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 California 500: medical care at a NASCAR Winston Cup race.
Stock car racing is America's fastest-growing professional sport. With more than 5.5 million paid admittances and another 148 million watching the 34-race NASCAR Winston Cup series on television, emergency physicians are increasingly called upon to organize medical support for such events. Currently, little reliable information is available to assist in determining what specific personnel and equipment are necessary to optimally support a race event. ⋯ These data may assist individuals planning medical support for large motorsports venues.
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To determine whether Advanced Trauma Life Support (ATLS) practices characterizing initial resuscitation and interfacility transfer at rural trauma hospitals are associated with risk-adjusted survival. ⋯ Some ATLS interventions (BLOOD, TRAN, and TRAN-GCS) are associated with improved survival for selected high-risk subgroups in these 21 rural Level III trauma hospitals.
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Comparative Study
Amiodarone and rural emergency medical services cardiac arrest patients: a cost analysis.
Recent American Heart Association guidelines suggest amiodarone as an antiarrhythmic in refractory ventricular fibrillation (VF) and pulseless ventricular tachycardia (VT). The authors sought to assess the impact of amiodarone use on outcomes and cost associated with this practice in a rural emergency medical services (EMS) state. ⋯ Based on current data, instituting amiodarone treatment for refractory VF and pulseless VT in a rural EMS setting requires the investment of substantial resources, relative to current treatment strategies, for any potential survival benefit.
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The emergency department (ED) is ideally reserved for urgent health needs. The ED, however, is often the site of care for nonurgent conditions. The authors investigated whether emergency medical technicians could decrease ED use by patients with nonurgent concerns who use 911 by appropriately identifying and triaging them to alternate care destinations. ⋯ An EMS-based program may represent one approach to limiting nonurgent ED use.
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Comparative Study
Automated external defibrillation by very young, untrained children.
For patients with sudden cardiac death (SCD), the time interval to defibrillation is the main determinant of survival. As such, the American Heart Association has attempted to promote public-access defibrillation (PAD). Previous studies have shown that automated external defibrillators (AEDs) can be used successfully by untrained adults. ⋯ Although this study suggests that even very young, untrained children can successfully perform automated external defibrillation, training does significantly decrease the time to delivery of first shock.