Articles: emergency-medical-services.
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To describe the patient characteristics, circumstances and community response in cases of out-of-hospital cardiac arrest; to evaluate the effect on survival of the introduction of prehospital defibrillation; and to identify factors that predict survival. ⋯ The survival rate was lower than expected. The availability of prehospital defibrillation did not affect survival. To improve survival rates after cardiac arrest ambulance response times must be reduced and the frequency of bystander-initiated CPR increased. Once these changes are in place a beneficial effect from advanced manoeuvres such as prehospital defibrillation may be seen.
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Little attention is being paid to the special needs of elderly persons in emergency departments. Emergency health care professionals feel less comfortable caring for elderly than for nonelderly patients. The social and personal concerns of the elderly frequently are not addressed in ED encounters. ⋯ These problems are particularly important at this time because many hospitals and their EDs are faced with significant problems of overcrowding and inadequate resources to meet the health care needs of the communities they serve. Although the elderly are the fastest-growing segment of the population, little or no planning is ongoing to meet the emergency health care needs of the elderly in the future. The task force has provided specific recommendations for addressing these problems.
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Although intracerebral hemorrhage is one of the most serious complications during oral anticoagulant therapy, there are no guidelines on emergency treatment with respect to reversal of anticoagulation effect in these patients. ⋯ Treatment with prothrombin complex concentrate reverses anticoagulation more rapidly than fresh-frozen plasma, which might be of importance for the prevention of further bleeding.