Articles: emergency-medical-services.
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In a study of 200 patients with chest wounds in whom the need for referral to a centre with radiographic facilities was not obvious, careful clinical examination (pulse, blood pressure, respiratory rate, haemoglobin value and chest auscultation) was found to be a reliable triage tool. The sensitivity of one or more positive signs was 99.2% with a false-positive rate of 16% and a false-negative rate of 2%. The positive predictive value of two or more positive signs was found to be 99.1%.
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The survival rate for patients with prehospital cardiac arrest has improved in some communities with early defibrillation by emergency medical technician-defibrillators (EMT-Ds). In rural areas, previous studies on survival with defibrillation by EMT-Ds have been variable. We conducted an EMT-D study to determine effectiveness in various prehospital settings. ⋯ The neurologic status of survivors at time of hospital discharge was normal in 72%. The average response time, defined as time of emergency medical services activation to the time of EMT-D arrival, was 7.3 +/- 5.8 and 3.7 +/- 2.0 minutes for nonsurvivors and survivors, respectively (P less than .002). There were no survivors when the response time was more than eight minutes.(ABSTRACT TRUNCATED AT 250 WORDS)