Prehospital and disaster medicine
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Prehosp Disaster Med · Jul 1999
Predictors of demand for emergency prehospital care: an Australian study.
Determining the predictors of demand for emergency prehospital care can assist ambulance services in undertaking policy and planning activities. ⋯ Demand for ambulance services can be predicted by a number of demographic, medical status, and insurance variables. Age and triage levels are key influences on demand for ambulance services. Ambulance insurance status provides an economic incentive to use ambulance services regardless of the urgency of the medical condition.
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Prehosp Disaster Med · Jul 1999
Comparative StudyGeriatric trauma patients at a suburban level-I trauma center in Japan.
Despite the increases in the aged population in Japan, there are little data on geriatric patients with traumatic injuries. A prospective clinical study was carried out to evaluate the use of the emergency medical services (EMS) system, mechanisms of injury, and prehospital assessment and triage of elderly victims of trauma. ⋯ The data suggest that in geriatric-age patients, direct transfer patients have a lower mortality rate than do indirect transfer patients when controlled for ISS. Therefore, it seems that a different set of triage criteria should be developed and implemented for geriatric-age victims with trauma-induced injuries and that those who meet these more stringent criteria should be transferred directly to a Trauma Center.
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Prehosp Disaster Med · Jul 1999
Comparative StudyDifferences in mortality rates among trauma patients transported by helicopter and ambulance in Maryland.
A comprehensive state-wide emergency medical services and helicopter transport system has been developed in the State of Maryland on the principle that early definitive care improves patient outcomes. The purpose of this study was to determine if empirical data exist to support the theory that air medical transportation services provided by the Maryland State Police (MSP) Aviation Division contribute to an improved trauma patient survival rate in Maryland. ⋯ The State of Maryland has demonstrated a commitment to its citizenry and invested heavily in its public safety air medical service. This study suggests the rapid air transport of victims of traumatic events by specialized personnel in Maryland has a positive effect on the outcome of severely injured patients. Further research is necessary to clarify the causal relationships in order to more fully elucidate the value of this resource.
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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.