Annals of emergency medicine
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To determine the rate of bystander CPR before and after implementation of a telephone CPR program in King County; to determine the reasons for dispatcher delays in identifying patients in cardiac arrest in delivering CPR instructions over the telephone; and to suggest time standards for delivery of the telephone CPR message. ⋯ In a metropolitan emergency medical services system, a dispatcher-assisted telephone CPR program was associated with an increase in bystander CPR. Delays in proper delivery of telephone CPR can be minimized through training.
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Most prehospital interventions, both pharmacologic and procedural, have been accepted without clear demonstrations of their abilities to impact patient outcomes or without clear indications that withholding or delaying the intervention pending arrival at a definitive emergency department will adversely affect the patient. Interventions that have the benefit of supportive research have been applied equally to urban and nonurban emergency medical services environments. In selecting interventions, inadequate consideration has been given to the differences in emergency medical services personnel training, frequencies of their exposure to patients, frequencies of skill use, and availabilities of effective continuing education programs in the urban and nonurban environments. These issues are discussed, and the necessary focus of the future of emergency medical services in urban, suburban, and rural environments is predicted.
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This study evaluated the efficacy of glucagon for prehospital therapy of hypoglycemia in patients without IV access. ⋯ Glucagon is safe and effective therapy for hypoglycemia in the prehospital setting.
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This study was undertaken to determine whether flight nurses can perform surgical cricothyrotomies with acceptable success and complication rates. ⋯ Surgical cricothyrotomy in the field can be performed reliably by specially trained nurses. Because only the most critically ill or injured patients with unmanageable airways are subjected to this procedure, a significant complication rate can be anticipated.