Emergency Medicine Book

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Emergency Medical Service

Aka: Emergency Medical Service, EMS Transport, Emergency Transport, Patient Transport, Ambulance, Prehospital Care, ALS Ambulance, BLS Ambulance, Ground Transport Ambulance, Air Ambulance, Mobile Intensive Care Unit
  1. See Also
    1. Emergency Medicine Treatment and Labor Act (EMTALA)
    2. EMS Trauma Triage Protocol
    3. Trauma Center
  2. Precautions
    1. Medical provider Transferring a patient to another facility is responsible for the patient in transfer
      1. See Emergency Medicine Treatment and Labor Act (EMTALA)
    2. Ambulance Diversion
      1. Avoid diversion if possible
      2. EMTALA applies to hospital owned Ambulances
      3. Follow a clearly defined hospital policy for Ambulance diversion
      4. Diversion is a courtesy only (paramedics may still transport to your facility)
    3. Patient refusal of transport
      1. Obtain details from paramedic
        1. Chief complaint for Ambulance call, patient history, exam findings, Vital Signs
        2. Determine if patient is refusing transport or the paramedics deem transport unnecessary
        3. Determine why patient is refusing transport
      2. Does patient have decision making capacity to refuse?
        1. See CURVES Capacity Assessment Tool
        2. Can the patient express the risks, benefits and alternatives to hospital transport?
      3. Indications for patient to be transported against their will (with police involvement)
        1. Medical emergency AND
        2. Lack of decision making capacity or surrogate (See CURVES Capacity Assessment Tool)
      4. Pearls
        1. Best approach is to convince the patient to be transported voluntarily
    4. References
      1. Mel in Herbert (2016) EM:Rap 16(3): 2
  3. Types: Patient Transport Units
    1. Ambulette (wheelchair van)
      1. No emergency services (transport only)
    2. Basic Life Support Unit (BLS Ambulance)
      1. Carries a stretcher and basic emergency equipment (e.g. oxygen, bandages)
      2. Patient is typically attended to by an EMT-basic who may obtain Vital Signs, basic assessment and perform CPR
    3. Advanced Life Support Unit (ALS Ambulance)
      1. Paramedic staffed Ambulances able to perform Advanced Airway and ACLS management
    4. Mobile Intensive Care Unit
      1. Physician, nurse or advanced-care paramedic staffed Ambulances (air or ground)
      2. Provides full spectrum critical care for unstable, complicated patients especially on prolonged transport
  4. Types: EMS Response Codes
    1. Codes
      1. Code 1
        1. Non-Emergency Transport
      2. Code 2
        1. Semi-life threatening response
        2. Requiring expedited transport (but while following standard traffic rules)
        3. Typical inter-hospital transport
      3. Code 3
        1. Life-threatening response with lights and sirens
        2. Transport of unstable patients (e.g. STEMI, rupturing AAA, SAH)
    2. References
      1. http://en.wikipedia.org/wiki/Emergency_service_response_codes
  5. References
    1. Mell in Herbert (2015) EM:Rap 15(4): 10

Ambulances (C0002422)

Definition (UMD) Vehicles designed for transporting the sick or wounded that are equipped with the necessary devices and supplies to maintain or improve the clinical status of the patient during transport.
Definition (MSH) A vehicle equipped for transporting patients in need of emergency care.
Concepts Medical Device (T074)
MSH D000552
SnomedCT 49122002, 44613004
HL7 2.16.840.1.113883.1.11.19734
Swedish Ambulanser
English Ambulance, device, ambulance, ambulances, Ambulance, Ambulance, device (physical object), Ambulance, NOS, Ambulances
Czech sanitky
Finnish Ambulanssit
Russian MASHINA SKOROI POMOSHCHI, SKOROI POMOSHCHI MASHINY, МАШИНА СКОРОЙ ПОМОЩИ, СКОРОЙ ПОМОЩИ МАШИНЫ
Japanese 救急移動車, 傷病者運搬車, 患者運搬車, 患者搬送車, 移動救急設備, 救急車
French Ambulances
Croatian AMBULANTNA KOLA
Polish Ambulansy, Karetki pogotowia ratunkowego, Samochody sanitarne, Ambulans
Norwegian Ambulanser
Spanish ambulancia (objeto físico), ambulancia, Ambulancias
German Krankenwagen
Italian Ambulanze
Dutch Ambulance, Ambulances, Ziekenauto's, Ziekenwagens
Portuguese Ambulâncias
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Emergency medical service (C0013961)

Definition (MEDLINEPLUS)

If you get very sick or badly hurt and need help right away, you should use emergency medical services. These services use specially trained people and specially equipped facilities.

You may need care in the hospital emergency room (ER). Doctors and nurses there treat emergencies, such as heart attacks and injuries. For some emergencies, you need help where you are. Emergency medical technicians, or EMTs, do specific rescue jobs. They answer emergency calls and give basic medical care. Some EMTs are paramedics - they have training to do medical procedures on site. They usually take you to the ER for more care.

If you or someone you know needs emergency care, go to your hospital's emergency room. If you think the problem is life threatening, call 9-1-1.

Definition (MSH) Services specifically designed, staffed, and equipped for the emergency care of patients.
Concepts Health Care Activity (T058)
MSH D004632
SnomedCT 409971007
LNC LP57605-5
English Emergency Medical Service, Emergency Medical Services, Medical Service, Emergency, Medical Services, Emergency, Service, Emergency Medical, Services, Emergency Medical, Emergency Service, Medical, Emergency Services, Medical, Medical Emergency Service, Medical Emergency Services, Service, Medical Emergency, Services, Medical Emergency, MED SERV EMERGENCY, SERV EMERGENCY MED, EMERGENCY SERV MED, EMERGENCY MED SERV, EMS, emergency medical services, emergency medical service, emergency care, care emergency, emergency service, Emergency services, Emergency medical service, Emergency medical services, Emergency medical services (qualifier value), Emergency Services
Swedish Akutsjukvård
Czech rychlá zdravotnická pomoc, urgentní lékařské služby, záchranná zdravotní služba
Finnish Akuuttihoitopalvelut
Russian SKORAIA MEDITSINSKAIA POMOSHCH', NEOTLOZHNAIA MEDITSINSKAIA POMOSHCH', NEOTLOZHNAIA POMOSHCH', NEOTLOZHNAIA MEDITSINSKAIA POMOSHCH' DOBOL'NICHNAIA, НЕОТЛОЖНАЯ МЕДИЦИНСКАЯ ПОМОЩЬ, НЕОТЛОЖНАЯ МЕДИЦИНСКАЯ ПОМОЩЬ ДОБОЛЬНИЧНАЯ, НЕОТЛОЖНАЯ ПОМОЩЬ, СКОРАЯ МЕДИЦИНСКАЯ ПОМОЩЬ
Japanese 救急医療, 救急保健医療サービス, 入院前救急治療, イマージセンター, 救急医療サービス
French Services des urgences médicales, Services d'aide médicale urgente, SAU (Service d'Accueil et de traitement des Urgences), Samu, Services de réanimation médicale, Services d'accueil et de traitement des urgences, Services d'aide médicale d'urgence
Croatian HITNA MEDICINSKA SLUŽBA
Polish Pomoc medyczna w nagłych przypadkach, Pomoc doraźna, Medyczna pomoc doraźna, Pomoc przedszpitalna, Usługi medyczne w nagłych przypadkach, Pogotowie ratunkowe, Pomoc lekarska w stanach nagłych, Świadczenia z zakresu pomocy nagłej, Świadczenia z zakresu doraźnej pomocy
Norwegian Akuttmedisinske tjenester
Portuguese Pronto-Socorro, Serviços Médicos de Emergência
German Notfalldienste, medizinische
Italian Servizi di medicina d'urgenza
Spanish servicios médicos de emergencia (calificador), servicios médicos de emergencia, Servicios Médicos de Urgencia
Dutch Spoedeisende hulp, diensten
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Transportation of Patients (C0040757)

Definition (MSH) Conveying ill or injured individuals from one place to another.
Definition (CSP) service which provides a means of moving persons, human tissues, or health care goods and materials from one place to another, with the intent of providing health care services; includes pharmacy deliveries, Life Flight, ambulances, coroner services, etc.
Concepts Health Care Activity (T058)
MSH D014187
English Patients Transportation, Patients Transportations, Transport of Wounded and Sick, Transport, Wounded and Sick, Transportation of Patients, health care transport service, TRANSPORT OF WOUNDED SICK, TRANSPORT WOUNDED SICK, patients transportation, transportation patients, patient transportation, Transport of sick and wounded
Swedish Patienttransporter
Czech převoz pacientů, transport pacientů, doprava pacientů
Finnish Sairaankuljetus
Russian TRANSPORTIROVKA RANENYKH I BOL'NYKH, TRANSPORTIROVKA BOL'NYKH, ТРАНСПОРТИРОВКА БОЛЬНЫХ, ТРАНСПОРТИРОВКА РАНЕНЫХ И БОЛЬНЫХ
French Transport de blessés et de malades, Transport de patients, Évacuation sanitaire, Transport sanitaire
Italian Trasporto dei malati, Trasporto dei pazienti
Croatian TRANSPORT BOLESNIKA
Polish Transport pacjentów, Transport chorych, Transport rannych, Przewóz pacjentów
Japanese 患者の輸送, 患者搬送, 傷病者輸送, 患者輸送
Norwegian Transport av pasienter, Pasienttransporter, Transport av syke og sårede, Transport av sårede og syke, Syketransporter, Syketransport, Pasienttransport
German Krankentransport, Transport Verwundeter und Kranker
Dutch Vervoer van gewonden en zieken, Vervoer van patiënten
Portuguese Transporte de Feridos e Doentes, Transporte de Pacientes
Spanish Transporte de Heridos y Enfermos, Transporte de Pacientes
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Ground transport ambulance (C0179021)

Concepts Manufactured Object (T073)
SnomedCT 44613004
English Ambulances, Ground Transport, Ground transport ambulance, device, Ground transport ambulance, Ground transport ambulance, device (physical object)
Spanish ambulancia de transporte terrestre (objeto físico), ambulancia de transporte terrestre
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Air Ambulances (C0206185)

Definition (UMD) Aircraft (e.g., helicopters, airplanes), designed for transporting the sick or wounded, that are equipped with the necessary devices and supplies to maintain or improve the clinical status of the patient during transport.
Definition (MSH) Fixed-wing aircraft or helicopters equipped for air transport of patients.
Concepts Manufactured Object (T073)
MSH D017732
SnomedCT 73957001
English Ambulances, Air, Air Ambulances, Air Ambulance, Ambulance, Air, Ambulances, Air Transport, Air transport ambulance, device, air ambulance transport, air ambulance, Air transport ambulance, Air ambulance, Air transport ambulance, device (physical object)
Swedish Ambulansflyg
Finnish Ilma-ambulanssit
Russian AVIASANITARNYE TRANSPORTNYE SREDSTVA, VOZDUSHNO-TRANSPORTNYE SANITARNYE SREDSTVA, AVIATSIIA SANITARNAIA, VERTOLETNYE SREDSTVA SANITARNYE, АВИАСАНИТАРНЫЕ ТРАНСПОРТНЫЕ СРЕДСТВА, АВИАЦИЯ САНИТАРНАЯ, ВЕРТОЛЕТНЫЕ СРЕДСТВА САНИТАРНЫЕ, ВОЗДУШНО-ТРАНСПОРТНЫЕ САНИТАРНЫЕ СРЕДСТВА
Japanese 航空機-救命, 救命ヘリコプター, ヘリコプター-救命, 救命ヘリコプタ, 救命航空機
French Ambulances aériennes, Ambulances aéroportées
Polish Samoloty sanitarne, Helikoptery sanitarne, Śmigłowce sanitarne
Norwegian Luftambulanser
Czech letecká záchranná služba, letadla pro transport pacientů
Portuguese Unidades Aéreas de Emergência, Transporte Aéreo de Pacientes, Ambulâncias Aéreas, Resgate Aéreo
Spanish ambulancia aérea (objeto físico), ambulancia aérea, Ambulancias Aéreas
German Luftrettungsfahrzeuge, Rettungsfahrzeuge, Luft-
Italian Eliambulanze
Dutch Ambulancevliegtuig, Ambulancevliegtuigen, Vliegtuigen, ambulance-
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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