Articles: emergency-medical-services.
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The demands made upon the Bristol obstetric flying squad over the past 14 years have been analysed. During this period, the number of calls received per year has decreased dramatically. ⋯ Of importance to anaesthetists is the gross reduction in the number of cases where it is necessary to give anaesthesia 'in the field'. This may lead to complacency and lack of familiarity with the equipment carried by the flying squad.
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Prompt identification of cardiac arrest by emergency dispatchers can save valuable time and increase the likelihood of successful resuscitation. The authors reviewed 516 cardiac and 146 non-cardiac calls to identify features of a probable cardiac arrest call. ⋯ When the patient is over 50 years old and the caller is emotional, the possibility of cardiac arrest is high, suggesting that questions about consciousness and breathing should be asked immediately. Additional information can be obtained or telephone cardiopulmonary resuscitation (CPR) instructions can be given after dispatch of an emergency vehicle.
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Triage of potentially injured patients to the appropriate trauma hospital was carried out using mechanism of injury as a triage criterion rather than physiologic changes (trauma score). Injury mechanism includes field evidence of high energy transfer, such as falls of more than 15 feet, automobile accidents with structural intrusion, extrication difficulties, passenger ejection, or death at the scene. ⋯ Methods of evaluation of overtriage and undertriage are presented, but accepted standards for these must be addressed in each trauma system. Injury mechanism as a primary trauma triage criterion is an acceptable means of identification of potential injury for transport to a trauma facility.