Articles: emergency-medical-services.
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During an 18-month study period, the mobile intensive care unit (MICU) in Jerusalem responded to 307 pediatric emergencies, representing 5% of the total MICU case load. The most common medical problems were seizures, diagnosed in 100 cases (32%), and conditions related to trauma, diagnosed in 77 cases (23%). Forty-one cases (13%) were cardiac arrests. ⋯ Eighteen cardiac arrest patients (82%) were found in asystole, and most had previous serious medical problems. Based on our experience children are less likely to require or benefit from advanced levels of prehospital care compared to the adult population. When resources for advanced care are limited, priority should be given to adult emergencies.
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Vestn. Khir. Im. I. I. Grek. · Jul 1985
Review Comparative Study[Surgical treatment of injuries abroad (review of foreign literature)].
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From 1972 to 1982 there was a 23.9% decline in the number of deaths due to trauma in Nebraska. During this time, an improved emergency medical services (EMS) system was being implemented, including training of EMT's and paramedics, physician education in advanced trauma life support (ATLS), establishment of three helicopter transport services, and designation of trauma centers in the two most populous (of six) EMS regions. ⋯ We found that growth of the EMS system, as measured by the cumulative number of EMT's trained, correlated strongly with the decline in prehospital (r = 0.95; p less than 0.001), in-hospital (r = 0.84; p less than 0.001), total (r = 0.95; p less than 0.001), vehicular (r = 0.86; p less than 0.001), and nonvehicular (r = 0.93; p less than 0.001) trauma deaths. Our findings suggest that improvements in the statewide EMS system along with better hospital care have caused a significant decline in the number of trauma deaths over a 14-year period.
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The field identification of the patients who should be taken to trauma centers is a major problem of trauma care. This study appears to be the first to use multivariate analysis to systematically design a field triage instrument and to evaluate its performance in terms of a meaningful and plausible criterion for which patients ought to be treated at trauma centers. Four new triage instruments were created and their performance compared to that of two existing measures, the Trauma Score and the CRAMS scale. ⋯ The one purely physiologic instrument tested appeared to be inferior to instruments that included anatomic and historic as well as physiologic indices. Simple checklists performed approximately as well as weighted scales. No instrument was found to be high in both sensitivity and positive accuracy.