Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Randomized Controlled Trial Clinical Trial
A randomized, controlled trial of the efficacy of closed chest compressions in ambulances.
To examine the feasibility of closed chest compressions in ambulances. ⋯ The percentage of correct compressions in all the vehicles tested was lower when compared with the percentage on the ground, and the increase in heart rate was higher. Only one of these results was statistically significant. A further study with more participants seems warranted.
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Routine vital signs assessment is considered a fundamental component of patient assessment. This study was undertaken to determine whether advanced life support (ALS) emergency medical services (EMS) providers depend on vital signs information in managing their patients. ⋯ The presence or absence of vital signs information does influence some of the patient care decisions of EMS providers; however, the clinical implications of these decisions are unclear. Further studies are needed to determine whether ALS providers can adequately manage actual patients without obtaining vital signs.
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To determine whether the presence of an on-scene medical control physician (OSMCP) alters the management and outcome of out-of-hospital nontraumatic, nonasystolic cardiac arrest (CA) patients. ⋯ Out-of-hospital CA patients treated in the OSMCP group had a trend toward more frequent ROSC upon ED arrival and a higher rate of survival to hospital discharge. The OSMCP group patients received medications at nearly twice the rate of the PO group patients. Although a larger trial is needed, more frequent dosing of drugs during CA may have contributed to increased survival in the OSMCP group.
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Injury is a leading cause of death and disability. Preventing injuries from ever occurring is primary injury prevention (PIP). ⋯ Essential PIP activities for leaders and decision makers of every EMS system include: protecting individual EMS providers from injury; providing education to EMS providers in PIP fundamentals; supporting and promoting the collection and utilization of injury data; obtaining support for PIP activities; networking with other injury prevention organizations; empowering individual EMS providers to conduct PIP activities; interacting with the media to promote injury prevention; and participating in community injury prevention interventions. Essential PIP knowledge areas for EMS providers include: PIP principles; personal injury prevention and role modeling; safe emergency vehicle operation; injury risk identification; documentation of injury data; and one-on-one safety education.
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1) To perform a statewide analysis of the frequency of major pediatric trauma cases and the use of resuscitation skills by paramedics (EMT-Ps). 2) To determine whether EMT-Ps use resuscitation skills less frequently for injured children than for older patients. ⋯ EMT-Ps infrequently manage seriously injured children. i.v.s are less frequently placed in pediatric trauma patients, even in the setting of physiologic abnormalities. The contributions of these field procedures to patient outcomes should be evaluated further.