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 determine the locations of nonresidential out-of-hospital cardiac arrests (OHCAs) in the City of Pittsburgh and to determine whether there are "high-risk" locations that might benefit from placement of automated external defibrillators (AEDs). ⋯ The majority of nonresidential OHCAs occur as singular, isolated events. Other than nursing homes and dialysis centers, there were no identifiable high-risk locations for nonresidential OHCA within the City of Pittsburgh.
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Patient refusal of paramedic transport against medical advice (AMA) has significant medical-legal implications. Previous studies have investigated patient outcomes after refusal of transport, but none has focused on these events in minors. This study was performed to evaluate the outcomes of this patient population after refusal of transport as well as the significance of base hospital physician discussion with parents in the decision to refuse transport. ⋯ Children whose parents refused EMS transport received medical follow-up in the majority of cases, with a small group requiring admission.
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There is little published evidence to support the benefits of prehospital drug administration by ambulance personnel in reducing subsequent hospital utilization by the medical patients receiving such drugs. The authors studied the outcome of patients treated by Ontario's Emergency Health Services "Symptom Relief Drug Program," which was developed to relieve patient symptoms in the field for specific medical emergencies. ⋯ The lower rate of admissions for chest pain patients is the first published evidence of prehospital drug treatment's reducing hospital utilization in a sub-group of such medical patients. The "Symptom Relief Drug Program" is effective in improving patients' field conditions and can decrease ED LOS in hypoglycemic persons receiving glucagon injections. More outcome research pertaining to ambulance-administered prehospital drug treatment is warranted.
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To delineate the present characteristics of emergency medical services (EMS) on the island of Madagascar. ⋯ This study shows that urban EMS is more organized, has a better-developed infrastructure, and has more personnel than its counterparts in rural areas. Future work will determine the impact of a rising population shift from rural to urban areas on this evolving EMS system.