Articles: emergency-medical-services.
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Emerg. Med. Clin. North Am. · Feb 1990
ReviewThe impact of emergency medical helicopters on prehospital care.
Emergency medical helicopter services have grown exponentially over the past seventeen years. These services offer rapid transport by flight crews to tertiary care centers with a higher level of medical capabilities. An impact because of helicopters on survival has been well-documented for trauma patients. Assessing usage for other critical care patients remains to be delineated further.
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Intraosseous infusion is an outmoded technique that is gaining new prominence in the field of emergency medicine. Although not recommended as a replacement for conventional modes of intravascular access, this alternative provides rapid venous access during life-threatening emergencies. A review of the literature indicates that the intraosseous route provides relatively safe, rapid, and reliable access to the systemic venous circulation and is associated with an acceptably low complication rate. This article offers a brief historical overview of this technique and discusses insertion methods, clinical applications, and nursing management of pediatric intraosseous infusion.
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Civilian helicopters and emergency medical services in the United States have been in existence for approximately 15 years. The rapid growth of this type of health care delivery coupled with an increasing number of accidents has prompted professional and lay scrutiny of these programs. ⋯ Significant questions regarding the number of pilots in a helicopter and in a program remain to be answered. This article reviews the role of emergency medical air transport services in providing care to trauma patients, staff training and evaluation, and safety criteria and offers recommendations to minimize risks to patients and crews.
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In a study of 200 patients with chest wounds in whom the need for referral to a centre with radiographic facilities was not obvious, careful clinical examination (pulse, blood pressure, respiratory rate, haemoglobin value and chest auscultation) was found to be a reliable triage tool. The sensitivity of one or more positive signs was 99.2% with a false-positive rate of 16% and a false-negative rate of 2%. The positive predictive value of two or more positive signs was found to be 99.1%.
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Vasoactive (vasodilating and vasoconstricting) and inotropic drugs are widely used in intensive therapy. Major progress in their use in recent years has been due to a greater understanding of the physiological derangements of the critically ill. ⋯ An understanding of the basic anatomy and physiology of the cardiovascular system (CVS) is essential to an understanding of the methods used for monitoring and measurement (1). Logical therapeutic interventions follow from consideration of these measured and derived parameters.