Articles: emergency-medical-services.
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The hospital of Brugge relies on selection of the emergency calls and sends a Mobile Intensive Care Unit (MICU) whenever cardiac arrest (CA) is suspected. The University Hospital of Leuven does no selection of calls and responds to every emergency call by sending an ambulance with an advanced life support (ALS) trained nurse. The MICU is called when the ambulance crew recognizes the emergency to be a CA. ⋯ On the contrary, low versus high bicarbonate dosage has hardly any influence on immediate success (restoration of spontaneous circulatory activity) but low bicarbonate dosage favours long-term success (survival accompanied by recuperation of brain function). Our data support a negative effect on long-term survival with recuperation of consciousness from infusion of more than 1 mEq/kg body weight of sodium-bicarbonate during CPR. No final conclusions can be drawn so far as to the mechanisms of this negative effect at the level of the brain.
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In-flight medical emergencies were evaluated among passengers arriving at Los Angeles International Airport (LAX) from October 1985 through March 1986. All emergency department, LAX first-aid station, and paramedic records were examined. There were 8,735,000 passenger arrivals at LAX during the study period; 260 passengers (0.003%) developed medical complaints in flight, and of these 260, 115 (44.2%) had symptoms that lasted for more than one hour. ⋯ Most of the illnesses encountered did not require advanced medical treatment. We conclude that while in-flight medical illnesses occur more frequently than believed by airlines, true emergencies are rare. The rarity of true in-flight medical emergencies coupled with low physician availability bring into question the benefit of any comprehensive medical kit on airliners.
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National attention has been directed to the problem of "dumping" of uninsured patients upon public hospitals. Federal law addresses only transfers of emergency room patients without regard to possible financial motivation. ⋯ Both the hospital and the physician responsible for the care of a patient who is transferred in violation of the law may be subject to Medicare sanctions, including termination or suspension from participation and fines up to $50,000 for each occurrence. Proposed regulations affirm that private practitioners who provide uncompensated emergency room services under an oral agreement may be subject to sanctions in the event of a violation.
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Data about the number and treatment of trauma-patients are, certainly in our country, very rare. In this study we showed that such a registration with grading of the severity of the injuries following the ISS-Score is feasible and useful. Further and more extensive registration seems necessary in order to obtain a better insight in epidemiology and treatment of trauma patients in our country.
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Triage nursing is evolving as a subspeciality of emergency nursing. Of the five major types of triage systems in use, four utilize nursing personnel. The Advanced Triage System is the most comprehensive system and is utilized in the Emergency Department at Harbor-UCLA Medical Center. This article defines the process of triage, reviews various types of triage systems and discusses the role of the triage nurse in the Advanced Triage System utilized at Harbor-UCLA Medical Center.