Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Systemic antibiotic prophylaxis (SAP) for combat wounds is controversial. Current military practice favors its use, despite scant supporting evidence. ⋯ We detected independent and combined associations among SAP, irrigation, and significantly decreased wound infection rates. Effects of SAP and irrigation may be synergistic. Copious irrigation with potable water or sterile isotonic solution should be performed at the earliest practical juncture after a wound occurs. SAP should be administered if irrigation cannot be performed, and may be warranted in addition to irrigation for complex or contaminated wounds or if expeditious return to duty is required. Larger epidemiologic studies are needed to validate our findings.
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Although socioeconomic status (SES) has been linked to multiple health outcomes, there have been few studies of the effect of SES on the provision of bystander cardiopulmonary resuscitation (CPR) during cardiac arrest events and no studies that we know of on the effect of SES on the provision of dispatcher-assisted bystander CPR. This study sought to define the relationship between SES and the provision of bystander CPR in an emergency medical system that includes dispatcher-provided CPR instructions. ⋯ This study suggests that higher bystander SES is associated with increased rates of bystander CPR with and without dispatcher instructions. CPR training programs that target lower-SES communities and assessment of these training methods may be warranted.
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Despite conflicting evidence regarding its efficacy, helicopter transportation of trauma victims is widespread. We determined the effect of adding a second helicopter to a countywide emergency medicine system on trauma-related mortality. ⋯ Introduction of a second helicopter to the east end of Long Island was associated with a significant reduction in the total trauma mortality.
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To identify the specific educational strategies used by paramedic educational programs that have attained consistently high success rates on the National Registry of Emergency Medical Technicians (NREMT) examination. ⋯ Twelve specific strategies were identified by representatives from high-performing paramedic education programs. Further study should be conducted to determine whether implementation of these recommendations would improve program pass rates on the NREMT credentialing examination and improve entry-level paramedic field performance.