Annals of emergency medicine
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The twin goals of health care reform--providing universal coverage and limiting health care costs--will require increased primary care access and reductions in the overuse of inappropriate subspecialty interventions. The emergency department provides acute care access for all patients and nonemergency care for those patients unable to find other sources of care. ⋯ These two effects may endanger the viability of the ED as the safety net of the health care system. The impact of health care reform on the emergency care system of the nation requires careful analysis to protect the important role of the ED in providing acute care and in guaranteeing access to care.
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Meta Analysis
Effect of out-of-hospital defibrillation by basic life support providers on cardiac arrest mortality: a metaanalysis.
Although some studies demonstrate otherwise, we hypothesized that metaanalysis would demonstrate a reduction in the relative risk of mortality when basic life support (BLS) providers can defibrillate out-of-hospital cardiac arrest patients. ⋯ BLS defibrillation can reduce the relative risk of death for out-of-hospital cardiac arrest victims in ventricular fibrillation. Weaknesses in individual study designs and regional clustering limit the strength of this metaanalysis and conclusion.
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Comparative Study
A comparison of adenosine and verapamil for the treatment of supraventricular tachycardia in the prehospital setting.
To compare the efficacy and base hospital physician use of adenosine with that of verapamil in the prehospital treatment of supraventricular tachycardia (SVT). ⋯ Our study showed no difference in conversion rates between verapamil and adenosine. Base hospital physicians were more likely to order adenosine than verapamil. Paramedics and base hospital physicians often misinterpret tachydysrhythmias.