Two-Tiered Ambulance Dispatch and Redeployment considering Patient Severity Classification Errors

Managing High Frequency of Ambulance Calls in Hospitals: A Systematic Review

Background

This study addresses the critical issue of high-volume emergency calls in hospitals, focusing on the strain caused by frequent caller patients on ambulance services. The aim was to synthesize various management methods for handling high-frequency hospital calls.

Methods

The systematic review was conducted following the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines and guided by the Cochrane Handbook for systematic reviews. Inclusion criteria encompassed studies focusing on the management of emergency departments in hospitals, exploring various medical conditions requiring ambulance attention, and reporting on the impact of a high volume of ambulance calls on hospitals. Databases including PubMed, Web of Science, and Google Scholar were searched from January 1, 2005, to May 1, 2022. The quality of included studies was assessed using the Critical Appraisal Skills Programme (CASP) Checklist.

Results

Out of 2390 identified citations, 18 studies met the inclusion criteria. These studies, from 12 countries, presented diverse methods categorized into country policy-based management, modeling approaches, and general strategies. Key findings included the effectiveness of risk stratification models and community-based interventions in managing high call frequencies and improving patient care. Our review identified effective strategies such as risk stratification models and community-based interventions, which have shown significant impacts in managing high call frequencies, aligning closely with our objective. These approaches have been pivotal in reducing the burden on emergency services and improving patient care.

Conclusion

The study synthesizes effective management methods for high-frequency ambulance calls, including predictive modeling and community interventions. It highlights the need for multi-faceted management strategies in different healthcare settings and underscores the importance of continued research and implementation of these methods to improve emergency service efficiency.

Average thickness of the bones of the human neurocranium: development of reference measurements to assist with blunt force trauma interpretations

The accurate interpretation of a blunt force head injury relies on an understanding of the case circumstances (extrinsic variables) and anatomical details of the individual (intrinsic variables). Whilst it is often possible to account for many of these variables, the intrinsic variable of neurocranial thickness is difficult to account for as data for what constitutes 'normal' thickness is limited. The aim of this study was to investigate the effects of age, sex and ancestry on neurocranial thickness, and develop reference ranges for average neurocranial thickness in the context of those biological variables. Thickness (mm) was measured at 20 points across the frontal, left and right parietals, left and right temporals and occipital bones. Measurements were taken from post-mortem computed tomography scans of 604 individuals. Inferential statistics assessed how age, sex and ancestry affected thickness and descriptive statistics established thickness means. Mean thickness ranged from 2.11 mm (temporal squama) to 19.19 mm (petrous portion). Significant differences were noted in thickness of the frontal and temporal bones when age was considered, all bones when sex was considered and the, right parietal, left and right temporal and occipital bones when ancestry was considered. Furthermore, significant interactions in thickness were seen between age and sex in the frontal bone, ancestry and age in the temporal bone, ancestry and sex in the temporal bone, and age, sex and ancestry in the occipital bone. Given the assorted influence of the biological variables, reference measurement ranges for average thickness incorporated these variables. Such reference measurements allow forensic practitioners to identify when a neurocranial bone is of normal, or abnormal, thickness.

Ambulances Deployment Problems: Categorization, Evolution and Dynamic Problems Review

In this paper, an analytic review of the recent methodologies tackling the problem of dynamic allocation of ambulances was carried out. Considering that state-of-the-art is moving to deal with more extensive and dynamic problems to address in a better way real-life instances, this research looks to identify the evolution and recent applications of this kind of problem once the basic models are explored. This extensive review allowed us to identify the most recent developments in this problem and the most critical gaps to be addressed. In this sense, it is essential to point out that the dynamic location of emergency medical services (EMS) is nowadays a relevant topic considering its impact on the healthcare system outcomes. Issues related to forecasting, simulation, heterogeneous fleets, robustness, and solution speed for real-life problems, stand out in the identified gaps. Applications of machine learning the deployment challenges during epidemic outbreaks such as SARS and COVID-19 were also explored. At the same time, a proposed notation tries to tackle the fact that the word problem in this kind of work refers to a model on many occasions. The proposed notation eases the comparison between the different model proposals found in the literature.