EMS World

FEB 2019

EMS World Magazine is the most authoritative source in the world for clinical and educational material designed to improve the delivery of prehospital emergency medical care.

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EMSWORLD.com | FEBRUARY 2019 33 built into the system," Bladin says. "The Pul s ara plat fo r m is a us ef ul to ol to get communication to the entire team directly from the emergency department. There is no longer a need for multiple phone calls between staff, which allows us to keep a close eye on time metrics." How It Works For example, upon identif ying symp- toms of acute ischemic stroke, the treat- ing paramedic uses the application on a smartphone to input patient information and activate a universal clock that times the delivery of care. The paramedic enters their scene arrival and departure times and selects the destination hospital. Crucial data such as the last-known-well time, blood glucose level, anticoagulant use, stroke scale findings, and known medi- cations are also entered. The technology calculates an approximate arrival time using GPS and alerts the receiving hospital emergency department that a patient with suspected stroke is inbound. The receiv- ing clinician can review the information and activate the stroke team. When this happens, members instantly receive an alert on their mobile devices. The data entered by the paramedic and the patient's anticipated arrival time are available for their review. Each mem- ber of the team can see when others acknowledge the activation. As indi- vidual elements of stroke treatment are prepped and available, the entire team is notified, so each provider knows the status of the patient at all times. Individual team members can be called or messaged directly via the platform, streamlining com- munication and deliver y of care. Another benefit is the abilit y to deliver complex patient informa- tion via secure, encr ypted text. This allows receiving physicians to begin their assessment before the patient passes through the hospital doors, saving critical time. Kathleen Bagot, PhD, a researcher with the Florey Institute, is closely monitoring the implementation of the s ystem in Vic toria. "We have re cei ve d ve r y p ositi ve fe e d b ack about the notion of s treamlining communication," Bagot says. "For the EMS personnel there are minimal fields to complete initially, with the abilit y to add more [information] later without any delay. Paramedics can get the initial alert out and get things in action quickly." After transferring patients to the hos- pital team, EMS personnel can continue to monitor their progress through the platform. Field personnel "really value the case summar y coming back to them after the case is concluded," Bagot says. It allows paramedics to continually eval- uate the care they delivered and their overall role in patient outcomes. If a patient is delivered to a regional hospital initially and then transferred to a higher-level facilit y with specialized s troke care, their information can be shared with experts at the final destina- tion hospital. This allows the patient to be transferred directly into the neurology or inter ventional radiology department. Time Savings In an initial six-month pilot program at Bendigo Health, a hospital about 100 miles northwest of Melbourne, results were promising. In preliminary data presented at the Paramedics Australasia conference, the median time from a patient's arrival at the hospital until their initial CT scan was cut in half, from 46 to 23 minutes. Median door-to-needle time decreased from 111 minutes to 78, a 30% reduction. 1 The EMS system also discovered ben- efits after implementing the streamlined communications for stroke and STEMI patients: When ambulances arrived at the hospital, patients were triaged ear- lier, transfer of care happened fa ster, and ambulances that had transpor ted a suspected stroke case left the hospital to return to ser vice in significantly less time than before. Healthcare providers in Victoria hope their continuing trial in two regional hos- pitals ser ved by 25 ambulance branches will gather impor tant additional data about the use of mobile care coordina- tion in the treatment of acute ischemic stroke and allow them to continue to deliver the highest-qualit y care to the patients they ser ve. REFERENCE 1. Bagot KL, Cadilhac DA, Bernard S, et al. Improving acute cardiac and stroke treatment times by streamlining multi-disciplinar y communication: Preliminar y results for the Pulsara App Pilot. Poster presentation at Paramedics Australasia International Conference, 2017. ABOUT THE AUTHOR Shawna Renga, AS, NREMT-P, is a writer and paramedic in California, where she also ser ves as an instruc tor at the United States Coast Guard Medical Suppor t Ser vices School. WHATEVER THE SITUATION... KEEP IT COOL G OHCL.COM • 1.800.848.1633

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