Articles: emergency-medical-services.
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Clinical cardiology · Mar 1990
ReviewRole of the emergency department in decreasing the time to thrombolytic therapy in acute myocardial infarction.
Delay from the onset of acute myocardial infarction (AMI) symptoms to initiation of thrombolytic therapy can be reduced by improving patient recognition of AMI symptoms and encouraging speedier action in seeking medical assistance and improving the time it takes for medical personnel to evaluate the patient's symptoms and initiate appropriate therapy. Attempts to improve patient response to AMI symptoms have met with limited success. Prehospital administration of thrombolytic drugs may be of value, but many AMI patients are not transported by the emergency medical services system. ⋯ Unfortunately, much of what is known about the time sequence of ED thrombolytic therapy in the United States comes from organized trials in a small number of centers. Little is known about how often non-ED physicians participate in the decision-making process (either in person or by phone consultation), or how many delays are potentially avoidable. Current evidence suggests that preestablished ED treatment plans and protocols can reduce the time delay for many patients who present with AMI, especially if paramedics can transmit diagnostic quality ECGs to the hospital.
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The Flying Squad of the Accident and Emergency Department, of the Derbyshire Royal Infirmary, was established in 1955 by Collins. The initial function was to provide emergency care to victims of industrial accidents. ⋯ The outcome in medical emergencies is reported as dismal (Robertson & Steedman, 1985; Rowley & Collins, 1979) yet the number of calls for the flying squad to attend medical emergencies are many. Previous reports have recorded 20-30% of Squad calls responding to medical emergencies (Gorman & Coals, 1983; Rowley & Collins, 1979; Steedman & Robertson, 1986; Harrop & Bodiwala, 1983).
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Vestn. Khir. Im. I. I. Grek. · Mar 1990
[Principles of the treatment of patients with combined injuries and multiple fractures].
Based on an experience with 597 patients the authors have formulated main principles of treatment of poly-traumas. Nine groups of patients were established depending on the severity of polytrauma. ⋯ It should be performed rapidly, atraumatically and without blood loss. The application of apparatuses of external fixation on the basis of wires is thought to be expedient at this period.
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Vestn. Khir. Im. I. I. Grek. · Mar 1990
[Organization of medical services for the victims of the earthquake in the city of Spitak, Armenian S.S.R].
Sanitary losses in the city of Spitak were about 47.8%, injures of the middle and critical degree being diagnosed in 9.5%. During the first period (from December 9 to 14, 1988) patients admitted to the hospitals predominantly had traumas of the head, chest, extremities, vertebral column (86.3%). ⋯ Success of treatment of the patients with this pathology was promoted by their having obtained qualified surgical and anesthesiological aid before evacuation to medical institutions of the Center in full value in combination with temporary admittance to the hospital at an average for 12-18 hours up to complete arrest of shock. During the first steps of evacuation the amputation of extremities was fulfilled in 3 cases.