Annals of emergency medicine
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Clinical Trial Controlled Clinical Trial
Effect of out-of-hospital albuterol inhalation treatments on patient comfort and morbidity.
To determine the effect of the institution of out-of-hospital albuterol treatments for acute asthma on out-of-hospital time intervals emergency department (ED) morbidity. ⋯ The institution of out-of-hospital use of nebulized albuterol increased scene time and increased first posttreatment peak expiratory flow rates significantly. There was a significant decrease in initial patient severity as measured on the modified Fischl index, although the validity of this index has not been established. It did not affect travel interval, length of stay in the ED, or medication use after ED presentation.
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Comparative Study Clinical Trial
A prospective comparison of paramedic judgment and the trauma triage rule in the prehospital setting.
To study paramedic judgment and the Trauma Triage Rule in prehospital trauma triage. ⋯ The TTR and paramedic judgment are effective in identifying patients who require trauma center care in the prehospital setting. The TTR and paramedic judgment combined have the greatest predictive value in identifying seriously injured patients.
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Comparative Study
Increasing the efficiency of emergency medical services by using criteria based dispatch.
To determine whether criteria based dispatch (CBD) improved the efficiency of the emergency medical services system. ⋯ CBD increased the efficiency of the EMS system by significantly reducing ALS responses to incidents not requiring ALS intervention and reducing requests by BLS units for dispatch of ALS units while maintaining a consistent time from receipt of call to dispatch.
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Comparative Study Clinical Trial
Facilitation of peripheral intravenous access: an evaluation of two methods to augment venous filling.
To evaluate two methods of augmenting venous filling as potential aids to i.v. cannulation. ⋯ Application of either the Esmarch bandage or the Rhys-Davies exsanguinator caused significant filling of antecubital fossa veins in excess of that produced by a venous tourniquet alone in normovolemic, normotensive volunteers.
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To determine the incidence, demographics, clinical indicators of survival, and frequency of cervical-spine fractures to define appropriate emergency airway management in hanging victims. ⋯ In nonjudicial hanging victims seen by paramedics and transported to an ED, cervical-spine injury is rare. Cerebral hypoxia rather than spinal cord injury is the probable cause of death and should be the primary concern in treatment of this patient population. Following external stabilization of the neck, nasal or oral endotracheal intubation is appropriate emergency airway management in hanging victims.