Prehospital and disaster medicine
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Prehosp Disaster Med · Jul 1993
Accuracy of the Prehospital Index in identifying major hemorrhage in trauma victims.
To determine the sensitivity of the Prehospital Index (PHI) in identifying patients with severe blood loss, a one-year review was conducted at a regional trauma facility. ⋯ The data suggest that patients with PHI scores greater than 3 require close hemodynamic monitoring to rule out significant blood loss and may warrant immediate cross-matching on arrival to the ED.
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Prehosp Disaster Med · Jul 1993
Emergent intubation and CT scan pathology of blunt trauma patients with Glasgow Coma Scale scores of 3-13.
Widely accepted guidelines for use of pharmacologic agents for prehospital intubation have not been fully developed. Toward the goal of formulating specific guidelines, this study sought to determine how well the Glasgow Coma Scale (GCS) score stratifies the need for emergent intubation (within 30 minutes of emergency department arrival or in the prehospital setting). ⋯ Patients with a presenting GCS score of less than or equal to 9 represent candidates for the use of pharmacologic agents to facilitate aggressive airway control by well-trained and supervised emergency medical technicians (EMTs). Emergent intubation of patients with a GCS score of 10-13 is problematic. Patients with a presenting GCS score of 10-13 must be evaluated individually and closely monitored.(ABSTRACT TRUNCATED AT 250 WORDS)
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Prehosp Disaster Med · Jul 1993
Multicenter Study Comparative Study Clinical TrialExacTech blood glucose meter clinical trial.
Current prehospital protocols for the management of patients with altered mental status include the empiric administration of hypertonic glucose, naloxone, and thiamine. The injudicious use of 50% dextrose (D50W) may result in hyperosmolarity, a worsening of hypokalemia, and unwarranted additional health-care costs for the patient. The administration of D50W also may worsen the neurological outcome of patients with local or generalized ischemia. ⋯ The device functioned accurately and consistently in the prehospital environment over a wide range of temperatures, and in the hands of many different individuals.