Annals of emergency medicine
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Erroneous time documentation of emergency treatment caused by the variation in the accuracy of timepieces has profound medical, medicolegal, and research consequences. The purpose of this study was to confirm the variation of critical timepiece settings in an urban emergency care system noted in previous studies and to implement and monitor the results of a prospective program to improve time synchronization. ⋯ Emergency medical timepieces are often inaccurate, making it difficult to reconstruct events for medical, medicolegal, or research purposes. Community synchronization of timepieces to the atomic clock can reduce the problem significantly, but the effects of a one-time attempted synchronization event are short-lived. [Ornato JP, Doctor ML, Harbour LF, Peberdy MA, Overton J, Racht EM, Zauhar WG, Smith AP, Ryan KA: Synchronization of time-pieces to the atomic clock in an urban emergency medical services system. Ann Emerg Med April 1998;31:483-487.].
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Comparative Study
Effects of adding links to "the chain of survival" for prehospital cardiac arrest: a contrast in outcomes in 1975 and 1995 at a single institution.
The concept of a "chain of survival" to improve outcome from prehospital cardiac arrest has been defined and promulgated over the last two decades. The purpose of this study was to compare outcomes of prehospital cardiac arrest in 1975 and 1995 at a single institution. ⋯ Survival decreased dramatically during the 20-year study period. This may be because of the high incidence of chronic disease, the greater frequency of asystole and pulseless electrical activity, and the inclusion of patients with "end-of-life" arrests in which ACLS protocol was initiated in the 1995 cohort. The patient population in which ACLS is initiated is the weakest link in the "chain of survival."