Articles: emergency-medical-services.
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Helvetica chirurgica acta · Jul 1991
[Helicopter and emergency physician at the accident site. Medical comparison between altitude and flat land emergency care].
In-field intensive care reduces lethality and morbidity in severe trauma. We analyze and compare 400 medical helicopter rescue flights in the region of Basel and 325 medical air-rescues in the mountains of Interlaken. The presence of a physician in the helicopter is based on an interventional concept, with clinical diagnosis, monitoring and early intensive in-field care. ⋯ In spite of high rates of severe conditions in both regions (57% in Basel, 17% in the mountains), the low mortality prior to and during air transport (2.5% in the Basel and 2.7% in the Interlaken region) confirms the necessity of the concept of early in-field intensive therapy. This concept allows good analgesia, is save and comfortable for the patients. The presence of a physician in the air rescue team has to be recommended not only for rescues in the plain, but also in the mountains.
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To determine the outcome of out of hospital defibrillation in Scotland during the year after the introduction of automated external defibrillators in October 1988. ⋯ An effective scheme for out of hospital defibrillation can be introduced rapidly, and with limited training implications and costs, by the use of automated external defibrillators in ambulances.
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Pediatric emergency care · Jun 1991
Difficulties encountered in transport of the critically ill child.
A prospective survey of difficulties encountered in 100 pediatric emergency interhospital transfers was undertaken to identify needs for education of referring doctors and of transport service staff, as well as weaknesses in the organization of a pediatric emergency transport service (PETS). Such obstacles to smooth retrieval included administrative difficulties, mistakes in management, and unresolved acute severe physiologic derangements in the child. ⋯ Difficulties owing to conditions of transport (eg. vibration, dysbarism, and air turbulence) were uncommon (five percent of patients). Regular reviews of performance of all PET services, combined with measures to educate referring doctors, can improve patient outcome.