Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Effective mass casualty triage requires rapid and accurate decision making. First responders need to be trained, but opportunities to practice triage and receive individualized feedback during traditional mass casualty (MC) exercises are uncommon. It was hypothesized that novice learners would improve in speed, accuracy, and self-efficacy after deliberate practice triaging multiple simulated casualties in a MC exercise using high-fidelity manikins. ⋯ Novice learners demonstrated improved triage and intervention scores, speed, and self-efficacy during an iterative, multimanikin MC training experience.
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Randomized Controlled Trial Comparative Study
Comparison of use of the the Airtraq with direct laryngoscopy by paramedics in the simulated airway.
Paramedics often encounter patients with difficult airways requiring emergent airway management. ⋯ The Airtraq was shown to be equal to or faster than DL. The Airtraq has a rapid learning curve demonstrated by a significantly decreased time to ventilation between scenarios 1 and 4.
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Currently, policy makers in the Netherlands are discussing the possibility to expand the availability of Helicopter Emergency Medical Services (HEMS) from 12 hours to 24 hours per day. For this, the preferences of the general public towards both the positive effects and negative consequences of HEMS should be taken into account. Therefore, the willingness to pay (WTP) for lives saved by HEMS was calculated. ⋯ The WTP derived from this study is by far exceeding the 1-1.5 Million-euro necessary per HEMS per year for the expansion from a daytime HEMS to a 24-h availability in the Netherlands. Respondents are willing to pay for lives saved by HEMS in spite of increases in flights and concurrent noise disturbances. These results may be helpful for the decision-making process, and may provide a positive argument for the expansion of HEMS availability.
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Research over the last decade has supported the use of cold intravenous (IV) fluid as a method for initiating therapeutic hypothermia in post-cardiac arrest resuscitation. However, prehospital care programs employing this treatment have encountered various difficulties. Barriers to prehospital induced hypothermia (IH) protocols include the lack of effective or economically reasonable methods to maintain cold saline in the field. Validation of a simple method could allow agencies to equip numerous rigs with cold saline. The aim of this study was to determine whether a standard commercial cooler can maintain two 1-L normal saline solution (NSS) bags below 4 degrees C in three different environments. ⋯ Prehospital refrigeration devices are needed for current and future IH protocols. Low-technology methods in the form of a cooler and ice packs can provide cold saline storage for longer than a full 24-hour shift in a room-temperature ambulance. In extremely hot conditions, 4 degrees C NSS can be maintained for nearly 11 hours using this method. This model exhibits an economical, easily deployable cold saline storage unit.