Prehospital and disaster medicine
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Prehosp Disaster Med · Jan 1994
Motor vehicle safety, health care, and taxes. National Highway Traffic Safety Administration, U.S. Department of Transportation.
Motor vehicle injuries are a major public health problem. They are a primary cause of: 1) death and injury in the United States; and 2) result in a substantial loss of productive life. These injuries and fatalities have serious social and economic consequences for the injured individual, their families, and society. This report focuses on the portion of health care expense borne by the public and the tax revenue implications of these injuries and fatalities. ⋯ It is obvious that inaction is a costly alternative and that anticipated population gains will require further reductions in injury and fatality rates just to maintain current injury and fatality rates. Fortunately, countermeasures are to be available that can accomplish this. Lack of vigilance that would result in deterioration of safety levels would be even more costly.
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Prehosp Disaster Med · Jan 1994
Comparative StudyIntravenous maintenance with a saline lock intermittent infusion device in the prehospital environment.
A study was done with EMS personnel to determine the ease of use and acceptance of a saline lock (SL), intermittent infusion device in place of traditional intravenous tubing and fluid bags for prehospital intravenous (IV) maintenance. STUDY HYPOTHESES: Saline lock, intermittent infusion device use in specific clinical scenarios is easier, less expensive, and as effective as traditional IV tubing and fluid bags. The emergency medical technician-paramedic (EMT-P) would accept the implementation of saline locks in the emergency medical services (EMS) system. ⋯ There were completed questionnaires for 79 successful SL initiated in 98 attempts of IV access on 80 patients over a four-month period. When compared to traditional IV fluid bags, SL were judged by the paramedics to be less time-consuming to initiate and maintain (55 of 79 or 70%), easier to use (51 of 79 or 65%) and facilitated patient transportation (73 of 79 or 92%).(ABSTRACT TRUNCATED AT 250 WORDS)
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Current paramedic training mandates complete immobilization of all patients, symptomatic or not, whose mechanism of injury typically is viewed as conducive to spinal trauma. It is common to observe confrontations between paramedics and walking, asymptomatic accident victims who fail to understand why they should "wear that collar and be strapped to that board." Immobilized, frustrated patients then may wait for hours in a busy emergency department until a physician declares them to be without spinal injury. Patients frequently refuse treatment and transport. ⋯ Paramedics already assess most, if not all, of the criteria standard to C-spine clearance algorithms, but are inconsistent in their documentation of the presence or absence of all of the relevant findings.