Prehospital and disaster medicine
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1) To determine if paramedics could select appropriate patients for use of the saline lock; 2) to evaluate saline-lock patency upon arrival at the emergency department (ED); and 3) to define any cost-savings associated with the use of the saline lock. ⋯ The use of saline locks is an alternative to the use of traditional IVs in certain patients in the prehospital setting.
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Prehosp Disaster Med · Jul 1994
Comparative StudyThe effect of hospital resource unavailability and ambulance diversions on the EMS system.
1) There is no increase in transport or scene time of diverted patients and no increase in distances traveled; 2) hospital resource shortages bear no relationship to the number of patients diverted; and 3) paramedics are able to match their patient correctly with the resources available at a given hospital. ⋯ In this system, hospital diversions increase transport times and distances traveled. Diversion of patients correlated strongly to unavailability of specific categories. Paramedics make errors in determining appropriate CC diversions. Systems reviewing their diversion problems need to assess the impact of longer out-of-hospital times and of certain diversion categories, and to clarify definitions.
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Prehosp Disaster Med · Jul 1994
Determinants of on-scene time in injured patients treated by physicians at the site.
The controversy surrounding the use of advanced life support (ALS) for the pre-hospital management of trauma pivots on the fact that these procedures could cause significant and life-threatening delays to definitive in-hospital care. In Montreal, Québec, on-site ALS to injured patients is provided by physicians only. The purpose of this study was to identify parameters associated with the duration of scene time for patients with moderate to severe injuries treated by physicians at the scene. ⋯ This study shows that physician-provided, on-site ALS causes significant increase in scene time and total prehospital time. These delays are associated with an increase in the risk for death in patients with severe injuries.
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Prehosp Disaster Med · Jul 1994
Comparative StudyEffects of EMS transportation on time to diagnosis and treatment of acute myocardial infarction in the emergency department.
Recent studies have documented decreased time to emergency department (ED) thrombolytic therapy with the use of prehospital electrocardiography. ⋯ Emergency medical services transport of AMI patients in this study decreased time to diagnosis and treatment and may be a confounder in studies that assess the value of field EMS interventions. Non-EMS AMI patients did not receive as rapid diagnosis and treatment, and emergency physicians should evaluate and address this issue in their departments.
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Prehosp Disaster Med · Jul 1994
Clinical Trial Controlled Clinical TrialEffectiveness of interactive videodisc instruction for the continuing education of paramedics.
To evaluate the effectiveness of interactive videodisc (IVD) instruction of paramedics through the use of computer analysis of trip sheets. ⋯ Eight hours of IVD instruction did not result in improved paramedic performance as judged by computer analysis of trip sheets.