Articles: emergency-medical-services.
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Since 1982 the St. Radboud hospital, Nijmegen, has a contiguity plan for peace-time disasters which describes the way to deal with great numbers of patients of traffic-, environmental- or industrial-calamities. ⋯ Also is indicated how to organise communication between hospital, municipality, police and fire-brigade. The plan also provides possibilities for information towards press and relatives of the victims.
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Survival to hospital discharge was related to the clinical history and emergency care system factors in 285 patients with witnessed cardiac arrest due to ventricular fibrillation. Only the emergency care factors were associated with differences in outcome. ⋯ Expected survival rates were higher with early defibrillation (38 +/- 3%; 95% confidence limits) than the observed rate (28 +/- 3%). Because outcome from cardiac arrest is primarily influenced by delays in providing cardiopulmonary resuscitation and defibrillation, factors affecting response time should be carefully examined by all emergency care systems.