Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
-
To determine the frequency and consequences of vehicular crashes among dedicated pediatric and neonatal transport teams. ⋯ Collisions/crashes among pediatric transport teams are unusual. However, they have resulted in deaths, injuries, and disability. Collisions/crashes appear to be caused by the actions of a team member and/or those of third parties. Specific safety policies on the part of the team and/or vehicle owner or provider may prevent or decrease collisions/crashes.
-
To evaluate the effect of a new protocol allowing paramedics to administer morphine without a physician order to patients with extremity trauma with respect to time of morphine administration, scene time, morphine amount and number of doses per patient, and proportion of patients receiving morphine. ⋯ A change in protocol that permits trained paramedics to administer morphine without physician approval reduces time to analgesia administration without influencing the amount of morphine delivered per patient or the rate of prehospital morphine use. Further study should measure the effect on base hospital physician interruptions and patient outcome.
-
The interval from collapse to electrical rescue shock is a critical determinant of successful defibrillation in cardiac arrest. In order to achieve the earliest possible defibrillation, many emergency medical services (EMS) systems equip first-responding units with an automated external defibrillator (AED). ⋯ The findings suggest that a 1-minute goal and a 90-second minimum standard for time to first shock are appropriate for EMT AED defibrillation in the field.
-
Multicenter Study Comparative Study
Automated external defibrillator (AED) utilization rates and reasons fire and police first responders did not apply AEDs.
To determine the rate at which fire and police first responders (FRs) apply automated external defibrillators (AEDs) and to ascertain reasons for not applying them. ⋯ Fire and police FRs did not apply AEDs to a significant number of OHCA patients. Use of the transport ambulance defibrillator was the primary reason given for not applying the FR AED. Given low AED application rates by FRs, future studies are needed to determine the characteristics of communities in which equipping FRs with AEDs is the most beneficial deployment strategy, and how to increase AED application by FRs in communities with FR AED programs.