greenzuloo.blogg.se

17 Even in cases of mild TBI, such as concussion, patients react slowly, particularly when interhemispheric transfer of information is required. 16 Likewise, functional magnetic resonance imaging (fMRI) studies support the hypothesis that patients with TBI require more of their brain to perform a simple task. From the literature, we know that severe TBI is associated with prolonged simple and choice reaction times when patients are presented with visual, auditory, and tactile stimuli. Richard Winn MD, in Youmans and Winn Neurological Surgery, 2017 Reaction TimeĬlinicians' awareness that TBI alters reaction time is important to daily rounds, because slowed processing may be misconstrued as abulia, aphasia, or disorientation when, in actuality, the patient may eventually come up with the answer if given enough time. This further solidifies EMS as a distinct clinical subspecialty involving the prehospital care of sick and injured patients, regardless of specific local or regional system design.

In 2010, EMS was approved by the American Board of Medical Specialties as the sixth subspecialty of emergency medicine, with development of standard examination and certification procedures underway. 5,61įrom their earliest beginnings as purely military organizations to the complex heterogeneous models in place today, EMS systems have evolved into critical providers of health care and a critical component of modern emergency medicine. 16 Furthermore, response times should be targeted to specific regional needs and may be maximized by a strong community-wide first-responder presence, strategic placement of ambulances based on historical call data, mobile mapping or global positioning systems, and adequate fleet maintenance. 59,61 E911 systems-in which caller location is available instantly-can decrease response times because they help plan more direct routes to the scene and reduce the likelihood of ambulance crews becoming lost. Retrospective and post hoc analyses of urban EMS transport show a possible survival benefit for patients transported to hospitals in 4 minutes or less, although the advantage was not significant for those not in cardiac arrest. 60 Studies of set response time criteria have shown mixed results. 59 Specifically, national guidelines recommend medical intervention within 4 to 6 minutes of EMS activation for patients in cardiac or respiratory arrest, although such intervention may include dispatcher-assisted bystander CPR or AED use. Adams MD, in Emergency Medicine, 2013 Response TimeĮMS response time is often used as a benchmark of overall system performance, with accepted standards of 4 minutes for BLS and 8 minutes for ALS arrival. In recent years a major issue in RT research has been the extent to which RT measures reflect general or specific age-related influences. RT measurement in the context of mental chronometry has been a valuable tool in the information-processing perspective on cognition, and a very large number of studies have been reported within this tradition. A number of studies then appeared in which RT was the focus of the research.īeginning in the 1960s, there was an increase in the use of RT as a primary dependent variable because it was assumed to reflect the duration of interesting mental processes. There were sporadic investigations of the relations between age and RT until about 1950, when interest in this topic increased because of an assumption that an individual's RT might be informative about the status of his or her neurological system. The first systematic assessment of the relations between adult age and reaction time (RT) was performed by Galton in the late 1800s, although analyses of his data were not published until much later.

Salthouse, in Encyclopedia of Gerontology (Second Edition), 2007 Historical Background 3 Agility and balance tests are often measured by time or accuracy (e.g., correct two out of three). Agility is defined as the ability to change directions rapidly when one is moving at a high rate of speed. 175 Ideally, testing should be related to the specific activity. The first part measures static and dynamic sitting and standing balance ( Table 17.14) and the second part assesses gait ( Table 17.15).

The Tinetti assessment tool has two parts. The functional reach test involves the patient reaching forward as far as possible without falling forward or taking a step while the examiner measures for distance horizontally. 155 O’Brien 155 advocated the Sharpened Romberg test, functional reach test, timed get-up-and-go test (see Chapters 2 and 11), and Tinetti assessment tool for balance and gait. Balance testing is especially important in the elderly population. For activities requiring agility, balance, and good reaction time, the physical fitness profile should include these items.