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 analgesic administration in the out-of-hospital setting is influenced by the gender of the patient or the gender of the paramedic. ⋯ The gender of the paramedic did not appear to influence the odds of analgesic administration. Female patients were less likely to receive opioids. Paramedic gender does not explain this finding.
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To determine the prevalence and significance of ST-segment elevation resolution between prehospital and first hospital ECG. ⋯ We found that ST-segment resolution occurred prior to catheterization in 1 of 5 patients with prehospital STEMI, emphasizing the necessity of prehospital ECG in risk stratification of patients with suspected coronary disease. Coronary lesions and intervention rates did not differ between STR and non-STR, suggesting that catheterization is warranted even when STEMI criteria are no longer met in-hospital.
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Preemployment testing is utilized by many ambulance services. Surprisingly, there is limited published research on the efficacy of this testing in determining an employee's ability to complete the requirements of this physically demanding occupation. ⋯ It was concluded that the scoring system did not exclude participants with poor fitness levels, as many participants recorded low scores in several test components yet still passed the test. We recommend that before redesigning the HRFT, studies should be first conducted on the occupational demands and physical standards required for this important profession.
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This report describes the development of an evidence-based guideline for external hemorrhage control in the prehospital setting. This project included a systematic review of the literature regarding the use of tourniquets and hemostatic agents for management of life-threatening extremity and junctional hemorrhage. ⋯ A clinical care guideline is proposed for adoption by EMS systems. Key words: tourniquet; hemostatic agents; external hemorrhage.
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To describe the characteristics of older people who fall and call an emergency ambulance, and the operational and clinical impact of the ambulance responses they receive. ⋯ In this population, ambulance services appear to provide timely responses to older people who have fallen, and "long-lies" are relatively uncommon. More than one-quarter of patients were not transported to an emergency department, and repeat use of ambulance resources appears to be common. Opportunities exist to explore alternate pathways and models of care that maximize outcomes for nontransport patients as well as improving operational efficiency of the ambulance service.