Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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To determine whether paramedics influence the outcome of cardiac arrest patients in a rural area. ⋯ In this rural setting, a paramedic on the scene significantly improved the ROSC (paramedics = 46% vs 18% for EMT-III, p = 0.01) and survival to ICU admission (38% vs 15%, p = 0.03). The presence of a paramedic on the scene increased survival to hospital discharge neurologically intact (20% vs 9%), although this was not statistically significant.
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To determine the effect of the blizzard of 1996 on the utilization of a pediatric emergency department (ED). ⋯ Among other effects, a significant increase in severity of presentations to a pediatric ED following a severe storm can be observed.
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Comparative Study
Air vs ground transport and outcome in trauma patients requiring urgent operative interventions.
To study trauma patients requiring urgent operative interventions to determine whether transport mode was associated with outcome difference. ⋯ This study failed to identify, but had insufficient power to rule out, outcome benefit to air medical transport in a subset of trauma patients requiring urgent operative interventions.
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To determine whether mode of arrival is associated with seriousness of etiology and use of diagnostic testing in patients treated in the emergency department for headache. ⋯ In this EMS system, patients with headache who arrive by EMS are more likely to have serious causes. Mode of arrival may be of use to the clinician in assessing risk of serious illness among patients with headache. Whether this observation represents an element of self-triage or a combination of other factors remains to be determined.
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To evaluate prehospital and receiving emergency department (ED) analgesia administration in air-transported patients with isolated fractures. ⋯ Some patients receiving intratransport fentanyl received no ED analgesia, and those who did receive ED analgesia often had administration delays surpassing the clinical half-life of intratransport-administered fentanyl. Further study should investigate whether setting-specific analgesia practice differences reflect true differences in analgesia needs, overmedication by prehospital providers, or undermedication by ED staff.