Annals of emergency medicine
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Comparative Study Clinical Trial Controlled Clinical Trial
Agreement between peripheral venous and arterial lactate levels.
To test the hypothesis that measurements of peripheral venous lactate (V-LACT) can be substituted for arterial lactate (A-LACT) in predicting arterial hyperlactacidemia. ⋯ Correlation between A-LACT and V-LACT was high in this cohort of patients, but agreement is imperfect. The odds of arterial hyperlactacidemia appear to be reduced substantially by the finding of a normal V-LACT but are only marginally increased if the V-LACT is increased. Caution should be used in the routine substitution of V-LACT for A-LACT.
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We sought to assess the involvement of law enforcement agencies in out-of-hospital emergency medical care and their attitudes toward expanded roles in emergency medical services (EMS) systems. ⋯ Many law enforcement agencies are involved to some extent in providing out-of-hospital emergency medical care, and most of the agencies we surveyed would support additional medical training and new or expanded roles for themselves in EMS systems.
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Comment Clinical Trial Controlled Clinical Trial
Risk stratification of patients with syncope.
To develop and validate a risk classification system for patients presenting to emergency departments with syncope. ⋯ Historical and ECG factors available at the time of presentation can be used to stratify risk of arrhythmias or mortality within 1 year in ED patients presenting with syncope.
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To determine patient-specific socioeconomic and health status characteristics for patients arriving by ambulance at an emergency department. ⋯ Ambulance use varies by age, clinical severity, income, patient-specific characteristics of physical function, and type of health insurance. Medicaid coverage and frequent ED use are not predictive of increased ambulance use.
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Comparative Study
Evaluation of a model for improving emergency medical and trauma services for children in rural areas.
To evaluate the effectiveness of a rural emergency medical and trauma services project in increasing the knowledge and confidence of emergency care personnel in the management of acutely ill and injured children. ⋯ The rural pediatric emergency medical and trauma services project was effective in increasing the knowledge and confidence of emergency care personnel in the management of acutely ill and injured children. This project offers a model that can be replicated in other rural areas nationally.