Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Recent American Heart Association (AHA) guidelines have suggested that advanced life support (ALS) providers should have "regular field experience," defined as six to 12 intubations/year, as a prerequisite to patient endotracheal intubation (EI). The authors sought to assess the impact of this guideline on rural emergency medical services (EMS) practice. ⋯ Rural EMS providers rarely use EI skills, particularly in pediatric patients. If recent AHA intubation guidelines are to be followed in rural EMS settings, a small number of EMS providers will meet minimum EI utilization requirements.
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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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There are 12 million children in the United States with special health care needs. Improvements in medical technology, managed care, and changing social views about the institutionalization of children have all contributed to an increasing number of children with special health care needs (CSHCN) residing primarily in their home communities. Because of the dynamic and fragile nature of the medical conditions typically borne by CSHCN, the need for emergency care is not uncommon and prehospital providers are increasingly likely to encounter this population. ⋯ With the support of grant funding from the federal Emergency Medical Services for Children (EMSC) program, a project was undertaken by investigators in the Center for Prehospital Pediatrics at Children's National Medical Center to develop prehospital protocols for CSHCN. This report details the protocol development process, discusses suggestions for their use, and presents the detailed protocols. The protocols are intended to serve as a resource template for the development and/or revision of jurisdiction-specific, customized practice guidelines.
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To prospectively determine if on-site physicians at a mass gathering reduced the number of ambulance transports to local medical facilities. The authors also wished to determine the level of care provider (emergency medical technician, EMT-P, registered nurse, or medical doctor) required to treat and disposition each patient. ⋯ On-site physician-level medical care at large mass gatherings significantly reduces the number of patients requiring transport to hospitals, thus reducing the impact on the local EMS system and surrounding medical facilities.
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Many emergency departments (EDs) receive patients from concert or other mass gathering events. The study objective was to determine whether routine emergency medical services (EMS) transport to a hospital from an indoor arena facility is warranted. ⋯ Patients transported from indoor arena events rarely result in inpatient admissions. Alcohol- and drug-related problems were the primary diagnoses in 31% of these patients and required the most time in the ED. Rock concerts had more alcohol and drug cases than other events.