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 availability of ambulances to respond to emergency calls is related to their ability to return to service from the hospital. Extended hospital turnaround times decrease the number of available unit hours ambulances are deployed, which in turn can increase coverage costs or sacrifice coverage. ⋯ This study demonstrated that patient acuity, destination hospital, and time of day were associated with variation in ambulance turnaround times. Research describing other system characteristics such as current emergency department census and patient handoff procedures may further demonstrate areas for improvement in HTAT. Results from this analysis may be used to inspire EMS administrators and EMS medical directors to start tracking these times to create a predictive model of EMS staffing needs.
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To determine whether prehospital providers can successfully place a pediatric King laryngeal tube (LT-D) and ventilate a Laerdal SimBaby pediatric simulator during a respiratory arrest simulation. ⋯ The pediatric King LT-D was quickly and reliably placed. Providers perceived the pediatric King LT-D to be easier to use than pediatric endotracheal intubation in this setting.
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Statewide emergency medical services (EMS) data linked to outcomes are critical for promoting high-quality emergency care; however, many states do not have such a resource. ⋯ Developing a statewide EMS database linked to hospital outcomes is feasible. The processes used in this study and match rate estimates may provide a template for other states to follow, enhancing opportunities for outcomes-based EMS research and EMS quality assurance efforts.
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Practice Guideline
Noninvasive positive pressure ventilation: resource document for the National Association of EMS Physicians position statement.
The National Association of EMS Physicians (NAEMSP) believes that noninvasive positive pressure ventilation (NIPPV) is an important treatment modality for the prehospital management of acute dyspnea. This document serves as a resource to the NAEMSP position on prehospital NIPPV.
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Regionalization of emergency care for patients with serious infections has the potential to improve outcomes, but is not feasible without accurate identification of patients in the prehospital environment. ⋯ Including prehospital provider impression to objective physiologic factors identified three more patients with infection at the cost of overtriaging five. Future research should determine the effect of training or diagnostic aids for improving the sensitivity of prehospital identification of patients with serious infection.