Advancing a machine learning-based decision support tool for pre-hospital assessment of dyspnoea by emergency medical service clinicians: a retrospective observational study

BMC Emergency Medicine, Journal Year: 2025, Volume and Issue: 25(1)

Published: Jan. 5, 2025

Abstract Background In Sweden with about 10 million inhabitants, there are one primary ambulance missions every year. Among them, around 10% assessed by Emergency Medical Service (EMS) clinicians the symptom of dyspnoea. The risk death among these patients has been reported to be remarkably high, at 11,1% and 13,2%. aim was develop a Machine Learning (ML) model provide support in assessing pre-hospital settings compare them established triage tools. Methods This retrospective observational study including 6,354 who called Swedish emergency telephone number (112) between January December 2017. Patients presenting main dyspnoea were included which recruited from two EMS organisations Göteborg Södra Älvsborg. Serious Adverse Event (SAE) used as outcome, defined any following:1) within 30 days after call for an ambulance, 2) final diagnosis time-sensitive, 3) admitted intensive care unit, or 4) readmission 72 h hospital receiving time-sensitive diagnosis. Logistic regression, LASSO logistic regression gradient boosting compared Rapid Triage Treatment System Adults (RETTS-A) National Early Warning Score2 (NEWS2) respect discrimination calibration predictions. Eighty percent (80%) data development 20% validation. Results All ML models showed better performance than RETTS-A NEWS2 all evaluated metrics. algorithm had overall best performance, excellent predictions, consistently higher sensitivity detect SAE other methods. ROC AUC on test increased 0.73 (95% CI 0.70–0.76) 0.81 0.78–0.84) using boosting. Conclusions caused suffering dyspnoea, method demonstrated predicting SAE, substantial improvement over more methods NEWS2.

Language: Английский

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Machine learning for prehospital care of patients with severe burns

Burns, Journal Year: 2024, Volume and Issue: 50(4), P. 1041 - 1043

Published: Feb. 28, 2024

Language: Английский

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Global Insights on Prehospital Stroke Care: A Comprehensive Review of Challenges and Solutions in Low- and Middle-Income Countries

Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(16), P. 4780 - 4780

Published: Aug. 14, 2024

Stroke is a leading cause of disability and mortality worldwide, it disproportionately affects low- middle-income countries (LMICs), which account for 88% stroke fatalities. Prehospital care delays are crucial obstacle to successful treatment in these settings, especially given the limited therapeutic window thrombolytic treatments, may greatly improve recovery chances when initiated early after onset. These caused by lack public understanding symptoms, sociodemographic cultural variables, insufficient healthcare infrastructure. This review discusses issues detail, emphasizing disparities awareness reaction times between locations socioeconomic classes. Innovative options reducing include deployment mobile units community-based educational campaigns. also how technology improvements personalized initiatives might response LMICs. The primary goal give thorough assessment challenges potential remedies that serve as foundation policy reforms LMICs, eventually improving lowering disease-related disability.

Language: Английский

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Trauma center proliferation in the United States: concerns and potential solutions

OTA International The Open Access Journal of Orthopaedic Trauma, Journal Year: 2025, Volume and Issue: 8(1)

Published: Feb. 5, 2025

Abstract There has been an increase in the number of Level I and II trauma centers across United States past few decades. However, data suggest that access to care remains poor rural areas country, while many urban areas, center density may be too high. Excessive proliferation potential for negative effects on patient increased system costs. The efficiency competency each decreased by having less patients, with research, surgeon experience, training programs residents, fellows, medical students, other allied health providers all affected. Because these concerns, Orthopaedic Trauma Association (OTA) Health Policy Committee reviewed trends needs considered effect as well experience training. This article reviews different types their designation process, growth during committee identified explored issues provides suggestions improvement. Potential solutions include developing applying strict criteria determining needed within a given region, considering local population, cost containment, impact adjacent educational research missions. is opportunity OTA work even more collaboratively American College Surgeons develop such involved orthopaedic accreditation requirements. Collaboration between professional societies state federal agencies help optimize distribution centers.

Language: Английский

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Emergency Medical Services and Stroke Management: A Review of Current Guidelines and Practices

Journal of Current Health Sciences, Journal Year: 2025, Volume and Issue: 5(1), P. 15 - 26

Published: Feb. 17, 2025

The worldwide occurrence of strokes reaches around 15 million cases per year while these conditions persist in more than 100 patients at once. Worldwide stroke stands as the second main cause mortalities since 88% all deaths occur within low- and middle-income countries (LMICs). Emergency Medical Services establish critical intervention paths because they detect early providing immediate on-scene treatment quick response times that directly affect patient recovery. effectiveness proposed quality indicators to improve prehospital remains unknown independently from other indicators. research tackles developing EMS functions management through an analysis which shows how triage tools together with telehealth integration mobile services shorten door-to-needle period results. potential point-of-care diagnostic for subtype identification gets investigated identify their contribution optimizing decision-making processes. text examines crucial issues care such restricted service accessibility minimal training support inadequate evidence-based protocol data. reduction mortality improvement recovery requires future focus on collaboration multilevel stakeholders technology innovation policy equality optimize underserved healthcare environments.

Language: Английский

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Emergency Medical Services Strategic Design: A Comprehensive Multiobjective Approach to Ensure System Sustainability and Quality

Smart Cities, Journal Year: 2025, Volume and Issue: 8(2), P. 52 - 52

Published: March 17, 2025

Emergency medical services (EMSs) are critical to reducing fatalities and improving patient outcomes in emergencies such as traffic accidents, where response time is a decisive factor. This study proposes comprehensive systematic approach designing optimizing EMS systems tailored for urban accidents. By integrating Geographic Information Systems (GISs), hypercube queuing models, Economic Value Added (EVA) calculations, multi-criteria decision-making (MCDM) techniques, we developed model that balances service efficiency, financial sustainability, equitable access emergency care. The was applied estimate key performance metrics, time, coverage, the GINI index equity, under varying numbers of ambulances demand scenarios. In addition, EVA calculated different configurations leased owned ambulances, offering perspective assess viability public–private partnerships (PPPs) EMSs. Using fuzzy Analytic Hierarchy Process (AHP) CoCoSo (Combined Compromise Solution) methods, this identified optimal number required minimize maximize ensure sustainability. proposed has been real case Colombia. Furthermore, offers financially viable solution with positive values guarantee long-term sustainability partnership. paper advances literature by providing practical framework systems, particularly developing countries constraints resource limitations represent significant challenges. methodology improves efficiency economic ensures equity life-saving

Language: Английский

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Student Paramedic and Practice Educator Experiences of Ambulance Placements. A Rapid Evidence Review

Health Science Reports, Journal Year: 2025, Volume and Issue: 8(3)

Published: March 1, 2025

Ambulance practice placements overseen by paramedic educators form an essential aspect of training for student paramedics; however, this approach, adapted from other healthcare professions, is a relatively new model paramedicine and evidence regarding its application in prehospital contexts limited. Therefore, rapid review aimed to explore educator experiences ambulance placements. EBSCOhost was used search the Cumulative Index Nursing Allied Health Literature Complete MEDLINE databases inception March 2024. Screening data extraction performed one reviewer verified second. Included studies were appraised using Critical Appraisal Skills Programme qualitative checklist thematic synthesis results undertaken. Of 134 records screened, seven included review, representing 131 participants United Kingdom, Australia New Zealand. Four themes identified, including support, student-practice relationships, organization communication, operational factors. Outdated workplace practices, personal factors, education-industry barriers unpredictable working environments impacted Better communication needed between universities services improve consistency paramedics educators.

Language: Английский

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Bridging Data Gaps in Emergency Care: The NIGHTINGALE Project and the Future of AI in Mass Casualty Management

Journal of Medical Internet Research, Journal Year: 2025, Volume and Issue: 27, P. e67318 - e67318

Published: April 10, 2025

In the context of mass casualty incident (MCI) management, artificial intelligence (AI) represents a promising future, offering potential improvements in processes such as triage, decision support, and resource optimization. However, effectiveness AI is heavily reliant on availability quality data. Currently, MCI data are scarce difficult to obtain, critical information regarding patient demographics, vital signs, treatment responses often missing or incomplete, particularly prehospital setting. Although NIGHTINGALE (Novel Integrated Toolkit for Enhanced Pre-Hospital Life Support Triage Challenging Large Emergencies) project actively addressing these challenges by developing comprehensive toolkit designed support first responders enhance collection during MCIs, significant work remains ensure tools fully operational can effectively integrate continuous monitoring management. To further advance efforts, we provide series recommendation, advocating increased European Union funding facilitate generation diverse high-quality datasets essential training models, including application transfer learning development supporting while fostering collaboration between end users technical developers. By securing resources, efficiency adaptability applications emergency care, bridging current gaps ultimately improving outcomes situations.

Language: Английский

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Guidelines for Pre-Hospital Care of Individuals with Autism Spectrum Disorder: Best Practices and Recommendations

Published: Jan. 1, 2025

Language: Английский

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Triage Prehospital EMS and Medical Care

Albanian Journal of Trauma and Emergency Surgery, Journal Year: 2024, Volume and Issue: 8(2), P. 1419 - 1424

Published: July 20, 2024

Introduction: Prehospital emergency medical services (EMS) are essential to care. They provide assessment and treatment for seriously ill or injured patients transport them by ambulance an department. Adopting triage methods systematically prioritizing according how urgent need care, including Triage of requests acute treatment, is a promising development in our healthcare system. In Kosovo, there gap between the effects prehospital systems impact using same system two more EMS settings. this quality improvement study, implementing TT app intervention was associated with higher rates inefficient However, supporting professionals their decision-making calculating probability individual patient needing specialized care at scene injury new approach optimize field. If we can fully realize potential approach, it could significantly improve efficiency effectiveness leading better outcomes. Standards most health be educated trained critical component EMS. Education, education, training three levels should obligatory enhance children adults risk. It high time develop test conceptual scheme model that will rely on responds conditions Develop clinical guidelines, algorithms, protocols All must ongoing coaching, communication courses, BLS AED, Pediatric, PHTLS, Adult Advanced Life Support, ATLS, International Trauma Support. Conclusion: vital optimizing outcomes high-pressure world. process rapidly assessing patient's condition determine urgency appropriate destination definitive treatment. Done effectively, ensures receive right level time, maximizing chances survival minimizing long-term complications.

Language: Английский

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