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A Secure Cloud-Assisted Wireless Body Area Network in Mobile Emergency Medical Care System
Recent advances in medical treatment and emergency applications, the need of integrating wireless body area network (WBAN) with cloud computing can be motivated by providing useful and real time information about patients’ health state to the doctors and emergency staffs. WBAN is a set of body sensors carried by the patient to collect and transmit numerous health items to medical clouds via wireless and public communication channels. Therefore, a cloud-assisted WBAN facilitates response in case of emergency which can save patients’ lives. Since the patient’s data is sensitive and private, it is important to provide strong security and protection on the patient’s medical data over public and insecure communication channels. In this paper, we address the challenge of participant authentication in mobile emergency medical care systems for patients supervision and propose a secure cloud-assisted architecture for accessing and monitoring health items collected by WBAN. For ensuring a high level of security and providing a mutual authentication property, chaotic maps based authentication and key agreement mechanisms are designed according to the concept of Diffie-Hellman key exchange, which depends on the CMBDLP and CMBDHP problems. Security and performance analyses show how the proposed system guaranteed the patient privacy and the system confidentiality of sensitive medical data while preserving the low computation property in medical treatment and remote medical monitoring.
Journal Article
Living and dying in Brick City : stories from the front lines of an inner-city E.R.
Dr. Davis looks at the healthcare crisis in the inner city from the perspective of a doctor who works on the front line of emergency medical care in the community where he grew up, and as a member of that community who has faced the same challenges as the people he treats every day.
Book
Work in stressful conditions in medical emergency system during the COVID-19 pandemic
The pandemic caused a change in the way of providing healthcare services, limiting direct access to doctors, suspending planned treatments and medical consultations, but despite the risks and restrictions, the medical rescue system as a key element of health care for the society continues to function. The system provides medical assistance to patients in the most severe condition, both with a negative result for SARS-Co V-2, as well as with a positive or undiagnosed result. It is a review aimed at analyzing the most important psychological aspects of the work of emergency medical care system personnel during the COVID-19 pandemic. PubMed, Cochrane Library, and Google Scholar search were used to analyze the problem. The following keywords were used to search for information sources: paramedic, work, emergency medical care system, emergency department, ambulance service, COVID-19, pandemic, SARS-Co V-2, Coronavirus. The articles were selected in terms of the psychological aspects of the work of the emergency medical care system personnel during the pandemic in 2020-2021. The psychosocial problems that come to the fore during a pandemic include increased levels of stress, anxiety, depression, burnout, emotional exhaustion, vicarious traumatization, and post-traumatic stress disorder. In the context of the increased risk of psychological problems due to pandemic, it is necessary to provide psychological support to the medical staff, both in terms of psychological support for the entire team and individually. Med Pr. 2022;73(3):241-50 Key words: COVID-19, pandemic, stress, emergency medical care system, paramedic, work conditions
Journal Article
Little Elephant's blocked trunk
\"An elephant has being playing with his toys and putting all of them away in the wrong place. Soon his mother notices that something is not quite right with her little one's trunk\"-- Provided by publisher.
Book
Antibiotic utilization for adult acute respiratory tract infections in United States Emergency Departments
Antibiotic stewardship programs have been a major focus in recent years to curtail antibiotic resistance. The purpose of this study was to evaluate antibiotic utilization for acute respiratory tract infections (ARTI) in the Emergency Department (ED) setting.
A retrospective analysis of adult ARTI visits to EDs utilizing 2011–2017 National Hospital Ambulatory Medical Care Survey- Emergency Department (NHAMCS-ED) datasets was conducted. Included were all visits of adults (≥18 years) diagnosed with ARTI. Antibiotics were determined based upon NHAMCS-ED use of the Multum Lexicon Drug Database coding system. All significance tests were two-sided, P-value <0.05 for significance.
A total of 4632 unweighted ED visits, which represented more than 28 million US ED visits from 2011 to 2017, with 57.2% receiving a prescription for antibiotics. Antibiotic prescriptions for ARTI significantly declined from 65.8% in 2011 to 54.3% in 2017 (P = 0.046). Among all visits, patients were more likely to receive an antibiotic if they were over age 45 (33.0% vs 27.6%, P = 0.005), male (36.7% vs. 32.3%, P = 0.039), and presenting in a non-MSA ED (21.4% vs. 14.5%, P = 0.002). No association was found between antibiotic prescription and race (P = 0.076) insurance (P = 0.488), CBC (P = 0.148), x-ray (P = 0.278), and blood cultures (P = 0.182).
We found a significant reduction in the utilization of antibiotics among adult ARTI visits to U.S. EDs from 2011 to 2017. This is an improvement from previous studies which showed no change, suggesting that antimicrobial stewardship efforts may be impacting overall antibiotic use and should continue to be practiced.
Journal Article
A retrospective cohort study of the 2-week-wait referral pathway vs. neurology same day emergency care
Background and AimThe UK uses the 2-week-wait (2WW) pathway for rapid access to cancer services, however the proportion of patients diagnosed with cancer is very low. We compared the efficacy of the services at the neurology same day emergency care (SDEC) service with the National Hospital for Neurology and Neurosurgery (NHNN), referred via the 2WW pathway.MethodsRetrospective cohort analysis of 57 patients in neurology SDEC service and 57 patients in NHNN 2WW pathway over a 3-month period.ResultsMost patients seen in SDEC are referred via the emergency department (56%) and in NHNN via primary care (95%). Patients seen in the NHNN 2WW clinic take on average 5 times longer to be seen, are half as likely to be seen by a consultant and take 1 month longer to reach the final diagnosis. Across services, two thirds of referrals met the 2WW criteria, however the proportion of patients that were diagnosed with cancer was very low (6%).ConclusionsThe neurology SDEC service facilitated faster access to imaging, earlier diagnosis and a higher proportion of consultant reviews when compared to the 2WW referral pathway. These results provide a basis for further studies aiming to optimise patient access to neurology services rapidly and effectively.
Journal Article