International Journal of Environmental Research and Public Health

Research

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14 pages, 713 KiB

Open AccessArticle

Contribution of Live Video to Physicians’ Remote Assessment of Suspected COVID-19 Patients in an Emergency Medical Communication Centre: A Retrospective Study and Web-Based Survey

by Robert Larribau, Beth Healey, Victor Nathan Chappuis, Dominique Boussard, Florent Guiche, Tara Herren, Birgit Andrea Gartner and Laurent Suppan

Int. J. Environ. Res. Public Health 2023, 20(4), 3307; https://doi.org/10.3390/ijerph20043307 - 14 Feb 2023

Viewed by 1495

Abstract

The COVID-19 pandemic had a major impact on emergency medical communication centres (EMCC). A live video facility was made available to second-line physicians in an EMCC with a first-line paramedic to receive emergency calls. The objective of this study was to measure the [...] Read more.

The COVID-19 pandemic had a major impact on emergency medical communication centres (EMCC). A live video facility was made available to second-line physicians in an EMCC with a first-line paramedic to receive emergency calls. The objective of this study was to measure the contribution of live video to remote medical triage. The single-centre retrospective study included all telephone assessments of patients with suspected COVID-19 symptoms from 01.04.2020 to 30.04.2021 in Geneva, Switzerland. The organisation of the EMCC and the characteristics of patients who called the two emergency lines (official emergency number and COVID-19 number) with suspected COVID-19 symptoms were described. A prospective web-based survey of physicians was conducted during the same period to measure the indications, limitations and impact of live video on their decisions. A total of 8957 patients were included, and 2157 (48.0%) of the 4493 patients assessed on the official emergency number had dyspnoea, 4045 (90.6%) of 4464 patients assessed on the COVID-19 number had flu-like symptoms and 1798 (20.1%) patients were reassessed remotely by a physician, including 405 (22.5%) with live video, successfully in 315 (77.8%) attempts. The web-based survey (107 forms) showed that physicians used live video to assess mainly the breathing (81.3%) and general condition (78.5%) of patients. They felt that their decision was modified in 75.7% (n = 81) of cases and caught 7 (7.7%) patients in a life-threatening emergency. Medical triage decisions for suspected COVID-19 patients are strongly influenced by the use of live video. Full article

(This article belongs to the Special Issue Emergency Medical System and Emergency Medicine in the Time of COVID-19)

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12 pages, 914 KiB

Open AccessArticle

The Influence of the COVID-19 Pandemic on Emergency Medical Services to Out-of-Hospital Cardiac Arrests in a Low-Incidence Urban City: An Observational Epidemiological Analysis

by Chung-Hsien Liu, Ming-Jen Tsai, Chi-Feng Hsu, Cheng-Han Tsai, Yao-Sing Su and Deng-Chuan Cai

Int. J. Environ. Res. Public Health 2023, 20(3), 2713; https://doi.org/10.3390/ijerph20032713 - 3 Feb 2023

Cited by 2 | Viewed by 1388

Abstract

The Emergency Medical Services (EMS) system faced overwhelming challenges during the coronavirus disease 2019 (COVID-19) pandemic. However, further information is required to determine how the pandemic affected the EMS response and the clinical outcomes of out-of-hospital cardiac arrest (OHCA) patients in COVID-19 low-incidence [...] Read more.

The Emergency Medical Services (EMS) system faced overwhelming challenges during the coronavirus disease 2019 (COVID-19) pandemic. However, further information is required to determine how the pandemic affected the EMS response and the clinical outcomes of out-of-hospital cardiac arrest (OHCA) patients in COVID-19 low-incidence cities. A retrospective study was conducted in Chiayi, Taiwan, a COVID-19 low-incidence urban city. We compared the outcomes and rescue records before (2018–2019) and during (2020–2021) the COVID-19 pandemic. A total of 567 patients before and 497 during the pandemic were enrolled. Multivariate analysis revealed that the COVID-19 pandemic had no significant influence on the achievement of return of spontaneous circulation (ROSC) and sustained ROSC but was associated with lower probabilities of survival to discharge (aOR = 0.43, 95% CI: 0.21–0.89, p = 0.002) and discharge with favorable neurologic outcome among OHCA patients (aOR = 0.35, 95% CI: 0.16–0.77, p = 0.009). Patients’ ages and OHCA locations were also discovered to be independently related to survival results. The overall impact of longer EMS rescue times on survival outcomes during the pandemic was not significant, with an exception of the specific group that experienced prolonged rescue times (total EMS time > 21 min). Full article

(This article belongs to the Special Issue Emergency Medical System and Emergency Medicine in the Time of COVID-19)

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17 pages, 2128 KiB

Open AccessArticle

Evaluation Study on the Use of Non-Contact Prevention and Protection Products in the Context of COVID-19: A Comprehensive Evaluation Method from AHP and Entropy Weight Method

by Yanlong Guo, Xuan Li, Denghang Chen and Han Zhang

Int. J. Environ. Res. Public Health 2022, 19(24), 16857; https://doi.org/10.3390/ijerph192416857 - 15 Dec 2022

Cited by 3 | Viewed by 1834

Abstract

In the post-epidemic era, there is an endless supply of epidemic prevention products that cover a wide range of public areas. The introduction of such products has eased the tense pattern of virus proliferation in the context of the epidemic, and effectively demonstrated [...] Read more.

In the post-epidemic era, there is an endless supply of epidemic prevention products that cover a wide range of public areas. The introduction of such products has eased the tense pattern of virus proliferation in the context of the epidemic, and effectively demonstrated the initiatives implemented by the Chinese people in response to the outbreak. This paper therefore begins with the study of contactless epidemic prevention products, which appear in a form that meets the needs of contemporary society and offers a new mode of living to it. It enriches the measures for epidemic prevention and control. By obtaining satisfaction ratings from the user community, the performance of such products can be understood in time to provide a substantial basis for the subsequent upgrading and optimization or transformation of such products. This study uses the KJ method and questionnaires to construct an index system for contactless epidemic prevention products, grasp users’ needs for epidemic prevention products in real time, classify and identify such products, and select such products as epidemic prevention smart security gates, medical delivery robots, infrared handheld thermometers, thermographic body temperature screening, contactless inductive lift buttons, and contactless medical vending machines. The questionnaire was designed with four dimensions: safety, intelligence, aesthetics and economy. A sample size of 262 was collected through the distribution of questionnaires. We used AHP and entropy weighting methods for the comprehensive evaluation; AHP basically tells us how satisfied most users are with this type of product. The use of the entropy weighting method can achieve objectivity in the weighting process. Combining the two approaches helps to improve the scientific nature of the weighting of the evaluation indexes for contactless and epidemic-proof products. It is clear from the AHP analysis that, firstly, there are differences in the perceptions of the performance of this type of product between different age groups. Secondly, the user group rated the perceived performance of the product presented as high (

B_{n} > 0.200

), which users can subjectively and directly perceive. Next, the perceived future sustainable economic development of this product category is low (

B_{n} \leq 0.200

), and users place low importance on its economic aspects as an objective additional condition. The entropy method of analysis shows that, under reasonable government control of the market for intelligent products, the safety, intelligence and aesthetic effects of these products are significant (

C_{m} \leq 0.100

); further, the economic presentation of these products has yet to be optimized and upgraded (

C_{m} > 0.100

). Full article

(This article belongs to the Special Issue Emergency Medical System and Emergency Medicine in the Time of COVID-19)

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9 pages, 457 KiB

Open AccessArticle

Emergency Transport Refusal during the Early Stages of the COVID-19 Pandemic in Gyeonggi Province, South Korea

by Min Young Ryu, Hang A. Park, Sangsoo Han, Hye Ji Park and Choung Ah Lee

Int. J. Environ. Res. Public Health 2022, 19(14), 8444; https://doi.org/10.3390/ijerph19148444 - 11 Jul 2022

Cited by 1 | Viewed by 1375

Abstract

We analyzed the changes in patients’ clinical characteristics and transport refusal pre- and post-COVID-19 and identified the reasons for transport refusal using emergency medical services run sheet data from pre-COVID-19 (April–December 2019) and post-COVID-19 (April–December 2020) in Gyeonggi Province, South Korea. We included [...] Read more.

We analyzed the changes in patients’ clinical characteristics and transport refusal pre- and post-COVID-19 and identified the reasons for transport refusal using emergency medical services run sheet data from pre-COVID-19 (April–December 2019) and post-COVID-19 (April–December 2020) in Gyeonggi Province, South Korea. We included patients aged ≥18 years. Univariate and multivariate logistic regression analyses were performed to identify the relationship between patients’ personal factors and clinical characteristics and emergency transport refusal. During the control and study periods, 612,681 cases were reported; the transport refusal rates during the control and study periods were 6.7% and 8.2%, respectively. Emergency transport refusal was associated with younger age, the male sex, a normal mental status, a shock index < 1, and trauma in both the pre- and post-COVID-19 periods. Although fever prevented transport refusal during the pre-COVID-19 period (aOR, 0.620; 95% CI, 0.567–0.679), it became a significant risk factor for transport refusal during the post-COVID-19 period (aOR, 1.619; 95% CI, 1.534–1.709). The most common reason for transport refusal by critically ill patients was “because it was not accepted within the jurisdiction and remote transport was required.” It is necessary to expand the response capacity of patients with fever in the community to reduce the refusal of transport by critically ill patients. Full article

(This article belongs to the Special Issue Emergency Medical System and Emergency Medicine in the Time of COVID-19)

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11 pages, 348 KiB

Open AccessArticle

Analysis of Risk Factors for In-Hospital Death Due to COVID-19 in Patients Hospitalised at the Temporary Hospital Located at the National Stadium in Warsaw: A Retrospective Analysis

by Sławomir Butkiewicz, Artur Zaczyński, Michał Hampel, Igor Pańkowski, Robert Gałązkowski and Patryk Rzońca

Int. J. Environ. Res. Public Health 2022, 19(7), 3932; https://doi.org/10.3390/ijerph19073932 - 25 Mar 2022

Cited by 5 | Viewed by 1883

Abstract

The outbreak of the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) pandemic has affected all aspects of social life and brought massive changes to the healthcare sector. The aim of this study was to identify the factors affecting the mortality of COVID-19 patients [...] Read more.

The outbreak of the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) pandemic has affected all aspects of social life and brought massive changes to the healthcare sector. The aim of this study was to identify the factors affecting the mortality of COVID-19 patients at a temporary hospital in Warsaw (Poland). The present study was conducted based on a retrospective analysis of the medical records of patients hospitalised at the temporary hospital located at the National Stadium in Warsaw between 1 March 2020 and 30 April 2021. The study included all cases of patients who were brought directly or transferred to the National Hospital from other hospitals for further treatment. With regard to comorbidities, the analysis found that five comorbidities—namely, diabetes (OR = 1.750, 95% CI: 1.009–2.444, p < 0.05), stroke history (OR = 2.408, 95% CI: 1.208–4.801, p < 0.05), renal failure (OR = 2.141, 95% CI: 1.052–4.356, p < 0.05), chronic obstructive pulmonary disease (OR = 2.044, 95% CI: 1.133–3.690, p < 0.05) and heart failure (OR = 1.930, 95% CI: 1.154–3.227, p < 0.05)—had a significant impact on the survival of COVID-19 patients. The analysis identified 14 factors that had a significant impact on the prognosis and mortality of the COVID-19 patients studied. Full article

(This article belongs to the Special Issue Emergency Medical System and Emergency Medicine in the Time of COVID-19)

6 pages, 286 KiB

Open AccessCommunication

From Syndemic Lesson after COVID-19 Pandemic to a “Systemic Clinical Risk Management” Proposal in the Perspective of the Ethics of Job Well Done

by Francesco De Micco, Anna De Benedictis, Vittorio Fineschi, Paola Frati, Massimo Ciccozzi, Leandro Pecchia, Rossana Alloni, Nicola Petrosillo, Simonetta Filippi, Giampaolo Ghilardi, Laura Leondina Campanozzi and Vittoradolfo Tambone

Int. J. Environ. Res. Public Health 2022, 19(1), 15; https://doi.org/10.3390/ijerph19010015 - 21 Dec 2021

Cited by 15 | Viewed by 2094

Abstract

The syndemic framework proposed by the 2021–2030 World Health Organization (WHO) action plan for patient safety and the introduction of enabling technologies in health services involve a more effective interpretation of the data to understand causation. Based on the Systemic Theory, this communication [...] Read more.

The syndemic framework proposed by the 2021–2030 World Health Organization (WHO) action plan for patient safety and the introduction of enabling technologies in health services involve a more effective interpretation of the data to understand causation. Based on the Systemic Theory, this communication proposes the “Systemic Clinical Risk Management” (SCRM) to improve the Quality of Care and Patient Safety. This is a new Clinical Risk Management model capable of developing the ability to observe and synthesize different elements in ways that lead to in-depth interventions to achieve solutions aligned with the sustainable development of health services. In order to avoid uncontrolled decision-making related to the use of enabling technologies, we devised an internal Learning Algorithm Risk Management (LARM) level based on a Bayesian approach. Moreover, according to the ethics of Job Well Done, the SCRM, instead of giving an opinion on events that have already occurred, proposes a bioethical co-working because it suggests the best way to act from a scientific point of view. Full article

(This article belongs to the Special Issue Emergency Medical System and Emergency Medicine in the Time of COVID-19)

Review

Jump to: Research

11 pages, 340 KiB

Open AccessReview

Telemedicine in Emergency Medicine in the COVID-19 Pandemic—Experiences and Prospects—A Narrative Review

by Malgorzata Witkowska-Zimny and Barbara Nieradko-Iwanicka

Int. J. Environ. Res. Public Health 2022, 19(13), 8216; https://doi.org/10.3390/ijerph19138216 - 5 Jul 2022

Cited by 9 | Viewed by 3883

Abstract

Even before the year 2020, telemedicine has been proven to contribute to the efficacy of healthcare systems, for example in remote locations or in primary care. However, with the outbreak of the COVID-19 pandemic, telehealth solutions have emerged as a key component in [...] Read more.

Even before the year 2020, telemedicine has been proven to contribute to the efficacy of healthcare systems, for example in remote locations or in primary care. However, with the outbreak of the COVID-19 pandemic, telehealth solutions have emerged as a key component in patient healthcare delivery and they have been widely used in emergency medicine ever since. The pandemic has led to a growth in the number of telehealth applications and improved quality of already available telemedicine solutions. The implementation of telemedicine, especially in emergency departments (EDs), has helped to prevent the spread of COVID-19 and protect healthcare workers. This narrative review focuses on the most important innovative solutions in emergency care delivery during the COVID-19 pandemic. It outlines main categories of active telehealth use in daily practice of dealing with COVID-19 patients currently, and in the future. Furthermore, it discusses benefits as well as limitations of telemedicine. Full article

(This article belongs to the Special Issue Emergency Medical System and Emergency Medicine in the Time of COVID-19)

22 pages, 1672 KiB

Open AccessReview

COVID-19 Medical and Pharmacological Management in the European Countries Compared to Italy: An Overview

by Sergio Pandolfi, Luigi Valdenassi, Geir Bjørklund, Salvatore Chirumbolo, Roman Lysiuk, Larysa Lenchyk, Monica Daniela Doşa and Serafino Fazio

Int. J. Environ. Res. Public Health 2022, 19(7), 4262; https://doi.org/10.3390/ijerph19074262 - 2 Apr 2022

Cited by 3 | Viewed by 2688

Abstract

(1) Background: Italy accounts for more than 150,000 deaths due to the COVID-19 pandemic, leading the top rank in SARS-CoV-2-caused deceases in Europe. A survey on the different ways by which the COVID-19 pandemic emergency was managed in the foreign European countries compared [...] Read more.

(1) Background: Italy accounts for more than 150,000 deaths due to the COVID-19 pandemic, leading the top rank in SARS-CoV-2-caused deceases in Europe. A survey on the different ways by which the COVID-19 pandemic emergency was managed in the foreign European countries compared to Italy is the purpose of this paper. (2) Methods: A literature search and various mathematical algorithms to approach a rank scoring scale were used to describe in detail the different approaches used by European countries to manage the COVID-19 pandemic emergency. (3) Results: The study showed that Italy stands at the bottom ranking for COVID-19 management due to its high mortality rate. Possible causes of the observed huge numbers of hospitalization and deaths were (a) the demographic composition of the European country; (b) its decentralized healthcare system organization; (c) the role of correct pharmacology in the early stages before hospitalization. Post-mortem examinations were of paramount importance to elucidate the etiopathogenesis of COVID-19 and to tailor a suitable and proper therapy in the early symptomatic stages of COVID-19, preventing hospitalization. (4) Conclusions: Factors such as the significant impact on elderly people, the public health organization prevalently state-owned and represented mainly by hospitals, and criticism of the home therapy approach toward SARS-CoV-2-infected people, may have concurred in increasing the number of COVID-19 deaths in Italy. Full article

(This article belongs to the Special Issue Emergency Medical System and Emergency Medicine in the Time of COVID-19)

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