Prehospital and disaster medicine
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Prehosp Disaster Med · Jul 1996
Clinical Trial Controlled Clinical TrialDoes ambulance crew size affect on-scene time or number of prehospital interventions?
While large cities typically staff ambulances with two emergency medical services (EMS) professionals, some EMS agencies use three people for ambulance crews. The Greenville, North Carolina, EMS agency converted from three-person to two-person EMS crews in July 1993. There are no published reports investigating the best crew size for out-of-hospital emergency care. ⋯ Two-person EMS crews perform the same number of procedures as do three-person EMS crews. However, without the assistance of additional responders, two-person EMS crews may have statistically significantly longer on-scene times than three-person EMS crews.
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Prehosp Disaster Med · Jul 1996
Clinical TrialPrehospital use of a prototype esophageal detection device: a word of caution!
To determine the effectiveness of a prototype esophageal detection device (EDD) during use in the prehospital setting. ⋯ This prototype EDD adequately identifies esophageally placed endotracheal tubes. Correct identification of endotracheally placed tubes was less sensitive. Much work needs to be done regarding the use of negative aspiration devices to identify placement of endotracheal tubes.
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Emergency medical services collisions (EMVCs) are a largely unexplored area of emergency medical services (EMS) research. Factors that might contribute to an EMVC are numerous and include use of warning lights and siren (WL&S). Few of these factors have been evaluated scientifically. Similarly, the incidence and severity of EMVCs is poorly documented in the literature. This study sought to define the incidence and severity of, and where possible, identify any contributing factors to EMVCs in a large urban system. ⋯ A few drivers with previous EMVCs account for a disproportionate number of EMVCs and nearly 90% of all injuries. This risk factor--history of previous EMVC--has not been reported in the EMS literature. It is postulated that this factor ultimately will prove to be the major determinant of EMVCs. Data collection of EMS collisions needs to be standardized and a proposed collection tool is provided.
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To describe the epidemiology of pediatric emergency medical services (EMS) practice in a large patient population from several geographic areas. ⋯ This multistate analysis of pediatric EMS epidemiology confirms findings reported in smaller regional studies, with several exceptions. Excessive scene times were not noted. Few children had serious disorders as evidenced by abnormal vital signs. An ALS treatment, when available, was used infrequently. These findings have implications for EMS planners and educators.
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Prehosp Disaster Med · Jul 1996
Comparative Study Clinical Trial Controlled Clinical TrialComparison of high-dose epinephrine versus standard-dose epinephrine in adult cardiac arrest in the prehospital setting.
To compare the efficacy of high-dose epinephrine (HDE) with standard-dose epinephrine (SDE) in the management of cardiac arrest in adults in the prehospital setting. ⋯ There was no statistically significant difference in overall rate of survival to hospital admission or discharge between patients treated with SDE and those treated with HDE, regardless of the initial rhythm.