Articles: emergency-medical-services.
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One hundred eighty-seven cases of cardiac arrest of presumed cardiac etiology were analyzed to determine factors associated with successful out-of-hospital management by paramedic teams. Field and in-hospital records were reviewed to determine the response time of the advanced life support team, the ECG rhythm on arrival, the presence of paramedics on scene at the time of the arrest, whether bystander CPR had been initiated, and the eventual outcome of the resuscitation attempt. ⋯ When the advanced life support team arrived in less than four minutes, survival rates in the VF/VT group and "OTHER" rhythms group were 23.1% and 7.7%, respectively. When the field team arrived in less than four minutes and a bystander was performing CPR, the survival rates were 42.9% in the VF/VT group and 15.8% in the "OTHER." These data suggest that efforts to improve survival from out-of-hospital cardiac arrest in a community should be directed toward public education, reduction in response times of paramedic units, and lay CPR training.
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Acta Anaesthesiol Belg · Mar 1984
Mechanical ventilators for emergency medical care using. A manual resuscitation bag.
It is possible to construct a mechanical ventilator from the parts of a selfinflating resuscitation bag, in combination with a magnetic valve. These ventilators prove to be very helpful for transport of critically ill patients, of all categories, under various conditions. ⋯ The ventilators are cheap and reliable, with a stable performance but more sophisticated patterns of ventilation necessitate the use of volume and pressure monitoring. The mode of action of the ventilator, the compliance of different reservoir bags and the place of the mechanical monitor devices are discussed in this article.
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Clinical Trial
Prehospital defibrillation performed by emergency medical technicians in rural communities.
Survival after out-of-hospital cardiac arrest is poor in communities served only by basic ambulance services, but conventional advanced prehospital care is not an option for most rural communities. Ambulance technicians in 18 small communities (average population, 10,400) were trained to recognize and defibrillate ventricular fibrillation. Neither endotracheal intubation nor medication was used. ⋯ In the communities where early defibrillation was available, 12 of 64 patients (19 per cent) who were found in ventricular fibrillation were resuscitated and discharged alive from the hospital; this was true of only 1 of 31 such patients (3 per cent) in the control communities, where only basic life support was available (P less than 0.05). Ten (83 per cent) of the long-term survivors received electrical shocks administered solely by the technicians. Early defibrillation by minimally trained ambulance technicians is an effective approach to emergency cardiac care in rural communities.