European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Comparative Study
Understanding the prehospital physician controversy. Step 1: comparing competencies of ambulance nurses and prehospital physicians.
In many European countries prehospital care by emergency medical services (EMS) is supplemented by physician-staffed services. There is ongoing controversy on the benefits of a prehospital physician. Possible advantages are additional competencies of the physician. Similarities and differences in competencies of EMS providers and physicians have however never been studied. This study aims to compare competencies of ambulance nurses and helicopter EMS physicians in the Netherlands to gain better insight into the controversy of the prehospital physician. ⋯ The ambulance nurse and physician have various mutual competencies. In addition, the physician can provide specific competencies on the scene. Knowing the exact overlap and differences in competencies is the first step to understand the prehospital physician controversy. Our results can be used as a tool for the next step in research on prehospital care by EMS providers and physicians and to improve prehospital care.
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The possible benefits of ultrasonic cardiac output monitoring (USCOM) in emergency medicine practice could be significant if evaluated in a goal-directed protocol. The aim of this study was to perform a feasibility study in a physician-staffed prehospital emergency medicine system. This study enrolled a convenient sample of 50 patients with circulatory distress. ⋯ In case of failure, the patient was very often dyspneic (80 vs. 23%, when the technique was successful, P<0.001). Mean duration of USCOM examination was 105 ± 60 s. The acceptable success rate for a new technique we observed and the high easy-to-use score suggests that the use of USCOM is feasible in prehospital emergency medicine.
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The Licensing Act (2003) was implemented in England and Wales at midnight on 23 November 2005. Two studies have tried to assess the impact of the new legislation on emergency department attendances in London and South Yorkshire. Both studies reported a small increase in alcohol-related attendances to the emergency department after the new legislation. This study aimed to assess whether the Licensing Act (2003) has had a significant impact on the number and demography of assaults presenting to a Cambridgeshire emergency department. ⋯ The Licensing Act (2003) has been associated with minor changes in the epidemiology of assaults presenting to our emergency department. The magnitude of these changes is small, implying that they are practically unimportant. The Licensing Act has failed to reduce the burden of alcohol-related assaults presenting to our emergency department.