Browsing by Subject "Transport services"

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    Prehospital care providers' decision to transport the patient with a suicide attempt refusing care in the Cape Town Metropole, Western Cape: A survey based on the Mental Healthcare Act of 2002
    (2015) Evans, Katya; Geduld, Heike; Stassen, Willem
    Anecdotally incidents of inappropriate refusal of treatment or transportation by patients referred to hospital under the Mental Healthcare Act of 2002 have been noted. There is little documented about the knowledge and understanding of prehospital providers of the mental healthcare act, their responsibilities and the issues around patient competence and refusal of care. The transportation of patients presenting with a suicide attempt who have not yet been formally assessed for involuntary admission poses a particular problem. Aim: To determine the knowledge of prehospital providers with respect to the transport of patients presenting with suicide attempts and the mental health act and to describe their management of cases where these patients may refuse treatment. Methods: A cross-sectional survey and including open ended questions of 100 prehospital providers in the Western Cape both public and private. The questionnaire will include knowledge testing, vignettes describing patient management and open-ended questions regarding their opinions on suicidal patients. Simple descriptive statistics will be used for the knowledge test. Qualitative data will be coded using a grounded theory approach. Discussion: The findings of the study will be used to determine provider knowledge and attitudes regarding the prehospital management of patients presenting with suicide attempts. Recommendations will be made for provincial EMS guidelines and the results will be disseminated in an article for publication.
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    A retrospective evaluation of the impact of a dedicated obstetric and neonatal transport service on transport times within an urban setting
    (Springer, 2011) De Vries, Shaheem; Wallis, Lee; Maritz, David
    OBJECTIVE:To determine whether the establishment of a dedicated obstetric and neonatal flying squad resulted in improved performance within the setting of a major metropolitan area.DESIGN AND SETTING:The Cape Town metropolitan service of the Emergency Medical Services was selected for a retrospective review of the transit times for the newly implemented Flying Squad programme. Data were imported from the Computer Aided Dispatch programme. Dispatch, Response, Mean Transit and Total Pre-hospital times relating to the obstetric and neonatal incidents was analysed for 2005 and 2008. RESULTS: There was a significant improvement between 2005 and 2008 in all incidents evaluated. Flying Squad dispatch performance improved from 11.7% to 46.6% of all incidents dispatched within 4 min (p < 0.0001). Response time performance at the 15-min threshold did not demonstrate a statistically significant improvement (p = 0.4), although the improvement in the 30-min performance category was statistically significant in both maternity and neonatal incidents. Maternity incidents displayed the greatest improvement with the 30-min performance increasing from 30.3% to 72.9%. The analysis of the mean transit times demonstrated that neonatal transfers displayed the longest status time in all but one of the categories. Even so, the introduction of the Flying Squad programme resulted in a reduction in a total pre-hospital time from 177 to 128 min. CONCLUSION: The introduction of the Flying Squad programme has resulted in significant improvement in the transit times of both neonatal and obstetric patients. In spite of the severe resource constraints facing developing nations, the model employed offers significant gains.