Articles: emergency-medical-services.
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Evaluation of the burned patient in the emergency department and fluid resuscitation of burned patients are discussed in detail.
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A surveillance system identified all out-of-hospital cardiac patients under the age of 18 who received emergency care in suburban King County, Washington. The etiology, cardiac rhythm, and outcome were identified for each case. During a 6 1/2-year period, 119 cardiac arrests occurred (annual incidence, 12.7/100,000 among individuals less than 18). ⋯ Six percent of patients treated with basic EMT care were discharged, compared with 7% of patients treated with EMT and paramedic care. In contrast to resuscitation from cardiac arrest in adults, the likelihood of successful resuscitation in children is very poor. This is due to different etiologies and the higher proportion of asystole seen in pediatric cardiac arrest as compared with adults.
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One hundred seventy-eight endotracheal intubations by paramedics were reviewed prospectively during a nine-month period; 149 patients (83.7%) had medical conditions, and 29 (16.2%) had trauma. The endotracheal tube was successfully placed in 172 (96.6%); in four patients (2.2%), attempts were unsuccessful, and in two patients (1.1%), the attempt was aborted. ⋯ We conclude that endotracheal intubation can be accomplished successfully outside the hospital by paramedical personnel. Comprehensive training and continuous medical control of paramedics' activities seem to be essential requirements for its success.
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Vestn. Khir. Im. I. I. Grek. · Oct 1983
[Organization of medical services for patients with severe mechanical trauma].
Analysis of the work of surgical-reanimation teams of the Accident Station and the City Shock Center has shown that their joint activity can provide modern level of giving help to patients with traumatic shock. In organization of work of the City Shock Center of great importance is the distribution of duties among the team members.