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 assess regulatory trends in EMS medical direction by examining state EMS legislation and regulations, and legal qualifications for medical direction. ⋯ There is tremendous variation in regulatory requirements for physician participation in EMS medical direction activities at the ALS level. Few states have specific training or background requirements for the provision of OLMC, and a requirement for board certification in emergency medicine is the exception, not the rule.
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Randomized Controlled Trial Clinical Trial
A randomized, controlled trial of the efficacy of closed chest compressions in ambulances.
To examine the feasibility of closed chest compressions in ambulances. ⋯ The percentage of correct compressions in all the vehicles tested was lower when compared with the percentage on the ground, and the increase in heart rate was higher. Only one of these results was statistically significant. A further study with more participants seems warranted.
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Routine vital signs assessment is considered a fundamental component of patient assessment. This study was undertaken to determine whether advanced life support (ALS) emergency medical services (EMS) providers depend on vital signs information in managing their patients. ⋯ The presence or absence of vital signs information does influence some of the patient care decisions of EMS providers; however, the clinical implications of these decisions are unclear. Further studies are needed to determine whether ALS providers can adequately manage actual patients without obtaining vital signs.
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To determine whether the presence of an on-scene medical control physician (OSMCP) alters the management and outcome of out-of-hospital nontraumatic, nonasystolic cardiac arrest (CA) patients. ⋯ Out-of-hospital CA patients treated in the OSMCP group had a trend toward more frequent ROSC upon ED arrival and a higher rate of survival to hospital discharge. The OSMCP group patients received medications at nearly twice the rate of the PO group patients. Although a larger trial is needed, more frequent dosing of drugs during CA may have contributed to increased survival in the OSMCP group.