Articles: emergency-medical-services.
-
Current guidelines concerning trauma suggest that cervical spine immobilization be performed on all patients with penetrating wounds of the neck. This study was undertaken to examine the risks and benefits likely to be found when such care is provided in a hazardous environment, such as the battlefield, or the scene of a terrorist attack or domestic criminal action. Data for casualties from the Vietnam conflict were reviewed to determine the potential benefit of cervical spine immobilization on the battlefield. ⋯ Only 1.4% of all casualties who were candidates for immobilization might have benefitted from the care. However, the risk of performing immobilization in a hazardous environment is substantial since about 10% of casualties are incurred while helping other casualties. Mandatory immobilization of all casualties with penetrating neck wounds sustained in an environment hazardous to first aid providers has an unfavorable risk/benefit ratio.
-
In Maryland's coordinated, regionalized emergency medical system, prehospital care is given to an injured or ill person at home, on the street, or in a doctor's office before the patient is transported to a hospital. Prehospital care of patients has advanced significantly since the federal government passed emergency medical service (EMS) legislation in 1966. ⋯ It is reasonable for all hospitals operating a full-service Emergency Department to consider becoming base stations for consultation to prehospital care providers bringing patients to that hospital. This is well within the province of the Emergency Medicine specialist and will provide improved service to patients.
-
A retrospective audit was conducted evaluating the effectiveness of the computerized algorithm-directed triage at Brooke Army Medical Center. A total of 98,086 charts were reviewed. ⋯ Of these, 733 patients (1.2%) were retriaged from the acute care clinic to the ED. Based on these data, we conclude that the computerized algorithm-directed triage, using minimally trained personnel, appears to be an effective system.