Articles: emergency-medical-services.
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Public health reports · Jan 1990
Report on the International Conference on Emergency Health Care Development.
Emergency medical services (EMS) provide rescue, field stabilization, transportation to medical facilities, and definitive care for persons experiencing medical emergencies. In order to advance worldwide development and refinement of EMS systems, and their integration with emergency preparedness and response programs, the International Conference on Emergency Health Care Development was held in Crystal City, Arlington, VA, August 15-19, 1989. ⋯ Objectives of the conference were to clarify linkages between various levels of emergency response, to present methods for developing or improving EMS systems within societies with different resources, to demonstrate processes by which EMS systems have been developed, and to propose international emergency health care development goals. Topics included development of services in developing nations, case studies of underdeveloped countries' responses to natural disasters, and a method for updating disaster response through use of available medical resources.
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A model study was performed by an economist in Lower Frankonia (a mostly rural area of West Germany with several urban centers) to examine the efficiency and cost-effectiveness of the emergency medical service that included prehospital physician presence. To perform this examination about $3.5 million were spent to improve organization and communication within the local emergency medical service, to purchase additional equipment and further emergency vehicles, and to install prehospital emergency physician service. The median response time was lowered to 6 minutes. This report surveys whether these reforms and extra fundings were beneficial and cost-efficient.
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Of 347 victims of out-of-hospital cardiac arrest 196 (56.5%) died before and 109 (31.4%) after admission to hospital, while 42 patients (12.1%) were discharged alive. The 37 patients (10.7%) discharged without severe hypoxic brain damage were assigned to the group with "good", the remaining 310 patients to the group with "poor outcome". ⋯ Evaluation of the score revealed a specificity of 100% (0.95 confidence interval: 80%-100%) and predictive value of 100% (0.95 confidence interval: 95%-100%). A predictive score for specific identification of victims with poor prognosis can contribute to decision making in out-of-hospital cardiac arrest.