Articles: emergency-medical-services.
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The Connecticut helicopter emergency medical service (HEMS) has responded to 12 mass casualty incidents (MCI) in two years. Eight were drills and four were actual events. An MCI response plan was instituted prior to the onset of the HEMS program. ⋯ The roles of the HEMS in each MCI were: triage (n = 4), medical treatment (n = 4), transport (n = 3), augmented response (n = 1), and air surveillance (n = 0). The roles of HEMS response to MCI should be well-defined prior to an event. Air medical benefits include response within a large geographic area, highest level of prehospital medical care, identification of trauma receiving hospitals, and facilitation of transport.
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Pediatric emergency care · Dec 1990
Adoption of intraosseous infusion technique for prehospital pediatric emergency care.
A telephone survey was conducted, contacting 51 designated state EMS offices, to determine the extent of use of intraosseous (IO) infusions in prehospital pediatric emergency care nationally and to identify common means of promoting IO adoption, training EMS personnel, and monitoring intraosseous field use. Less than half of the respondents reported actual prehospital use of IO infusions in pediatric patients, and an additional third indicated that they were unaware of any future plans for introducing the technique into EMS practice. This study's documentation of the current limited prehospital use of intraosseous infusions indicates a need for concerted efforts to promote broad adoption and continued evaluation of the IO technique in prehospital pediatric emergency care. Suggestions to enhance adoption include increased utilization of existing successful IO teaching approaches, development of national EMS standards regarding intraosseous infusions, active involvement of EMS regulatory agencies for widespread practice changes, and consistent quality assurance activities.
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These guidelines were developed as national EMS voluntary standards to: 1) Establish standard nomenclature for levels of aeromedical crew members; 2) Define the training requirements for each level; 3) Define the medical control requirements for aeromedical crew members; 4) Describe the application of the standards; and 5) Describe the general content areas of the training of aeromedical crew members. The AMA Commission on EMS has reviewed the current draft of the proposed national EMS voluntary standards and decided to accept them for inclusion in this second edition of the Air Ambulance Guidelines with the expectation that the final version of the ASTM Committee F-30 standard will be essentially the same as the current draft standard. The guidelines are designed to acquaint practicing physicians, especially those practicing in rural and remote areas, with the following factors which affect the transportation of patients by air ambulance: 1) Risks to the patient flying at high altitudes; 2) Equipment, both general and specific, required to render anticipated care; 3) Qualifications of personnel aboard the air ambulance, and the level of care required in transit; 4) Care required for specific medical and surgical conditions during flight.
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1) Identification of marginal costs associated with prehospital resuscitation of cardiopulmonary arrest; 2) Determination of cost effectiveness for such resuscitation; and 3) Comparison of cost effectiveness of paramedic care with selected other medical interventions. ⋯ Out-of-hospital treatment by paramedics of cardiopulmonary arrest is more cost effective than heart, liver, bone marrow transplantation, or curative chemotherapy for acute leukemia.
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Connecticut medicine · Dec 1990
Comparative StudyA comparison of ground paramedics and aeromedical treatment of severe blunt trauma patients.
This study compared a hospital-based aeromedical program to a ground paramedic service in order to determine whether the element of prehospital time or prehospital care is the major contributor towards improved survival. One hundred twenty-six severe blunt trauma patients were studied. There were 93(73.81%) transported by air and 33(26.19%) transported by ground. ⋯ The air patients had a higher percentage of intubated patients (42% vs 3%) and use of PASG(56% vs 30%). There was no significant difference in the prehospital times of either the air or ground services once they had arrived at the scene. Since the scene time of both services is similar, the improved survival of the air patients may be due to the technical intervention procedures performed.