Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Cardiac arrest in children outside the hospital is associated with high mortality rates. Recent investigations have suggested that the use of advanced life support (ALS) measures by emergency medical services (EMS) personnel may decrease survival. These studies have used the pediatric Utstein style of defining ALS and basic life support (BLS) measures. The pediatric Utstein style defines BLS as "an attempt to restore effective ventilation and circulation" using noninvasive means to open the airway but specifically excludes the use of bag-valve-mask devices. Advanced life support is defined as the "addition of invasive maneuvers to restore effective ventilation and circulation." The authors of the study described below believe that using this definition would categorize some patients into an ALS group who would otherwise be categorized as having received BLS (i.e., "bag-valve-mask only"). ⋯ The use of ALS by prehospital personnel for children with out-of-hospital cardiac arrest did not improve survival to discharge from the hospital when compared with the use of BLS.
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Comparative Study
Tactical EMS: an emerging opportunity in graduate medical education.
Modification of traditional emergency medical services (EMS) principles and procedures for use in the tactical law enforcement setting is emerging as a subspecialty of emergency medicine. Few opportunities exist to train physicians in the principles of tactical medicine, and no studies demonstrate the effectiveness of physician-level training in tactical EMS. ⋯ The COMTOMS Physician Awareness course is effective in increasing physicians' knowledge and comfort levels in areas related to tactical EMS. Knowledge retention at four months is very good.
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Comparative Study
Helicopter transport of pediatric versus adult trauma patients.
Conflicting reports exist regarding the appropriate utilization of helicopter transport for victims of trauma. It has been suggested that adult patients are more severely injured compared with pediatric patients when transported by helicopter. The purpose of this study was to determine whether injury severity and survival probability in pediatric trauma patients were similar to those for adults when helicopter transport was utilized at a suburban trauma center. ⋯ Pediatric patients transported from the accident scene by helicopter have similar ISSs and RTSs compared with adults. These data suggest that prehospital selection criteria for the two groups are similar.