Articles: emergency-medical-services.
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The ability to recognize symptoms, to make priority decisions, to dispatch suitable ambulance transport and inform the crews, and finally, to initiate first aid via the caller is essential for optimum care of severely injured or ill patients outside the hospital. In Sweden, a special job-related course trains dispatch-center personnel to think in terms of symptoms and evolution of the victim's status, and to assess the level of seriousness.
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Of the three phases of disaster response, the primary phase (immediate postincident to six hours thereafter) represents the core of the EMS-augmented response to save lives. Activities during this phase include triage, victim control and stabilization, communications, and transportation. To cope successfully with the mass casualties of an actual disaster, special emergency forces must be trained (and rehearsed) to act together as a team to treat the critically ill and injured.
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The authors discuss the indications for emergency carotid endarterectomy, based on their experience between 1956 and 1975 when 15 patients with completed stroke and internal carotid occlusion (Group I) underwent this operation, and after 1975 when emergency revascularization was performed in 22 patients with unstable neurological deficit (Group II) and 21 patients with TIA's associated with preocclusive internal carotid stenosis (Group III). The good early and late results show that surgery was indicated in these cases. An attempt to identify the patients at high risk of acute ischemia on the basis of clinical or anatomical findings is made to ascertain the physiopathologic patterns of cerebral ischemia.