Facilitators of and barriers to emergency medical service use by acute ischemic stroke patients: A retrospective survey

Objective: The objective of the study was to identify facilitators and barriers to emergency medical service use among acute ischemic stroke patients in Korea.Methods: This paper presents a secondary analysis of a retrospective survey that collected data from questionnaires and medical records.Among 233 acute ischemic stroke patients enrolled in a large-scale study,160 patients who had arrived at a hospital within 72 h after symptom onset were included in the data analysis.Results: Users of emergency medical services needed a shorter time than non-users to arrive at hospital (140 min vs.625 min.,p =0.001) and were more likely to arrive at hospital within 3 h of symptom onset (51.9% vs.31.5%,p =0.013).For those who first contacted emergency medical service,the facilitators of emergency medical service use were the presence of hemiparesis (p =0.003),bilateral paralysis (p =0.040),and loss of balance (p =0.021).The predominant barrier was the failure to recognize the urgency of symptoms (p 0.006).Conclusions: The use of emergency medical services reduced prehospital delay and increased the likelihood of patient arrival at hospital within 3 h.Given that experiencing typical stroke symptoms was a facilitator of emergency medical service use yet failure to recognize the urgency of symptoms was a barrier,public awareness should be raised as regards stroke symptoms and the benefits of using emergency medical services.

Association of post-traumatic stress disorder and work performance: A survey from an emergency medical service, Karachi, Pakistan

BACKGROUND: The purpose of the study was to explore the association between posttraumatic stress disorder(PTSD) and work performance of emergency medical services personnel in Karachi, Pakistan.METHODS: Emergency medical service personnel were screened for potential PTSD using Impact of Event Scale-Revised(IES-R). Work performance was assessed on the basis of fi ve variables: number of late arrivals to work, number of days absent, number of days sick, adherence to protocol, and patient satisfaction over a period of 3 months. In order to model outcomes like the number of late arrivals to work, days absent and days late, negative binomial regression was applied, whereas logistic regression was applied for adherence to protocol and linear for patient satisfaction scores.RESULTS: Mean scores of PTSD were 24.0±12.2. No association was found between PTSD and work performance measures: number of late arrivals to work(RRadj 0.99; 0.98–1.00), days absent(RRadj 0.98; 0.96–0.99), days sick(RRadj 0.99; 0.98–1.00), adherence to protocol(ORadj 1.01; 0.99–1.04) and patient satisfaction(β 0.001%–0.03%) after adjusting for years of formal schooling, living status, coping mechanism, social support, working hours, years of experience and anxiety or depression.CONCLUSION: No statistically significant association was found between PTSD and work performance amongst EMS personnel in Karachi, Pakistan.

Overview of the Shenzhen Emergency Medical Service Call Pattern

BACKGROUND：In Shenzhen, the Emergency Medical Service （EMS） system has been in service since 1997. This study aims to examine the operation of Shenzhen 120 EMS center and to identify the reasons of calling EMS.BACKGROUND：In this retrospective quantitative descriptive study, the data from the Shenzhen 120 EMS registry in 2011 were analyzed.RESULTS：Shenzhen 120 EMS center is a communication command center. When the number of 120 are dialed, it is forwarded to the closest appropriate hospital for ambulance dispatch. In 2011, the Shenzhen 120 EMS center received 153 160 ambulance calls, with an average of 420 calls per day. Calling emergency services was mainly due to traffic accidents. Trauma and other acute diseases constituted a majority of ambulance transports. The adult patients aged 15-60 years are the principal users of EMS. There are no recognized ＇paramedic＇ doctors and nurses. The pre-hospital emergency service is under the operation of emergency departments of hospitals. Shenzhen at present does not have specialized pre-hospital training for doctors and nurses in posttrauma management. Moreover, specialized pre-hospital training, financial support, and public health education on proper use of EMS should be emphasized.CONCLUSION：The Shenzhen 120 EMS center has its own epidemiology characteristics. Traumatic injury and traffic accident are the main reasons for calling ambulance service. In-depth study emphasizing the distribution and characteristics of trauma patients is crucial to the future development of EMS.

Self-Reported Use of Personal Protective Equipment during the SARS-CoV-2 Pandemic in Emergency Medical Service Employees in Germany—A Survey

Background: Multicentric prospective cohort investigation survey conducted between 1st of March and 1st of April 2021on SARS-CoV-2 occupational risk for German Emergency Medical Services (EMS) personnel. Study Objectives: Primary: The objective is to take stock of the use and availability of Personal Protective Equipment (PPE) in German EMS, both at managerial and employee level, during the SARS-CoV-2 pandemic. Secondary: Generate additional data on individual perceptions of risk of infection and occurrence of infections at respective places of service. Methods: Multicentric prospective cohort investigation survey conducted online at two levels of German EMS personnel—EMS managers and EMS employees, both medical and paramedical—with questions adapted slightly to fit the respective study population. Results: A total of 34 responses were received in the managerial group;a total of 2389 responses were received in the group of employees. Self-reported PPE adherence of EMS employees for confirmed SARS-CoV-2 positive patients: use of gloves (99.8%), FFP2 or FFP3 masks (99.8%), gowns or coveralls (99.1%), goggles (89.7%), face shields (24.0%), surgical masks (0.0%). Self-reported PPE adherence of EMS employees for suspected SARS-CoV-2 positive patients: gloves (98.8%), FFP2 or FFP3 masks (total: 99.4%), gowns or coveralls (total: 95.9%), goggles (85.6%), face shields (19.2%), surgical masks (0.2%). Conclusions: Findings included an overall improved self-reported adherence to PPE compared to studies that were conducted before the pandemic. Self-reported general adherence to PPE recommendations when attending to confirmed SARS-CoV-2 positive patients was good, with the exception of goggles. Self-reported adherence to PPE recommendations dropped when attending to suspected SARS-CoV-2 positive patients.

Reliable Data Collection Model and Transmission Framework in Large-Scale Wireless Medical Sensor Networks

Large-scale wireless sensor networks(WSNs)play a critical role in monitoring dangerous scenarios and responding to medical emergencies.However,the inherent instability and error-prone nature of wireless links present significant challenges,necessitating efficient data collection and reliable transmission services.This paper addresses the limitations of existing data transmission and recovery protocols by proposing a systematic end-to-end design tailored for medical event-driven cluster-based large-scale WSNs.The primary goal is to enhance the reliability of data collection and transmission services,ensuring a comprehensive and practical approach.Our approach focuses on refining the hop-count-based routing scheme to achieve fairness in forwarding reliability.Additionally,it emphasizes reliable data collection within clusters and establishes robust data transmission over multiple hops.These systematic improvements are designed to optimize the overall performance of the WSN in real-world scenarios.Simulation results of the proposed protocol validate its exceptional performance compared to other prominent data transmission schemes.The evaluation spans varying sensor densities,wireless channel conditions,and packet transmission rates,showcasing the protocol’s superiority in ensuring reliable and efficient data transfer.Our systematic end-to-end design successfully addresses the challenges posed by the instability of wireless links in large-scaleWSNs.By prioritizing fairness,reliability,and efficiency,the proposed protocol demonstrates its efficacy in enhancing data collection and transmission services,thereby offering a valuable contribution to the field of medical event-drivenWSNs.

Stochastic Petri Net Based Modeling of Emergency Medical Rescue Processes During Earthquakes

The post-disaster emergency medical rescue(EMR) is critical for people’s lives. This paper presents a stochastic Petri net(SPN) model based on the process of the rescue structure and a Markov chain model(MC), which is applied to the optimization of the EMR process, with the aim of identifying the key activities of EMR. An isomorphic MC model is developed for measuring and evaluating the time performance of the EMR process during earthquakes with the data of the 2008 Wenchuan earthquake.This paper provides a mathematical approach to simulate the process and to evaluate the efficiency of EMR. Simultaneously, the expressions of the steady state probabilities of this system under various states are obtained based on the MC, and the variations of the probabilities are analyzed by changing the firing rates for every transition. Based on the concrete data of the event, the authors find the most time consuming and critical activities for EMR decisions. The model results show that the key activities can improve the efficiency of medical rescue, providing decision-makers with rescue strategies during the large scale earthquake.

Integration of Facility Location and Hypercube Queuing Models in Emergency Medical Systems

The purpose of emergency medical systems(EMS)is to save lives and reduce injuries with a quick response in emergencies.The performance of these systems is highly dependent on the locations of ambulances and the policy for dispatching them to the customers(i.e.,patients).In this study,two new mathematical models are presented to combine the decisions about the location and dispatching policy by integrating the location and hypercube queuing models.In the presented models,the flow-balance equations of the hypercube queuing model are considered as the constraints of the location model.In the first model,the status of each server is idle or busy at any moment,as in the classic hypercube queuing model.In the second model,the travel time is considered independent of the on-scene time,and the status of each server is idle,busy,and traveling,or busy and serving a customer on the incident site.To verify the models,some small-sized examples are first solved exactly.Then,an optimization framework based on the genetic algorithm is presented due to the complexity of the models for solving larger-sized examples.Two approaches(i.e.,the exact and simulation-optimization)are used to extend the framework.The results demonstrate that the proposed optimization framework can obtain proper solutions compared to those of the exact method.Finally,several performance measures are considered that can only be calculated using the second model.

Prehospital road traffic injuries among the elderly in Beijing, China： data from the Beijing Emergency Medical Center, 2004-2010

Background Road traffic injuries （RTIs） are a worldwide issue associated with increasing development and motorization. However, statistical studies do not include any analyses of Beijing＇s geriatric population. Using data from the Beijing Emergency Medical Center, we present the main characteristics of traffic injuries involving the elderly in Beijing. We also provide objective information for those concerned with the safety of traffic systems and the prevention of traffic injuries. Methods In a longitudinal, retrospective study, data were collected on 1706 victims aged 65 years and older who sustained traffic injuries in Beijing between 2004 and 2010. Personal information, time of injury event, emergency care response time, road user type, striking vehicle type, injury site, and severity of injury were analyzed using ;~2 tests and Logistic regression analysis. Results The annual rate of traffic injuries was 21.80 per 100 000 elderly people in Beijing, and the morbidity rate decreased from 2004 to 2010 （P 〈0.001）. The mean age was （72.92＋5.67） years, and 911 （53.40%） of the victims were male. The majority of victims sustained head and lower limb injuries and were classified as being of medium severity. Traffic collisions occurred most frequently in the daytime excluding rush hours; these collisions included being hit by a car （85.64%） and pedestrian victim injuries （79.19%）. Our statistical analysis found three factors for injury severity： abdominal injuries （P 〈0.001）, number of injury sites （P=0.027）, and head injuries （P=0.034）. The decline in traffic injuries is due to a decrease in victims aged 65-74 years and pedestrians; the sevedty of RTIs also decreased. Conclusions This study highlights the declining trend in traffic injuries among older adults in Beijing. However, traffic injuries remain a serious public health problem for the elderly and effective measures are required to reduce their incidence.

Impact of regional differences in stroke symptom awareness and low-income status on seeking emergency medical service in China

Background:Unawareness of stroke symptoms and low income are two barriers that affect the seeking of emergency medical service(EMS).This study aimed to assess the effect of unawareness and low income on seeking EMS and to investigate the regional distribution of the unawareness and low-income status and their associations with failing to call EMS in China.Methods:A total of 187,723 samples from the China National Stroke Screening Survey was interviewed cross-sectionally.Four status of awareness and annual income were identified:unaware and low-income,unaware-only,low-income-only,and aware and regular income.The outcomes were whether they intended to call EMS or not.The regional distribution of each status and their associations with not calling EMS were presented.Results:The status of unaware and low-income,unaware-only,and low-income-only accounted for 6.3%(11,806/187,673),11.9%(22,241/187,673),and 21.5%(40,289/187,673)of the total sample,respectively.Not calling EMS was significantly associated with the status of unaware and low-income(odds ratio[OR]:3.21,95%confidence interval[Cl]:3.07-3.35),unaware-only(OR:2.38,95%Cl:2.31-2.46),and low-income-only(OR:1.67,95%Cl:1.63-1.71),compared with the aware and regular income status.The Midwest regions had higher percentages of people in the unaware and low-income status;the East,South,and Central had higher percentages of unaware-only status;the North and Northeast regions had a higher percentage of low-income-only status,compared with other regions.Conclusion:The existence of the regional difference in unawareness and low income justifies the specific stroke education strategies for the targeted regions and population.

The impact of prehospital blood sampling on the emergency department process of patients with chest pain:a pragmatic non-randomized controlled trial

BACKGROUND:In patients with chest pain who arrive at the emergency department(ED)by ambulance,venous access is frequently established prehospital,and could be utilized to sample blood.Prehospital blood sampling may save time in the diagnostic process.In this study,the association of prehospital blood draw with blood sample arrival times,troponin turnaround times,and ED length of stay(LOS),number of blood sample mix-ups and blood sample quality were assessed.METHODS:The study was conducted from October 1,2019 to February 29,2020.In patients who were transported to the ED with acute chest pain with low suspicion for acute coronary syndrome(ACS),outcomes were compared between cases,in whom prehospital blood draw was performed,and controls,in whom blood was drawn at the ED.Regression analyses were used to assess the association of prehospital blood draw with the time intervals.RESULTS:Prehospital blood draw was performed in 100 patients.In 406 patients,blood draw was performed at the ED.Prehospital blood draw was independently associated with shorter blood sample arrival times,shorter troponin turnaround times and decreased LOS(P<0.001).No differences in the number of blood sample mix-ups and quality were observed(P>0.05).CONCLUSION:For patients with acute chest pain with low suspicion for ACS,prehospital blood sampling is associated with shorter time intervals,while there were no significant differences between the two groups in the validity of the blood samples.

Focused research in emergency medical systems in Asia: a necessity for trauma system advancement

Since trauma is a growing health problem worldwide,emergency trauma care including emergency medical services(EMS)is becoming an integral part of the healthcare system.The optimal EMS which will improve access to trauma care,will be different in each country because of different healthcare systems,trauma etiology,and economic situations.To adopt models that have succeeded in developed countries is not always appropriate.In order to identify the optimal EMS model in developing countries,comparing the systems among many countries in detail and examining their advantages and disadvantages would be necessary.Therefore,this article tries to identify important elements of EMS to achieve mature EMS systems based on comparisons of 7 Asian countries,and discusses the need to conduct more detailed and extensive comparisons.

Studyt on the Emergency Medical Service Evaluation and Improvement

The Emergency Medical Service（ EMS） system in China from service supply chain perspective is analyzed. Firstly,it reviews service supply chain researches in emergency medical service,and it is found that waiting time,safety,service integration and communication before the emergency surgery are the four indicators to measure the quality of emergency medical service. Secondly,the information barrier-inconsistent information flow-is prominent,which is between emergency in hospital and pre-hospital,after analyzing three different types of flows on service, information and logistics. Besides, comparing with Joint Commission International accreditation（ JCI） standards for hospitals in USA,the requirements of service integration and communication in Chinese hospital accreditation are much lower. In the end,a Smart First Aid Information Center（ SFAIC） model for first aid service is proposed. This model can be used to enhance information exchanges more effectively between first aid in-and pre-hospital. Moreover,it also shortens pre-surgery time and betters the communication and coordination between service sections. To put it in a nutshell,the improved medical service process can greatly increase emergency medical service quality.

A prediction model for large vessel occlusion in suspected stroke patients based on available prehospital information

Objective:Early and accurate identification of large vessel occlusion(LVO)acute ischemic stroke(AIS)patients is critically important for stroke management.Practicable scales with simple items can facilitate prehospital paramedics distinguishing LVO-AIS patients with high efficiency and help to avoid unnecessary and costly delays.The current study aims to develop a screening tool to predict AIS-LVO patients based on prehospital available data.Method:A total of 251 suspected stroke patients who were transported to the emergency department of our hospital via emergency medical services were consecutively enrolled from August,2020 to January,2022.Data including demographic information,medical history,clinical manifestations,and vital signs were collected.A multivariate logistic regression model was developed based on statistically significant variables selected from univariate analysis.Result:Forty-two patients(16.7%)were diagnosed as LVO-AIS based on imaging validation at admission.A comprehensive model was developed with past medical history factors such as atrial fibrillation and coronary heart disease,vital signs such as systolic blood pressure,and prominent symptoms and signs such as gaze palsy,facial paralysis,and dysarthria.The model showed better diagnostic performance in terms of area under the receiver operating characteristic curves(0.884,95%CI,0.830-0.939),which was higher than other common prehospital prediction scales such as the Face,Arm,Speech,Time test(FAST),the Field Assessment Stroke Triage for Emergency Destination(FAST-ED)scale,and the Gaze-Face-Arm-Speech-Time test(G-FAST).Calibration curve analysis,decision curve analysis,and clinical impact curve analysis further validated the reliability,net benefit,and potential clinical impact of the prediction model,respectively.Conclusion:We conducted a prediction model based on prehospital accessible factors including past history of atrial fibrillation and coronary heart disease,systolic blood pressure,and signs such as gaze palsy,facial palsy,and dysarthria.The prediction model showed good diagnostic power and accuracy for identification of the high-risk patients with LVO and may become an effective tool for the LVO recognition in prehospital settings.Future studies are warranted to refine and validate the model further in order to enhance the accuracy and objectivity of clinical judgments.

Trends and challenges of emergency and acute care in Chinese mainland:2005–2017

BACKGROUND:Emergency medical service system(EMSS)is essential in providing acute care services for health conditions.However,trends of emergency and acute care in China haven’t been studied systematically.METHODS:Relevant literature was carefully reviewed,including original and review articles,letters,government reports,yearbooks,both in Chinese and in English.Data on the number of emergency visits,physicians and beds in emergency departments(EDs),and the workforce of prehospital emergency care were summarized and analyzed from China Health and Family Planning Statistical Yearbooks(2006–2018).RESULTS:Over the past decade,the number of ED visits tripled from 51.9 million to 166.5 million;and utilization of pre-hospital emergency care increased from 3.2 million to 6.8 million.In response to rapid increases in demand,the number of licensed emergency physicians raised from 20,058 to 59,409;the beds’number increased from 10,783 to 42,367.For pre-hospital emergency care,the volume of health workforce increased from 3,687 to 8,671,with a 109%increase in the number of physicians from 1,774 to 3,712.However,overcrowding,the long length of stay in EDs,poor work environment,and work exhaustion were still the critical challenges faced by China’s EMSS.CONCLUSIONS:The number of emergency visits has grown with continual capability enhancement during the past decade.However,overcrowding,the long length of stay in EDs,poor work environment,and work exhaustion still need to be solved by China’s EMSS.These fi ndings and comparison with the USA could offer experiences and lessons to EMSS development worldwide,especially for developing countries.

Medical services for sports injuries and illnesses in the Beijing 2022 Olympic Winter Games

BACKGROUND:Beijing 2022 Olympic Winter Games was the second Games held amid the COVID-19 pandemic.To a certain extent,it has altered the way sporting activities operate.There is a lack of knowledge on injury risk and illness occurrence in elite winter sport athletes amid the COVID-19 pandemic.This study aimed to describe the incidence of injuries and illnesses sustained during the XXIV Olympic Winter Games in Beijing from February 4 to 20,2022.METHODS:We recorded the daily number of injuries and illnesses among athletes reported by Beijing 2022 medical staff in the polyclinic,medical venues,and ambulance.We calculated injury and illness incidence as the number of injuries or illnesses occurring during competition or training,respectively,with incidence presented as injuries/illnesses per 100 athlete-days.RESULTS:In total,2,897 athletes from 91 nations experienced injury or illness.Beijing 2022 medical staff reported 326 injuries and 80 illnesses,equaling 11.3 injuries and 2.8 illnesses per 100 athletes over the 17-day period.Altogether,11%of the athletes incurred at least one injury and nearly 3%incurred at least one illness.The number of injured athletes was highest in the skating sports(n=104),followed by alpine skiing(n=53),ice track(n=37),freestyle skiing(n=36),and ice hockey(n=35),and was the lowest in the Nordic skiing disciplines(n=20).Of the 326 injuries,14(4.3%)led to an estimated absence from training or competition of more than 1 week.A total of 52 injured athletes were transferred to hospitals for further care.The number of athletes with illness(n=80)was the highest for skating(n=33)and Nordic skiing(n=22).A total of 50 illnesses(62.5%)were admitted to the department of dentistry/ophthalmology/otolaryngology,and the most common cause of illness was other causes,including preexisting illness and medicine(n=52,65%).CONCLUSION:Overall,11%of athletes incurred at least one injury during the Games,which is similar to the findings during the Olympic Winter Games in 2014 and 2018.Regarding illness,2%of athletes were affected,which is approximately one-third of the number affected in the 2018 Olympic Winter Games.

Significant factors associated with fatal outcome in emergency open surgery for perforated peptic ulcer

AIM:To evaluate the main factors associated with mortality in patients undergoing surgery for perforated peptic ulcer referred to an academic department of general surgery in a large southern Italian city. METHODS:One hundred and forty-nine consecutive patients (M:F ratio=110:39,mean age 52 yrs,range 16-95) with peptic ulcer disease were investigated for clinical history (including age,sex,previous history of peptic ulcer,associated diseases,delayed abdominal surgery,ulcer site,operation type,shock on admission,postoperative general complications, and intra-abdominal and/or wound infections),serum analyses and radiological findings. RESULTS:The overall mortality rate was 4.0%.Among all factors,an age above 65 years,one or more associated diseases,delayed abdominal surgery,shock on admission, postoperative abdominal complications and/or wound infections,were significantly associated (x^2) with increased mortality in patients undergoing surgery (0.0001<P<0.03). CONCLUSION:Factors such as concomitant diseases,shock on admission,delayed surgery,and postoperative abdominal and wound infections are significantly associated with fatal outcomes and need careful evaluation within the general workup of patients admitted for perforated peptic ulcer.

Post-disaster medical rescue strategy in tropical regions

BACKGROUND:Earthquakes,floods,droughts,storms,mudslides,landslides,and forest wild fires are serious threats to human lives and properties.The present study aimed to study the environmental characteristics and pathogenic traits,recapitulate experiences,and augment applications of medical reliefs in tropical regions.METHODS:Analysis was made on work and projects of emergency medical rescue,based on information and data collected from 3 emergency medical rescue missions of China International Search and Rescue Team to overseas earthquakes and tsunamis aftermaths in tropical disaster regions — Indonesia-Aceh,Indonesia-Yogyakarta,and Haiti-Port au Prince.RESULTS:Shock,infection and heat stroke were frequently encountered in addition to outbreaks of infectious diseases,skin diseases,and diarrhea during post-disaster emergency medical rescue in tropical regions.CONCLUSIONS:High temperature,high humidity,and proliferation of microorganisms and parasites are the characteristics of tropical climate that impose strict requirements on the preparation of rescue work including selective team members suitable for a particular rescue mission and the provisioning of medical equipment and life support materials.The overseas rescue mission itself needs a scientific,efficient,simple workflow for providing efficient emergency medical assistance.Since shock and infection are major tasks in post-disaster treatment of severely injured victims in tropical regions,the prevention and diagnosis of hyperthermia,insect-borne infectious diseases,tropic skin diseases,infectious diarrhea,and pest harms of disaster victims and rescue team staff should be emphasized during the rescue operations.

Is routine pregnancy test necessary in women of reproductive age admitted to the emergency department?

BACKGROUND:This study aimed to determine the necessity of pregnancy test in women of reproductive age admitted to emergency department(ED) in routine practice.METHODS:We retrospectively reviewed the records of patients who presented to the ED between January 1,2006 and December 31,2010 and received a pregnancy test.RESULTS:The median age of 1 586 patients enrolled into the study was 27 years.Of these patients,19.55%had a positive result of pregnancy test.The most common complaint at admission was abdominal pain in 60.15%of the patients,and pregnancy test was prescribed.15.83%of the patients with abdominal pain had a positive result of pregnancy test.Of the patients,30.64%had nausea-vomiting at admission,and 11.52%had a positive result of pregnancy test.When other complaints were considered,the most commonly observed complaints were non-specific symptoms such as dizziness,malaise and respiratory problems.Of the patients,70.93%were not remembering the date of last menstruation,and 9.51%showed a positive result of pregnancy test.Urinary tract infection(UTI) was commonly diagnosed with an incidence of 17.65%,which was followed by nonspecific abdominal pain(NSAP)(16.77%) and gastrointestinal disorders such as gastritis and peptic ulcer(6.87%).Of the patients,88.40%were discharged from ED,and 11.60%were hospitalized.CONCLUSION:Pregnancy test should be given to women of reproductive age as a routine practice in ED in developing countries like Turkey.

Research on City Rapid Medical Decision System based on GIS

In order to guarantee the validity of the city emergency rescue, it will need to feedback goods demand and injuries to guide accident emergency rescue center in a timely, and also we need to fully grasp with emergency supplies and emergency hospital. Considering the effectiveness of city emergency rescue and timeliness, the paper analyzes and design Rescue Decision Support System for city distribution of emergency supplies and search of wounded man based on GIS. Emergency medical aid model established in this paper, taking ArcGIS＋VS2005 as the development platform, C# as development language, design and development the preliminary city emergency medical rescue simulation system based on GIS.

Medical Emergencies in Dental Clinics: A Survey of 2013 Dentists in China

Objective To investigate the feature and frequency of medical emergencies in dental clinics in China and the Methods A survey study was conducted among 2408 dentists who attended continuing educational courses held by Society of Sedation and Analgesia of Chinese Stomatological Association in 18 cities from December 2015 to December 2018.Demographic information of the dentists and the characteristics of medical emergencies they encountered were collected and analyzed.The associated demographic features for dentist experiencing medical emergencies were analyzed by logistic regression model.Results A total of 2013 dentists provided valid responses and reported 2923 events of medical emergencies in dental clinics.Among them,85.0%reported that they had encountered medical emergencies,and 35.5%had encountered at least twice.Syncope(35.9%)and hypoglycemia(30.3%)were the most common reported medical emergencies.Medical emergencies were most likely to occur during local anesthesia(49.9%),out-patient oral surgery(25.9%),and root canal treatment(11.3%).There were 6 patients(0.2%)died in emergencies.84.0%dentists reported that they had never received training courses about medical emergency management in dentistry other than Basic Life Support.Longer practicing time(10-15 years)(OR=0.59,95%CI:0.41-0.85,P=0.004),working in private dental facilities(OR=1.69,95%CI:1.20-2.38,P=0.003)were associated with an increased risk of experiencing medical emergencies.Conclusion More efforts are needed in prevention,early identification,and timely management of medical emergencies in dental clinics in order to prevent fatal outcomes.The results of this survey are useful information for re-designing emergency training courses for Chinese dentists.