Articles: emergency-medical-services.
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A simple 10-point scale was devised for the purpose of determining which trauma patients should go to a trauma center. The acronym "CRAMS" represents the five components measured: Circulation, Respiration, Abdomen, Motor, and Speech. The results of field triage were compared to final emergency department (ED) disposition. ⋯ This was compared to 8 defined as major trauma by Champion's Trauma Score. Of 313 defined as minor trauma by ED disposition (discharged home), 307 were defined as minor trauma (CRAMS greater than or equal to 9) in the field (specificity, 98%). The CRAMS scale provides an effective net for major trauma while ensuring that minor trauma is not unnecessarily diverted to a trauma center.
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Ann. N. Y. Acad. Sci. · Jan 1982
Community-based cardiopulmonary resuscitation: what have we learned?
During the past 9 years, more than 175,000 residents of Seattle have received basic training in cardiopulmonary resuscitation (CPR). On the basis of experience in that city and of observations from three other communities, there is little doubt that early initiation of CPA by a bystander is associated with a substantially improved survival. In one year, 43% of patients (47/109) found in a state of ventricular fibrillation survived to hospital discharge when bystanders initiated CPR. ⋯ In patients with out-of-hospital ventricular fibrillation, the factors that determine survival are predominantly related to the rapidity with which care is provided, namely, the time from collapse to initiation of CPR and the time to provision of advanced life-support measure. In many communities a 50% survival rate from ventricular fibrillation is probably attainable. Further improvement might accrue from the extensive deployment of inexpensive defibrillators capable of detecting ventricular fibrillation and suitable for use by the general public.