Articles: emergency-medical-services.
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Four hundred sixty-three cases of cardiac arrest treated in the pre-hospital setting by advanced life support (ALS) or paramedic units in Monroe County, New York, were evaluated using Eisenberg's criteria, which define factors known to be critical for successful resuscitation. Forty-eight patients met the criteria of witnessed collapse and cardiopulmonary resuscitation (CPR) within four minutes and ALS within ten minutes, with the initial rhythm of ventricular fibrillation or pulseless ventricular tachycardia. Of these, 16 (33%) patients were discharged from the hospital. ⋯ Of the 171 patients who suffered witnessed arrests of cardiac origin, 20 survived to be discharged. This represents a successful resuscitation rate of 12%. These percentages are within the range noted for other ALS services in the United States.
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This paper describes the process involved in establishing the nurse practitioner services at Oldchurch Hospital, Essex. It also contains an evaluation of the safety of such a practice and outlines the current operational guidelines.
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British heart journal · Dec 1989
Integration of ambulance staff trained in cardiopulmonary resuscitation with a medical team providing prehospital coronary care.
Ambulance staff with advanced training in cardiopulmonary resuscitation and equipped with monitor/defibrillators were used as the initial responders to collapse calls within a medically based prehospital coronary care system. During 21 months, in a population of approximately 120,000, ambulance staff successfully resuscitated six patients from ventricular fibrillation; there were four long term survivors. The median response time of emergency ambulances to collapse calls was eight minutes compared with 20 minutes for the medically manned mobile coronary care unit. ⋯ Nineteen other patients with important arrhythmias were referred for earlier medical management which in some cases may have saved lives. An additional eight long term survivors of out of hospital ventricular fibrillation were resuscitated by medical staff. The integration of paramedical with medical prehospital coronary care improved survival after out of hospital cardiac arrest.
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Aviat Space Envir Md · Dec 1989
Response capability during civil air carrier inflight medical emergencies.
Expanded civil aircraft medical emergency kits have been mandated on U. S. carriers since August 1986. Airlines provided the Federal Aviation Agency reports on medical kit usage and outcomes of the associated medical emergencies; 1,016 inflight medical events during the period August 1, 1986, through July 31, 1987, were available for review. ⋯ A minimum of 89 of the total cases resulted in flight diversions. The sphygmomanometer (739 cases) and stethoscope (734 cases) were the most frequently used kit items; oropharyngeal airways were utilized in 14 cases. Since standardized reporting formats are not required, evaluation of response capability remains incomplete.