Emergency medical services in Japan: An opportunity for the rational development of pre-hospital care and research

Lewin, Matthew R.; Hori, Shingo; Aikawa, Naoki

doi:10.1016/j.jemermed.2004.09.009

Cited by 16 publications

(12 citation statements)

References 35 publications

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“…In Japan, ambulance services select which type of centers patients should be transferred to. European or American style emergency medical systems which receive all types of patients are uncommon in Japan 11,12 . Although the ED at our hospital is classified as a tertiary critical care emergency center, our ED does receive all types of patients, much like the European or American style emergency medical systems.…”

Section: Discussionmentioning

confidence: 98%

“…European or American style emergency medical systems which receive all types of patients are uncommon in Japan. 11,12 Although the ED at our hospital is classified as a tertiary critical care emergency center, our ED does receive all types of patients, much like the European or American style emergency medical systems. Such an emergency medical care system, while valuable, is unusual in Japan.…”

Section: Discussionmentioning

confidence: 99%

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Blatchford scoring system is a useful scoring system for detecting patients with upper gastrointestinal bleeding who do not need endoscopic intervention

Masaoka¹,

Suzuki

Hori³

et al. 2007

J of Gastro and Hepatol

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Background and Aim: Several scoring systems have been devised to identify patients with upper gastrointestinal (UGI) bleeding who are at a high risk of adverse outcomes. We retrospectively evaluated the accuracy of the Blatchford scoring system for assessing the need for clinical intervention in cases of UGI bleeding admitted to the emergency department (ED). Methods: This was a retrospective study conducted on patients who underwent emergency GI endoscopy at the ED of our hospital. Those who needed blood transfusion, operative or endoscopic interventions to control the hemorrhage were classified into the 'high risk' group. Results: Of the 93 enrolled patients, 70 (75.3%) were classified into the high risk group. The Blatchford score was significantly higher in the high risk group than in the low risk group. When a cut-off value of 2 was used, the sensitivity and specificity of the Blatchford scoring system were determined to be 100% and 13%, respectively. Thus, the Blatchford scoring system was deemed to be useful for distinguishing between the high risk group and the low risk group of patients with GI hemorrhage admitted to the ED. Conclusion: The Blatchford scoring system is accurate for identifying definitively lowrisk patients of GI hemorrhage, even prior to the performance of emergency UGI endoscopy at the ED.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Blatchford scoring system is a useful scoring system for detecting patients with upper gastrointestinal bleeding who do not need endoscopic intervention

Masaoka¹,

Suzuki

Hori³

et al. 2007

J of Gastro and Hepatol

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“…We systematically requested additional data from authors, but we were unable to contact all authors. Three studies, comprising 63% of ED catheter-days in this review, come from Japan [31] and Turkey [26, 33], where ED practice patterns differ from that of the US, including ED length of stay [38, 39], ED volume [38–42], and acute care training [38–42]. Chiang [25] and Citak [26] analyzed pediatric populations alone, while Yilmaz [33] looked exclusively at CVCs used for parenteral nutrition.…”

Section: Limitationsmentioning

confidence: 99%

Systematic review of emergency department central venous and arterial catheter infection

et al. 2010

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BackgroundThere is an extensive critical care literature for central venous catheter and arterial line infection, duration of catheterization, and compliance with infection control procedures. The emergency medicine literature, however, contains very little data on central venous catheters and arterial lines. As emergency medicine practice continues to incorporate greater numbers of critical care procedures such as central venous catheter placement, infection control is becoming a greater issue.AimsWe performed a systematic review of studies reporting baseline data of ED-placed central venous catheters and arterial lines using multiple search methods.MethodsTwo reviewers independently assessed included studies using explicit criteria, including the use of ED-placed invasive lines, the presence of central line-associated bloodstream infection, and excluded case reports and review articles. Finding significant heterogeneity among studies, we performed a qualitative assessment.ResultsOur search produced 504 abstracts, of which 15 studies were evaluated, and 4 studies were excluded because of quality issues leaving 11 cohort studies. Four studies calculated infection rates, ranging 0–24.1/1,000 catheter-days for central line-associated and 0–32.8/1,000 catheter-days for central line-related bloodstream infection. Average duration of catheterization was 4.9 days (range 1.6–14.1 days), and compliance with infection control procedures was 33–96.5%. The data were too poor to compare emergency department to in-hospital catheter infection rates.ConclusionsThe existing data for emergency department-placed invasive lines are poor, but suggest they are a source of infection, remain in place for a significant period of time, and that adherence to maximum barrier precautions is poor. Obtaining accurate rates of infection and comparison between emergency department and inpatient lines requires prospective study.

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“…When an emergency call is received, the nearest available ambulance is sent to the incident. Tanigawaa and Tanaka (2006) and Lewin et al (2005) …”

Section: Case Studymentioning

confidence: 98%

A modified grouping genetic algorithm to select ambulance site locations

Comber

Sasaki

Sano

et al. 2011

International Journal of Geographical Information Science

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This paper describes the development and application of a modified Grouping Genetic Algorithm (GGA) used to identify sets of optimal ambulance locations. The GGA was modified to consider a special case with only two groups, and the reproduction and mutation schemes were modified to operate more efficiently. It was applied to a case study locating ambulances from a fixed set of alternative locations. The sites were evaluated using data of emergency medical services (EMS) calls summarised over census areas and weighted by network distance. Census areas serviced by the same selected location defined ambulance catchments. The results indicated alternative sites for ambulances to be located, with average EMS response times improved by 1 minute 14 seconds and showed the impacts of having different numbers of ambulances in current locations and in new locations. The algorithmic developments associated with the modified GGA and the advantages of using census areas as spatial units to summarise data are discussed.

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Emergency medical services in Japan: An opportunity for the rational development of pre-hospital care and research

Cited by 16 publications

References 35 publications

Blatchford scoring system is a useful scoring system for detecting patients with upper gastrointestinal bleeding who do not need endoscopic intervention

Blatchford scoring system is a useful scoring system for detecting patients with upper gastrointestinal bleeding who do not need endoscopic intervention

Systematic review of emergency department central venous and arterial catheter infection

A modified grouping genetic algorithm to select ambulance site locations

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