Articles: emergency-medical-services.
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Clinical cardiology · Mar 1990
ReviewRole of the emergency department in decreasing the time to thrombolytic therapy in acute myocardial infarction.
Delay from the onset of acute myocardial infarction (AMI) symptoms to initiation of thrombolytic therapy can be reduced by improving patient recognition of AMI symptoms and encouraging speedier action in seeking medical assistance and improving the time it takes for medical personnel to evaluate the patient's symptoms and initiate appropriate therapy. Attempts to improve patient response to AMI symptoms have met with limited success. Prehospital administration of thrombolytic drugs may be of value, but many AMI patients are not transported by the emergency medical services system. ⋯ Unfortunately, much of what is known about the time sequence of ED thrombolytic therapy in the United States comes from organized trials in a small number of centers. Little is known about how often non-ED physicians participate in the decision-making process (either in person or by phone consultation), or how many delays are potentially avoidable. Current evidence suggests that preestablished ED treatment plans and protocols can reduce the time delay for many patients who present with AMI, especially if paramedics can transmit diagnostic quality ECGs to the hospital.
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Emerg. Med. Clin. North Am. · Feb 1990
ReviewCommunication with emergency medical services providers.
Communication between the emergency medical services provider and the emergency physician can be either a rewarding or a frustrating experience. As many emergency physicians have found to their chagrin, the EMS provider has a memory for mistakes or bad tidings. This article discusses the relationship between EMS providers and emergency physicians.
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Emerg. Med. Clin. North Am. · Feb 1990
ReviewMass casualty incident. Integration with prehospital care.
Mass casualty incident involves the use of limited resources for multiple casualties. The emergency physician must be familiar with both prehospital and hospital plans for mass casualty care in order to facilitate optimal care and to maintain the continuum from field care to definitive treatment. ⋯ Emergency physicians involved in prehospital care should be certain that the local EMS system has adequate training and chances to update their skills and knowledge. Disaster drills of the EMS system are excellent ways to practice, to identify weaknesses, and for preplanning to enhance disaster medical care.
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All patient care aspects of prehospital health care delivery must be physician directed. This process of medical accountability seeks to assure quality EMS patient care. Emphasis in this chapter is on the two main configurations of EMS medical accountability, off-line medical direction and on-line medical control. Topics include EMS physician qualifications, responsibilities, and authority; the role of protocols and standing orders; medical control configurations; and others.