Articles: emergency-medical-services.
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There is often misunderstanding and conflict between the emergency physician and paramedic team, particularly as a new system is being implemented. This paper outlines a four-pronged approach to reduce this conflict: 1) community physician involvement in protocol development by means of a Paramedic Policy and Procedures Committee; 2) clinical training of paramedics in community hospitals; 3) involvement of community physicians in primary training and by riding rescue squads; and 4) formulation of a base station physician course to familiarize physicians with radio technique, system operation, and paramedic field work. An outline of the base station physician course is given and discussed. The reactions and outcome of the course and the positive changes it made in both physician and paramedic attitudes are discussed.
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There is an increasing demand for improved, up-to-date training and equipment for ground ambulance services across Canada. This paper presents the results of a survey of ambulance operations and their funding by the provinces, as well as a comparison of provincial legislation and recommendations on standards for equipment and the training of ambulance personnel. ⋯ The cost of ambulance services per capita and the cost to the user of an average 43-km run varied widely between the provinces. There was no correlation between the second cost and how well the province met the ACSCT's equipment standards.
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The Nuneaton derailment presents some unique problems as well as more common ones. The deployment of services presents a challenge and interrelationships are important (Keep, 1966). This challenge was mainly well met at Nuneaton, though there were difficulties in organizing medical care at the scene. ⋯ Instructions to staff should be revised and new staff briefed on arrival. Reliefs must be arranged and should be labelled and have job cards passed on to them. Abbreviated colour-coded action cards might be useful.
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The population is well aware today that the emergency doctor holds a strong position in the field of preclinical care. The time of onset of expert care of the emergency patient is of great significance in regard to survival and prevention of further damage. ⋯ In respect to content and form of training a proposal has been made representing a minimal requirement. It should be assured in modern day ambulance care that only qualified physicians participate who are familiar with the special situations encountered in emergency medicine.