Pre-doctor's facility crisis care - where now Prof. Gerard Bury Department of General Practice Vice-Chairman University.

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Pre-healing facility crisis care . Drivers for changeComhairle - Report of the Committee on A
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Pre-doctor\'s facility crisis mind - where now? Prof. Gerard Bury Department of General Practice Vice-Chairman University College Dublin Pre-Hospital Emergency Care Council

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Pre-clinic crisis nurture change Comhairle - Report of the Committee on A&E Services Close pre-doctor\'s facility and doctor\'s facility joins Improved postgraduate preparing for specialists and attendants Structured, multidisciplinary preparing National Health Strategy Consultant conveyed administrations Medical Council Interim Criteria for A&E Departments

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Pre-doctor\'s facility crisis mind Where now? Rescue vehicle benefit joining into the wellbeing framework Regionalisation of A&E administrations Third level preparing of EMTs Advanced care arrangement by EMTs GP communities ICT – new medicinal innovation Professionalization, capability confirmation and proof based practice for pre-healing center care

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Pre-doctor\'s facility crisis mind Scenario 1 49 year old lady falls in downtown area level, Dublin 8 Initial mid-section torment, then LOC Niece telephones 999 Two noteworthy clinics inside three miles Issues Dispatch Traffic Triage First responders Pre-entry guidelines

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Pre-doctor\'s facility crisis mind Scenario 2 Two auto RTA amongst Clifden and Leenane, Co. Galway Three individuals are harmed Clifden and Castlebar WHB ambulances react Issues Response times 15mins/30 mins Retrieval time 1 hour+ Local District Hospital GP reaction

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Pre-doctor\'s facility crisis mind Ambulance Services reaction times 1 week national enumeration of 999 calls: 3436 calls 73% crisis, 24% rustic At best, 47% of crises had a reaction in 8 minutes At most noticeably awful, 10% of crises had a reaction in 8 minutes Breen N, Woods J, Bury G, Murphy A, Brazier H. A national statistics of rescue vehicle reaction times to crisis brings in Ireland. JAEM 2000;17:392

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Pre-healing center crisis mind Spatial examination of RTAs & emergency vehicle benefit reactions 1 NWHB, WHB think about by NUIG and advisors: 1996-2000 5550 mischances 420 passings 1926 genuine wounds 7351 minor wounds Moore D, Murphy A. Spatial examination of street traaffic mishaps in the Western and North Western Health Boards. NUIG, 2002

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Pre-healing center crisis mind Spatial investigation 2

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Pre-doctor\'s facility crisis mind Spatial examination 3 WHB 17% of fatalities (26% around evening time) , 17% of genuine wounds (25% during the evening) not came to inside 25 minutes 27% of fatalities can\'t achieve clinic inside a hour NWHB 5% of fatalities (9% during the evening), 5% of genuine wounds (8% during the evening) not came to inside 25 minutes 31% of fatalities can\'t achieve doctor\'s facility inside 60 minutes

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Pre-doctor\'s facility crisis mind Spatial investigation 4: conclusions \'Brilliant hour\' mind – not by doctor\'s facilities First responders part – amid rescue vehicle reaction Long recovery times – expanded care abilities Use Regional EDs – extra recovery time Integrated care: AS, EDs, GPs, PHNs, 1 st Responders…

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Pre-doctor\'s facility crisis mind EMT preparing PHECC enrollment: new contestant & change preparing Diploma in EMT (UCD) Standard Operational Procedures EMT-A preparation – 2003

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Pre-doctor\'s facility crisis mind EMT preparing improvement Audit/QA/QI CME Competence Assurance Primary degree preparing

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Pre-doctor\'s facility crisis mind EMT-Advanced preparing Protocol driven carers – AOPs ACLS arrangement, liquid substitution, MIMMS prepared Some progressed paeds, obs mind Extended care aptitudes

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Pre-doctor\'s facility crisis mind EMT-An advancement Dispatch/triage Operational organization Further improvement

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Pre-doctor\'s facility crisis mind Service improvements Regionalisation of ED administrations: welcome however implications+ Appropriate choice of cases NB Retrieval and augmented care NB Bypass of a few focuses (for a few issues?) Integrated reactions with GPs, PHNs, Fire & Police… Audit

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Pre-doctor\'s facility crisis mind Scenario 1 Prioritized dispatch, PAI, people group defib plot, 12 lead telemetry, guide access to CPAU Scenario 2 GP reaction, organized EMT-A reaction, injury group in transit, sidestep DGH, group mind at UCHG

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Pre-doctor\'s facility crisis mind Conclusions Multi-sectoral improvements in pre-doctor\'s facility mind EMT/Ambulance Services improvements in preparing, sending and administrations Dispatch Teamwork Audit and confirmation!

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Pre-clinic crisis mind Effectiveness of pre-doctor\'s facility injury mind Cochrane Injuries Group/WHO – Jan 01 Reviews of: Early liquid organization Hypertonic versus isotonic revival Spinal immobilization Advanced versus fundamental life bolster No unmistakable confirmation of advantage Bunn F, Kwan I, Roberts I, Wentz R. Adequacy of pre-healing center injury mind. Cochrane Injuries Group, 2001

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Pre-doctor\'s facility crisis mind Cochrane Review conclusions These outcomes highlight the disregard of harm as a worldwide medical problem Injury research is unfunded and has minimal great quality research even in broadly honed zones There are boundless social, wellbeing and financial results

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