Annals of emergency medicine
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There is no better place to test life-saving resuscitation interventions than in the prehospital setting. Patients rarely survive cardiac arrest if resuscitation techniques have failed before leaving the scene. ⋯ Most important, by reinforcing standardized care, rigidly scrutinized trials improve patient care, regardless of the effect of the study intervention. The success of productive EMS research centers requires routine communication between hospital and EMS administrators and their medical directors, designation of mutually acceptable data collectors who guarantee confidentiality, reciprocal exchange of study data provided as educational seminars to the hospitals, commitments to support the budget requests of an EMS program and appropriate system modifications, inclusion of EMS personnel in study design from the very beginning, prospective education of the medical community and media before protocol implementation, an authoritative grassroots medical director, and a paramedic supervisor system.
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Animal models of resuscitation must be analyzed carefully before applying any interventions to human resuscitation. In addition to statistical concerns, the investigator must assess the clinical significance of the animal experience with an intervention. ⋯ After evaluating the animals used, the design in a series of animal experiments should be clinically applicable and the results reproducible. Finally, both process and outcome variables should be evaluated and improved in animal models before applying a new intervention to clinical care.