Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Prospective evaluation of an emergency medical services-administered alternative transport protocol.
The ability of emergency medical services (EMS) providers to offer an alternative means of nonemergent transport for patients with minor medical complaints is a rarely sanctioned concept in U.S. EMS systems. ⋯ The ability of EMS to safely triage patients who activate the 9-1-1 system to an alternative transport mechanism remains an unproven concept. Our study adds to the concerns of other published literature that EMS providers underestimate the potential severity of illness.
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Limited data exist that examine the relationship between prehospital response times (RTs) and improved patient outcomes. Objective. We tested the hypothesis that patient outcomes do not differ substantially based on an explicitly chosen advanced life support (ALS) RT upper limit of 10 minutes 59 seconds (10:59 minutes). ⋯ Compared with patients who wait 10:59 minutes or less for ALS response, Priority 1 patients who wait longer than 10:59 minutes could experience between a 6% increase and a 4% decrease in mortality, and do not have an increase in critical procedures performed in the field. Our data are most consistent with the inference that neither the mortality nor the frequency of critical procedural interventions varies substantially based on this prespecified ALS RT.
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This case series evaluated provider use of the King LTS-D as a primary airway in patients requiring rapid-sequence intubation (RSI). ⋯ In this case series, paramedics were able to successfully place and use the King LTS-D in patients meeting our emergency medical services (EMS) system indications for RSI.
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To compare the prehospital time intervals from patient contact and medication administration to clinical response for intranasal (IN) versus intravenous (IV) naloxone in patients with suspected narcotic overdose. ⋯ The time from dose administration to clinical response for naloxone was longer for the IN route, but the overall time from patient contact to response was the same for the IV and IN routes. Given the difficulty and potential hazards in obtaining IV access in many patients with narcotic overdose, IN naloxone appears to be a useful and potentially safer alternative.
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We sought to determine the effect of the preshock pause (PSP) on coronary perfusion pressure (CPP) decay and subsequent rescue shock (RS) outcome in porcine ventricular fibrillation (VF). ⋯ During the resuscitation PSP in these porcine studies of prolonged VF, CPP dropped precipitously, but RS outcome was not adversely affected.