Prehospital and disaster medicine
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Prehosp Disaster Med · Apr 1999
Randomized Controlled Trial Comparative Study Clinical TrialIntubation with transillumination: nasal or oral?
Transillumination-guided intubation is a useful back-up method when laryngoscopic intubation proves to be difficult or impossible. The Trachlight (Laerdal, N-4001 Stavanger, Norway) is suited for both nasal and oral use. Intubation times (IT) and success rates (SR) for nasal and oral intubation with the Trachlight were compared. ⋯ Oral and nasal success rates were compared using the sign test for paired observations. The differences between nasal and oral intubation concerning intubation time and the success rates were not significant. Nasal intubation with the Trachlight seems to be more difficult than the oral intubation.
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Prehosp Disaster Med · Apr 1999
Case ReportsAdenosine conversion of supraventricular tachycardia associated with high-dose epinephrine therapy for cardiac arrest.
Adenosine has received wide acceptance as the drug of choice for initial treatment of supraventricular tachycardias (SVT), and as a diagnostic adjunct in hemodynamically stable, wide-complex tachycardias. This report describes the successful use of adenosine for the treatment of SVT occurring after successful initial resuscitation from ventricular fibrillation, in which a high dose of the epinephrine protocol was used.
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Prehosp Disaster Med · Apr 1999
Development of an equipment and supply list for emergency medical services delivery at an annual air show.
Reports of medical care at mass gatherings reflect variability in mission and delivery models. Equipment recommendations are similarly varied. Thoughtful pre-planning and experience-based analysis are the best mechanisms for defining general and specific equipment recommendations. ⋯ The results of this analysis indicate that comprehensive emergency medical care from first aid to mass casualty care can be offered at reasonable equipment and supply costs, if existing equipment resources can be supplemented by expendable supplies from a pre-determined list. Given the need for large quantities of supplies for a mass casualty contingency and the low likelihood of occurrence, a loan arrangement with a supplier, with return of unused supplies, is particularly convenient and economical. The approach used in this study should be appreciable in other similar settings. In concurrent scheduled events, the iterative process described can lead to greater specificity of needs for expendable supplies.
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Prehosp Disaster Med · Apr 1999
Short-term crystalloid fluid resuscitation in uncontrolled intra-abdominal bleeding in swine.
Fluid therapy in uncontrolled bleeding is controversial. In a previously used experimental animal model of aortic injury, the outcome often was impaired by re-bleeding that began at least 20 minutes after crystalloid fluid resuscitation was initiated. Therefore, it was hypothesized that re-bleeding might be avoided if volume loading is carried out for 20 minutes and then discontinued. ⋯ Short-term crystalloid fluid therapy in uncontrolled aortic hemorrhage transiently improved the hemodynamic status and the oxygen consumption following the initial bleeding. Furthermore, the infusion did not cause re-bleeding of more than 100 ml, which occurred in previously conducted experiments when the infusion was continued for more than 20 minutes.
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Prehosp Disaster Med · Apr 1999
"Medical Miranda"--improved emergency medical dispatch information from police officers.
Medical Miranda, also called Secondary Emergency Notification of Dispatch (SEND), is a low cost, effective, and welcome addition to emergency medical dispatching systems. The benefits are recognized by emergency medical dispatchers who receive feeder calls from associated public safety agencies that have trained both their field staff and call-takers in the Medical Miranda protocol. ⋯ When the emergency medical dispatcher does not talk directly with the reporting scene personnel or caller, Medical Miranda increases the usefulness of the information the dispatcher receives, helps the dispatcher better understand the reported medical emergency, and improves response appropriateness in emergency medical service (EMS) systems where responses routinely are prioritized.