Articles: emergency-medical-services.
-
Prehospital patient management decisions are complex because the traumatized patient population is heterogeneous with respect to demographics, mechanism of injury, physiological response to injury, and time from injury to medical care. One hundred and nine blunt trauma patient evaluations by paramedics in a county-wide semirural emergency medical services (EMS) system were analyzed to determine paramedic time on the scene and the factors that might influence onscene time. Onscene time linearly correlated with a prolonged transport time. ⋯ However, patient groups with either a low TS or a low GCS score showed no significant improvement in TS with increasing onscene time. Without a strict management algorithm, paramedics use a variety of cues to guide their actions during the onscene management of blunt trauma. Future studies should address the impact of strict management algorithms on onscene time and ultimate patient outcome.
-
Prehospital trauma triage should permit accurate identification and transport of patients with critical injuries to trauma centers without overloading these centers with patients having minor injuries. In most trauma systems a combination of physiologic criteria (Trauma Score [TS]), mechanisms of injury (MOI), and anatomic injury (AI) are used as prehospital trauma triage criteria. The purpose of our study was to assess the predictive value of specific MOI and AI in detecting critically injured trauma victims (Injury Severity Score [ISS] of more than 15) and determine the best combination of TS, MOI, and AI that produced the lowest percentage of undertriage and overtriage. ⋯ A total of 97 patients had an ISS of more than 15. Three hundred forty-one (23%) had one of the specific MOI studied; 102 (6.9%) had one of the specific AI studied. Four hundred twelve patients (28%) had at least one of the study MOI or AI.(ABSTRACT TRUNCATED AT 250 WORDS)
-
All out-of-hospital cardiac arrest advanced life support (ALS) trip sheets were collected from January 1980 through December 1985 for this suburban-rural system. Information was extracted according to a uniform reporting format. ⋯ This study supports the need for early CPR in the prehospital care of potential sudden-death victims. We recommend, with qualification, this reporting format to emergency medical services systems to describe their cardiac arrest experience.