Annals of emergency medicine
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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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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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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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To describe the epidemiology of clonidine-related hospitalization in children, to evaluate the efficacy of naloxone, and to review the clinical effects of clonidine toxicity. ⋯ Clonidine ingestion is endemic in our area. Serious clinical effects mandate that all children with clonidine ingestion be triaged to a health care facility. Naloxone as an antidote for clonidine remains controversial.
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To determine the impact of an Advanced Cardiac Life Support (ACLS) training program on resuscitation and survival in a rural hospital. ⋯ After widespread ACLS training and code team organization, there was a significant increase in resuscitation efforts and reversal of death events despite a slight decline in the percentage of patients surviving resuscitation attempts. An ACLS training program in a rural hospital can contribute to increased overall survival.