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 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
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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Comparative Study
Characteristics of twice-transferred, rural trauma patients.
Undertriage has seldom been evaluated in the trauma population. In rural states patients often go to the nearest hospital first, where they are evaluated and, if necessary, transferred to another hospital. If they are undertriaged when transferred to the second hospital, they will require a second transfer to a higher-level trauma center. ⋯ The authors infer from the data analysis that more serious or complex injuries took longer to evaluate. Since these patients were physiologically stable, reducing the number of twice-transferred trauma patients will involve refining transfer protocols concerning the need for specialty care.
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Santo Domingo is the largest city in the Dominican Republic. In recent years this city has experienced a significant increase in ambulance services. ⋯ Volunteers appeared to be less educated but with a higher long-term interest in EMS. Salary and better work hours seem to be important factors affecting satisfaction of paid providers, whereas occupational health and life insurance appear to affect the satisfaction of volunteers.