Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Comparative Study
The effectiveness of lights and siren use during ambulance transport by paramedics.
To determine whether lights and siren (L&S) use during transport in the authors' EMS system results in reduced transport time to the hospital. Second, to determine whether L&S use results in any emergency department critical interventions in the time saved. ⋯ Use of L&S significantly shortens transport time. In this series of patients transported under the care of a paramedic, the time saved by the use of L&S was not usually associated with immediately apparent clinical significance.
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Revolutionary changes in the health care system necessitate subsequent changes in emergency medical services (EMS). The development and dissemination of the EMS Agenda for the Future focus attention on awareness and attitudes of field providers. This study attempted to measure awareness of and agreement with concepts set forth in the agenda. ⋯ EMS providers' awareness, perspectives, and attitudes are essential to the forward progression of the EMS Agenda for the Future. Successful implementation of the agenda will depend on these professionals' participation and support. Providers tended to agree most with traditional concepts discussed in the EMS Agenda for the Future. Awareness levels and attitudes toward the vision suggest implications for future education, planning, and research activities.
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To describe how primary care physicians (PCPs) transport seriously ill children from their offices to emergency departments (EDs). ⋯ The PCPs often failed to call EMS for seriously ill children seen in the office and, instead, used the family's auto for emergency transportation. In this survey, transport time and cost were not barriers to use of EMS. The physicians expressed a lack of confidence in EMS providers' pediatric skills. Targeting educational programs to PCPs that highlight 1) the availability, training, and skill of EMS personnel and 2) the medicolegal risks of family transportation may result in more appropriate use of EMS for children.
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To determine the safety and efficacy of succinylcholine, as an adjunct to endotracheal intubation, administered by paramedics trained in its use. ⋯ Paramedics trained to use succinylcholine, to assist the process of endotracheal intubation, can safely intubate a high percentage of patients.
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Clinical Trial
Prehospital identification of acute coronary ischemia using a troponin T rapid assay.
To evaluate the performance of a rapid assay for cardiac troponin T (cTn-T) in patients with chest pain in the prehospital setting. ⋯ The cTn-T rapid-assay device may be useful in the prehospital setting to identify a small number of patients with ACI. The authors caution, however, that a negative test in the prehospital setting cannot be used to rule out significant disease.