Articles: emergency-medical-services.
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Optimal emergency care of the child requires a well-developed EMS-C system. The components are easy to identify. We need macroregions with institutions acknowledging their institutional capabilities for pediatric emergency care and supporting field triage and transfer agreements. ⋯ Comprehensive pediatric emergency care involves integration of emergency stabilization patient care with community and hospital social services, patient education programs (such as Child Life), and comprehensive rehabilitation programs, as well as community accident prevention and basic life support programs. As we strive to develop optimal emergency medical services for our country to best serve our people, comprehensive emergency care of children must have separate consideration from comprehensive emergency care of adults. If we are to assure optimal outcome for the life-threatened child, we need to continuously assess regional needs and capabilities and encourage optimal involvement of health care providers and institutions.
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Despite the maturing of prehospital emergency care over the last 25 years, many controversies still persist. Although EMS personnel now widely recognize that medical cardiac arrest patients and traumatic cardiac arrest patients require different amounts of field stabilization and treatment, there is still no clear answer as to how much stabilization using what treatments is necessary. Similarly, although it is widely accepted that out-of-hospital cardiac arrest with ventricular fibrillation should be rapidly defibrillated, there is no consensus as to who should deliver the countershock and with the use of what equipment. These and many other controversies of prehospital care arise because this field is new and rapidly growing.
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The prehospital index (PHI) is a triage-oriented trauma severity scoring system. This prospective multicenter validation of the PHI was undertaken in response to a favorable pilot study. ⋯ The curves were generated for PHI versus emergency surgery, mortality, surgery and mortality, injury severity score, and ICU admission rate. These data compare favorably with those from previously published, prospectively tested, triage-oriented trauma severity scoring systems.