Articles: emergency-medical-services.
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The objective of this study was to prospectively determine the utility, efficiency, and reliability of early prehospital 12-lead electrocardiogram (ECG) application, the improvement in prehospital diagnostic accuracy, and paramedic and base physician opinions regarding early application of prehospital 12-lead ECGs in a broad range of stable chest pain patients. The patient population consisted of cooperative, stable adult prehospital patients with a chief complaint of nontraumatic chest pain of presumed ischemic origin. From July 17, 1989 through January 1, 1990 paramedics acquired prehospital 12-lead ECGs on 680 stable adult chest pain patients. ⋯ Paramedic application of prehospital 12-lead ECGs was found to be efficient and reliable, and it can be applied to most cooperative stable adult prehospital chest pain patients. Prehospital 12-lead ECGs significantly improve base physicians' diagnostic accuracy in myocardial infarction, angina, and nonischemic chest pain patients. Paramedic and base physicians' opinions regarding early application of prehospital 12-lead ECGs during patient evaluation were favorable.
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The lesions produced by the expansive wave are characteristic of severe injury produced by explosion. This type of injury is being classified as primary lesion. ⋯ In the discussion section we analyze the physical mechanisms leading to this primary lesion and we indicate the organs most commonly affected. We rise general considerations dealing with the management of these patients and we remark the advantages of a coordinated medical attendance policy.