Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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The National Emergency Medical Services Information System (NEMSIS) is a federally funded project designed to standardize emergency medical services (EMS) patient care reporting and facilitate state and national data repositories for the assessment of EMS systems of care. The purpose of this assessment is to characterize the annual NEMSIS 2012 Public-Release Research Dataset, detailing the strengths and limitations associated with use of these data for EMS quality assurance and/or research purposes. ⋯ The annual NEMSIS Public-Release Research Dataset is a valuable resource for evaluating the U.S. EMS activation population and can be used to conduct in-depth descriptions of the care of specific populations. However, the utility of the data are limited until the number of null values can be diminished and reporting becomes universal.
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This study was conducted to associate tourniquet use and survival in casualty care over a decade of war in order to provide evidence to emergency medical personnel for the implementation and efficacy of tourniquet use in a large trauma system. ⋯ Average injury severity increased during the decade of war for casualties with extremity injury. Both tourniquet use rates and casualty survival rates rose when injuries were amenable to tourniquets.
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Methods currently used to triage patients from mass casualty events have a sparse evidence basis. The objective of this project was to assess gaps of the widely used Simple Triage and Rapid Transport (START) algorithm using a large database when it is used to triage low-acuity patients. Subsequently, we developed and tested evidenced-based improvements to START. ⋯ In this research model using trauma registry data, most START under-triage errors occurred in elderly patients. Overall START accuracy was improved by placing elderly but otherwise minimally injured-mass casualty victims into a higher risk triage level. Alternatively, such patients would be candidates for closer monitoring at the scene or expedited transport ahead of other, younger "Minor/Green" victims.
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Diazepam and midazolam are commonly used by paramedics to treat seizures. A period of drug scarcity was used as an opportunity to compare their effectiveness in treating prehospital seizures. ⋯ For parenteral administration, midazolam demonstrated superior first-dose seizure suppression. This study demonstrates how periods of drug scarcity can be utilized to study prehospital medication effectiveness.
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Severely poisoned patients can benefit from intensive and specific treatments. Emergency medical services (EMS) may therefore play a crucial role by matching prehospital care and hospital referral to the severity of poisoned patients. Our aim was to investigate EMS accuracy in this condition. ⋯ A physician-operated EMS is an accurate system to provide prehospital care to IDP patients. However, dispatch physicians should pay attention, especially to toxicological anamnesis, to anticipate proper patient care.