Articles: emergency-medical-services.
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The Emergency Medical Service system must provide prompt CPR, early defibrillation and full advanced cardiac life support (ACLS) within the time 'window of effectiveness.' Timely availability of these combined components determines the chance for survival.
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Dtsch. Med. Wochenschr. · May 1991
Comparative Study[Prognostic significance of prehospital phase in acute myocardial infarct. Results of the Augsburg Myocardial Infarct Registry, 1985-1988].
Data collected by the Augsburg Infarct Register during 1985-1988 were analysed. There were 3,729 cases of acute myocardial infarct (2,672 men and 1,057 women; mean age 62.8 [25-74] years). Before hospitalization cardiac arrest had occurred in 1,401 persons (38%); resuscitation attempts were made in 494 of them (34%). ⋯ This caused decisive delays. The thrombolysis rate was 24%, if the pre-hospital interval was under 6 hours (mortality rate 6% with, 12% without thrombolysis). The prognosis of acute myocardial infarction could be improved by specific instructions to high-risk patients and their relatives and by widening emergency care provisions.
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HMO practice / HMO Group · May 1991
After-hours telephone triage. Recruitment, training and retention of personnel.
Harvard Community Health Plan's nighttime telephone triage program, currently known as Telecommunications, has evolved through several stages, corresponding to HCHP membership growth, technological enhancements, and changes in the medicolegal environment. Recruiting, training, and retaining staff for nighttime telephone triage are discussed.
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The costs of an after-hours triage service and potential savings for a medium-sized (90,000 member) division of an HMO are presented. Other benefits are also described, including access to member medical records and coverage information, direct-linked telephone conferencing, and more personalized and continuous care.
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The beginnings of organized emergency care can be traced through military history dating back to the Middle Ages. In 1769, the first civilian rescue society was established to look after shipwrecked persons. Sociological and technical requirements of the late 19th century led to the formation of different rescue associations and to writing of regulations for rescue and ambulance services. ⋯ Today the rescue service functions to bring a physician, often an anesthesiologist, to the victim as quickly as possible. Modern rescue laws fix a lead time of 5 to 15 minutes for a professional rescue service to reach the scene. The medical equipment and qualifications of personnel treating life-threatening trauma and diseases have improved, and in this context, the role of the anesthesiologist is important.