Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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To examine the practice of clinically "clearing" the cervical spine (c-spine) of trauma patients brought to the ED by EMS with cervical immobilization in place, and to examine developing trends in prehospital c-spine clearance. ⋯ There is tremendous variation in the ED practice of clinically clearing cervical spines. This, and a lack of support from many ED directors, may hinder attempts at development of research and standardized protocols for pre-hospital c-spine clearance.
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Comparative Study
Response interval comparison between urban fire departments and ambulance services.
To measure the response intervals of fire departments compared with ambulance services in three urban centers to determine whether defibrillators should be added to fire vehicles. ⋯ The shorter response interval of fire departments suggests placing defibrillators on fire response vehicles in an effort to decrease the time to defibrillation for cardiac arrest victims in this EMS system.
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The need for valid and reliable emergency medical services (EMS) data has long been recognized. EMS data are useful for monitoring resources and operations, documenting patient care and outcome, and evaluating injury prevention strategies. The goal of this project was to develop a computerized data set with the capability to generate a patient care record (PCR) to overcome some of the current EMS data limitations. ⋯ This computerized approach overcomes many limitations inherent with using paper-based systems for research. Linked with emergency department, hospital discharge, and mortality data, EMS data can be used in systems analyses related to patient outcome.
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To determine whether paramedics can safely use a spinal clearance algorithm to reduce unnecessary spinal immobilization (SI) in the out-of-hospital setting. ⋯ An out-of-hospital spinal clearance algorithm administered by paramedics can reduce SI by one-third. Any application of a spinal clearance algorithm should be accompanied by rigorous medical supervision.