient casemix between conveyed and non-conveyed patients and to analyze factors related to non-conveyance decision making. Methods: This was a prospective study design of EMS patients in Finland, and data was collected between 1st June and 30th November 2018. Adjusted ICPC2-classification was used as the reason for care. NEWS2-points were collected and analyzed both statistically and with a semi-supervised information extraction method. EMS patients’ geographic location and distance to health care facilities were analyzed by urban–rural classification. Results: Of the EMS patients (40,263), 59.8% were over 65 years of age and 46.0% of the patients had zero NEWS2 points. The most common ICPC2 code was weakness/tiredness, general (A04), as seen in 13.5% of all patients. When comparing patients between the non-conveyance and conveyance group, a total of 35,454 EMS patients met the inclusion criteria and 14,874 patients (42.0%) were not conveyed to health care facilities. According the multivariable logistic regression model, the non-conveyance decision was more likely made by ALS units, when the EMS arrival time was in the evening or night and when the distance to the health care facility was 21-40 km. Furthermore, younger patients, female gender, whether the patient had used alcohol and a rural area were also related to the non-conveyance decision. If the patient’s NEWS2 score increased by one or two points, the likelihood of conveyance increased. When there was less than 1 h to complete a shift, this did not associate with either nonconveyance or conveyance decisions. Conclusions: The role of EMS might be changing. This warrants to redesign the chain-of-survival in EMS to include not only high-risk patient groups but also non-critical and general acute patients with non-specific reasons for care. Assessment and on-scene treatment without conveyance can be called the “stretched arm of the emergency department”, but should be planned carefully to ensure patient safety. Keywords: Emergency medical services [MeSH], Non-conveyance, Conveyance</p

    Transverse energy production and charged-particle multiplicity at midrapidity in various systems from sNN=7.7\sqrt{s_{NN}}=7.7 to 200 GeV

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    Measurements of midrapidity charged particle multiplicity distributions, dNch/dηdN_{\rm ch}/d\eta, and midrapidity transverse-energy distributions, dET/dηdE_T/d\eta, are presented for a variety of collision systems and energies. Included are distributions for Au++Au collisions at sNN=200\sqrt{s_{_{NN}}}=200, 130, 62.4, 39, 27, 19.6, 14.5, and 7.7 GeV, Cu++Cu collisions at sNN=200\sqrt{s_{_{NN}}}=200 and 62.4 GeV, Cu++Au collisions at sNN=200\sqrt{s_{_{NN}}}=200 GeV, U++U collisions at sNN=193\sqrt{s_{_{NN}}}=193 GeV, dd++Au collisions at sNN=200\sqrt{s_{_{NN}}}=200 GeV, 3^{3}He++Au collisions at sNN=200\sqrt{s_{_{NN}}}=200 GeV, and pp++pp collisions at sNN=200\sqrt{s_{_{NN}}}=200 GeV. Centrality-dependent distributions at midrapidity are presented in terms of the number of nucleon participants, NpartN_{\rm part}, and the number of constituent quark participants, NqpN_{q{\rm p}}. For all AA++AA collisions down to sNN=7.7\sqrt{s_{_{NN}}}=7.7 GeV, it is observed that the midrapidity data are better described by scaling with NqpN_{q{\rm p}} than scaling with NpartN_{\rm part}. Also presented are estimates of the Bjorken energy density, εBJ\varepsilon_{\rm BJ}, and the ratio of dET/dηdE_T/d\eta to dNch/dηdN_{\rm ch}/d\eta, the latter of which is seen to be constant as a function of centrality for all systems.Comment: 706 authors, 32 pages, 20 figures, 34 tables, 2004, 2005, 2008, 2010, 2011, and 2012 data. v2 is version accepted for publication in Phys. Rev.
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