Prehospital and disaster medicine
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Prehosp Disaster Med · Apr 1996
Comparative StudyOut-of-hospital use of a pulse oximeter to determine systolic blood pressures.
Blood pressure (BP) in the out-of-hospital setting is one of the most important diagnostic tools used by emergency medical services (EMS) providers. Conventional methods of palpation and auscultation can be time consuming, and the measurements often are inaccurate because of the adverse working conditions encountered. Pulse oximetry waveform systolic blood pressure (POWSBP) measurement has been used successfully in emergency departments to monitor BP. The objective of this study was to compare the accuracy of field POWSBP measurements obtained by noninvasive electronic BP measurement (NIBPM), auscultation, and palpation in the out-of-hospital environment. ⋯ The use of POWSBP measurement is a fast, easy, and accurate technique with which to measure systolic BP in the field. It may have special importance for noisy environments and moving vehicles in which conventional methods of auscultation or palpation may be difficult.
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Prehosp Disaster Med · Jan 1996
Comparative StudyEvaluation of the Pediatric Trauma Triage Checklist as a prehospital pediatric trauma triage tool for the state of Florida.
Triage of injured children poses a significant challenge for prehospital care providers because there is not single trauma triage tool in use that has been developed specifically for children. The pediatric trauma score (PTS) probably is the single most studied and tested trauma triage tool developed solely for the pediatric population, and is an effective predictor of both severity of injury and potential mortality in injured children. However, the pediatric trauma score has been found to be an ineffective prehospital triage tool because it is not "user friendly" for field personnel. As such, the PTS has been modified to generate the more user-friendly "pediatric trauma triage checklist (PTTC)." ⋯ Use of the PTTC appears to have merit as a pediatric prehospital trauma triage tool but further study is recommended. The PTTC should be tested in a prospective, multiregional study involving a sample size sufficient to reach statistical significance.
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Prehosp Disaster Med · Jan 1996
Case ReportsTreatment of casualties of military conflicts at the Critical Medicine Clinic of the Central Hospital in Georgia.
Local military conflicts continue in many areas of the world. These conflicts produce multiple casualties to military personnel and civilians. This paper describes one aspect of the medical care required for victims of the civil conflict in the Republic of Georgia. ⋯ The results are encouraging. Major problems existed in the treatment and evacuation of the wounded. Furthermore, many of the victims were injured because of their carelessness and lack of experience on the battlefield.
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Prehosp Disaster Med · Jan 1996
Randomized Controlled Trial Clinical TrialThe esophageal detector device: accuracy and reliability in difficult airway settings.
The esophageal detector device (EDD) recently has been found to assess endotracheal (ET) tube placement accurately. This study describes the reliability of the EDD in determining the position of the ET tube in clinical airway situations that are difficult. ⋯ The EDD is an accurate and reliable device for detecting ET-tube placement in most clinical situations. Tube placement in fluid-filled trachea, lungs, or both, which occurs in pulmonary edema and drowning, may not be detected using this device.
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Prehosp Disaster Med · Jan 1996
In-field extremity amputation: prevalence and protocols in emergency medical services.
To determine current experience, attitudes, and training concerning the performance of in-field extremity amputations in North America. ⋯ The results suggest a need for established protocols to make the procedure easily accessible when needed, especially in large metropolitan EMS systems. This information should be emphasized during EMS training and reinforced through continuing education.