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
Wireless and satellite transmission of prehospital focused abdominal sonography for trauma.
As military operations become smaller and more remote and as humanitarian missions increase, ultrasound technology is emerging as a valuable asset for defining injuries in austere settings. This study evaluated the feasibility of focused abdominal sonography for trauma (FAST) examinations in a field environment with real-time images sent wireless to an antenna and over satellite. ⋯ This study suggests 1) that remote FAST examinations are plausible for prehospital care and triage using new-generation portable ultrasound units, 2) that line-of-sight transmission of FAST examinations when compared with on-site images results in no degradation in image quality or interpretability at distances used, 3) that ranges greater than 1,500 feet are feasible for interpretable examinations and therefore line-of-site mass casualty or field triage sites, and 4) that real-time INMARSAT transmission of FAST examinations at 64 kbps may serve a limited role for remote clinical interpretation.
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Bystander cardiopulmonary resuscitation (CPR) improves survival. The authors attempted to determine whether the rates at which CPR is performed differ when a cardiac arrest is witnessed by someone known or unknown to the victim. ⋯ Victims of cardiac arrest are more likely to receive CPR when the event is witnessed by bystanders unknown to the victim than if the arrest is witnessed by friends or family.
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Comparative Study
The utility of tympanic versus oral temperature measurements of firefighters in emergency incident rehabilitation operations.
Emergency incident rehabilitation (EIR) is the process by which firefighters receive medical screening and monitoring as well as oral rehydration while on the scene of intense or extended fire or rescue operations. A crucial parameter in EIR medical monitoring is temperature determination because heat-related illnesses are common. The objective of this study was to compare the use of oral temperature versus infrared tympanic temperature determinations of firefighters in the outdoor environment of EIR operations. ⋯ There is poor correlation between tympanic and oral temperature determinations in the EIR setting. Oral temperature determinations may be preferable to tympanic temperature determination in the EIR setting.
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A considerable number of emergency medical services (EMS) responses for cardiac arrest occur in long-term care facilities. In some instances, these responses are for residents who have expressed wishes not to be resuscitated by signing a do not resuscitate (DNR) order. ⋯ Efforts to clarify existing regulations, streamline the DNR transfer process, and improve communication between EMS and long-term care facilities may result in better fulfillment of residents' end-of-life wishes and a saving of EMS resources.
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In December 1999, a group of emergency physicians from the United States, Israel, and Ethiopia met for the Second Annual Symposium on Emergency Medicine and to perform an initial evaluation of the prehospital care system in Addis Ababa. The symposium was structured into a workshop on prehospital care and a clinical seminar for emergency medicine providers. ⋯ The authors present a list of priorities for the development of an emergency medical services (EMS) system for Addis Ababa that was generated in partnership with local government and the World Health Organization. The article contrasts these initial recommendations with those found in the literature on the development of EMS systems in developing nations.