PMID- 23116873
OWN - NLM
STAT- MEDLINE
DCOM- 20131112
LR  - 20181202
IS  - 1532-6497 (Electronic)
IS  - 1067-991X (Linking)
VI  - 31
IP  - 6
DP  - 2012 Nov-Dec
TI  - HEMS in Slovenia: one country, four models, different quality outcomes.
PG  - 298-304
LID - S1067-991X(12)00270-2 [pii]
LID - 10.1016/j.amj.2012.09.002 [doi]
AB  - OBJECTIVE: The objective of this study was to determine the quality of patient 
      care using quality indicators in 4 different Slovenian helicopter emergency 
      medical service (HEMS) models. METHODS: This was a cross-sectional study of all 4 
      HEMS in Slovenia. We collected data on quality for the period from July 2003 to 
      August 2008, in a sample of all eligible patients that were managed by HEMS 
      during the study period (N = 833). We obtained the following data on emergency 
      operations: the time and organizational features of the operation; the 
      description of the patients' condition; and the on-site diagnostic and treatment 
      procedures. We used the following as quality indicators: the number of 
      resuscitated patients that were intubated; the number of patients with a Glasgow 
      Coma Scale (GCS) score of # 8 that were intubated; the number of patients with 
      acute coronary syndrome that received treatment with morphine, oxygen, 
      nitroglycerine, and aspirin (MONA); the number of patients with a National 
      Advisory Committee on Aeronautics (NACA) scale score of $ 4 with an intravenous 
      line; the number of patients with a NACA score of $ 5 that were given oxygen; and 
      the number of patients with a NACA score of $ 4 that were given appropriate 
      analgesic treatment. RESULTS: Across all HEMS bases, 36 (87.8%) resuscitated 
      patients were intubated; 122 (81.9%) patients with GCS # 8 were intubated; 149 
      (89.2%) patients with ACS were given MONA treatment; 52 (92.9%) patients with a 
      NACA score of $ 4 were given an intravenous line; 254 (92.7%) patients with a 
      NACA score of $ 5 were given oxygen; and 18 (32.7%) trauma patients with a NACA 
      score of $ 4 were given intravenous analgesics. The quality of patient management 
      in HEMS in Slovenia is affected by the callout procedure, the presence or absence 
      of a fixed rope, the type of helicopter operator, and the provider of the doctor 
      in the helicopter team. CONCLUSIONS: The data from our study indicates that the 
      quality of patient management in HEMS in Slovenia is high. It also seems that 
      organizational factors play a role in the quality management of patients in HEMS 
      as well, but their effect remains unclear and needs further evaluation.
CI  - Copyright (c) 2012 Air Medical Journal Associates. Published by Elsevier Inc. All 
      rights reserved.
FAU - Klemenc-Ketis, Zalika
AU  - Klemenc-Ketis Z
AD  - Department of Family Medicine, Medical School, University of Maribor, Slovenia. 
      zalika.klemenc-ketis@uni-mb.si
FAU - Tomazin, Iztok
AU  - Tomazin I
FAU - Kersnik, Janko
AU  - Kersnik J
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Air Med J
JT  - Air medical journal
JID - 9312325
MH  - Acute Coronary Syndrome/drug therapy
MH  - Air Ambulances/organization & administration/*standards
MH  - Aircraft
MH  - Cross-Sectional Studies
MH  - Glasgow Coma Scale
MH  - Guideline Adherence/*statistics & numerical data
MH  - Humans
MH  - Intubation, Intratracheal/statistics & numerical data
MH  - Out-of-Hospital Cardiac Arrest
MH  - *Practice Guidelines as Topic
MH  - Quality of Health Care
MH  - Respiration, Artificial/methods
MH  - Slovenia
EDAT- 2012/11/03 06:00
MHDA- 2013/11/13 06:00
CRDT- 2012/11/03 06:00
PHST- 2012/11/03 06:00 [entrez]
PHST- 2012/11/03 06:00 [pubmed]
PHST- 2013/11/13 06:00 [medline]
AID - S1067-991X(12)00270-2 [pii]
AID - 10.1016/j.amj.2012.09.002 [doi]
PST - ppublish
SO  - Air Med J. 2012 Nov-Dec;31(6):298-304. doi: 10.1016/j.amj.2012.09.002.