Prehospital and disaster medicine
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Prehosp Disaster Med · Oct 1993
Multicenter Study Comparative StudyComparison of two systems for quality assurance of prehospital advanced life support services.
The need for quality assurance (QA) systems for review of prehospital advanced life support (ALS) care has long been recognized. However, there only have been limited published studies on the operation and cost of QA systems for prehospital care. A number of different systems currently are in use, and the relative effectiveness of different QA systems has not been well determined. ⋯ Either a computer-based or "manual" system for QA of prehospital ALS services can be utilized. A computer-based system requires more personnel time and is more expensive, but generates more reports per year than does the manual system. A computer-based system more readily can retrieve run report data for further review.
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Prehosp Disaster Med · Oct 1993
Medical control of mass gatherings: can paramedics perform without physicians on-site?
Evaluate the experience of paramedic personnel at mass gatherings in the absence of on-site physicians. ⋯ The medical system configuration modeled after practices of prehospital care, demonstrates physicians did not need to be on-site when adequate EMS medical control existed with less than 30 minutes on-scene time.
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Prehosp Disaster Med · Oct 1993
Prehospital pediatric endotracheal intubation: a survey of the United States.
The standard of practice and teaching for prehospital pediatric endotracheal intubation (PETI) in the United States currently is unknown. The accepted practice of prehospital PETI is of interest because it has contradictory support in the medical literature. ⋯ Endotracheal intubation is an accepted standard in prehospital pediatric care. This standard exists with marginal support in published literature and study of prehospital PETI is needed to define the benefits, risks, and optimal instruction methods for the procedure.
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Prehosp Disaster Med · Oct 1993
The emergency medical response to the Cantara hazardous materials incident.
On 14 July 1991, at 2150 h, a train derailment occurred near the Cantara rail curve about six miles above Dunsmuir in Northern California. The derailment spilled approximately 19,000 gallons of metam-sodium into the Sacramento River. When mixed with water, metam-sodium degrades to methylisothiocyanate (MITC) and other gases. ⋯ Most health care personnel interviewed complained about inadequate information about the substance and the situation. Local fire service mutual-aid agreements to obtain additional fire service and ambulance personnel worked well. It is important to emphasize that everyone who believed they had been exposed to the chemical underwent triage and received appropriate acute medical care.