Prehospital and disaster medicine
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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.
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Prehosp Disaster Med · Apr 1994
Comparative StudyCharacteristics of fatal ambulance crashes during emergency and non-emergency operation.
To analyze the characteristics of fatal ambulance crashes to assist emergency medical services (EMS) directors in objectively developing their EMS system's policy governing ambulance operations. ⋯ Few characteristics differentiate between fatal ambulance crashes during EU and NEU. The difference between EU and NEU were statistically significant in only three out of the 20 variables examined: 1) year occurred; 2) time of day; and 3) light condition. These data provide few objective measures that may be used to develop ambulance operation policies to decrease fatal ambulance crashes.
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Decisions to send an ambulance with or without lights and siren are made every day. While travel with lights and siren is presumed to have relatively more risk associated with it than travel without, little epidemiologic analysis has been conducted to compare the two modes of travel or to characterize collisions in general. ⋯ There is some elevated risk for collision and added injury during lights and siren travel compared to travel without LS. The causes for these collisions suggest that interventions designed to improve driver skills and increase citizen awareness of an approaching ambulance could help reduce the number of collisions.
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The safe and timely provision of blood is of crucial importance in the prevention and mitigation of morbidity and mortality due to trauma. The use of blood in the treatment of war casualties, soldiers as well as civilians, was analyzed retrospectively and the impact of massive blood transfusion on blood banking services and reserves of blood during the war in Sarajevo was assessed. ⋯ Based on these data, prospective requirements for blood usage should take into account casualty triage, as follows: for each casualty transported to the hospital, hospitalized, or transfused, 0.302, 0.796, and 1.912 liters of blood respectively, will be needed for the first 30 days of treatment. Recipients of massive blood transfusions are a significant drain on blood reserves in war. This experience can be utilized in the development of revised guidelines for blood usage for an entire population affected by war.