Articles: emergency-medical-services.
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Prehosp Disaster Med · Apr 1993
Comparative StudyComplication rates for the esophageal obturator airway and endotracheal tube in the prehospital setting.
The purpose of this study was to determine the complication rates associated with the use of the endotracheal tube (ET) and the use of the esophageal obturator airway/esophageal gastric tube airway (EOA/EGTA) during the treatment of patients with prehospital cardiac arrest. ⋯ The complication rate for the EOA/EGTA is unacceptably high, and careful thought must be given to its continued use.(ABSTRACT TRUNCATED AT 250 WORDS)
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Prehosp Disaster Med · Apr 1993
Ethical challenges in emergency medical services. A special contribution of the Ethics Committee, National Association of Emergency Medical Services Physicians.
Patient autonomy, beneficence, and justice are the fundamental ethical principles of an emergency medical service. Ethical conflicts are present in the daily practice of prehospital care. These conflicts surround issues of resuscitation, futile therapy, consent, and refusal of care, duty, and confidentiality. ⋯ Many learn by experience, some are guided by clear policy. Ideally, medical control personnel will be educated, interested, and available to address dilemmas which arise. Where possible, policies and procedures should be developed to address ethical issues which are likely to be faced by EMS personnel.
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The study objective was to determine if pulse oximetry readings obtained during helicopter transport were indicative of subsequent arterial blood-gas measured saturations. A prospective study design was chosen. Data were gathered on a convenience sample of patients 18 years and older not under cardiopulmonary resuscitation; 101 patients were used for the study. ⋯ There was also no significant difference between the patient's heart rate sensed by the pulse oximeter and the simultaneous palpated pulse rate. Percent saturation readings by repeated measures were statistically different (p < 0.05) showing a minimal improvement in saturation over time. Based on this study's findings, the authors feel the pulse oximeter can be a valuable adjunct to patient care during helicopter transport.
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Advanced Trauma Life Support requires surgical airway techniques to be used in patients when oral or nasal intubation is impossible or contraindicated. Few reports have examined the results of surgical cricothyroidotomy in prehospital trauma management. During a 12-month period, 600 patients were seen and treated by the Helicopter Emergency Medical Service medical team. ⋯ Three patient later died in hospital and four (37 per cent) survived. Three of the survivors made a good recovery, including one who was in cardiorespiratory arrest at the scene, and one remains severely disabled. Surgical cricothyroidotomy is a life-saving procedure in prehospital trauma management that must be performed without delay or hesitation if conventional airway manoeuvres are impossible or fail.
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Objectives of this study were to determine the number of prehospital emergency patients who were given advanced life support (ALS) drugs and to compare utilization rates for ALS drugs in urban and rural environments. Certified ALS emergency medical technicians (Arizona) have 29 therapeutic agents authorized for prehospital administration. These agents may be administered only under direction of a medical control authority or by following standing orders. ⋯ Severity of illness or injury prompted administration of ALS drugs to 8.1% of patients receiving prehospital emergency care. The most frequently utilized medication in the urban/rural areas was for treatment of cardiac symptoms. Variations between urban/rural drug utilization reflected the drugs of choice which are compatible with long transport times to a medical facility.