Articles: emergency-services.
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We reviewed the medical records of all patients who delivered in the prehospital or emergency department setting from 1980 through 1987 at Hennepin County Medical Center. There were 80 deliveries. Twelve women had no prenatal care; the remaining 68 women had an average of seven prenatal visits. ⋯ Twenty infants required some degree of resuscitation at the time of delivery, including 19 endotracheal intubations. Complications during delivery were numerous and included nuchal cord, breech presentation, shoulder dystocia, postpartum hemorrhage, pre-eclampsia, prolapsed cord, and meconium staining. Prehospital and ED delivery were associated with a high rate of maternal and infant complications.
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To determine the short-term functional and medical outcomes and predictors of outcome following discharge from an acute hospital emergency department, 100 elderly (greater than or equal to 65 yr) and 100 nonelderly (less than 65 yr) patients were studied prospectively. Patients were interviewed at three days and again at three weeks following emergency department discharge. The number of new prescriptions given to both groups in the emergency department was similar (elderly 41%; nonelderly, 31%). ⋯ None of the nonelderly required hospitalization or had died. Functional impairments were more common in the elderly both at baseline (elderly, 26%; nonelderly, 6%; P less than .01) and at three weeks (elderly, 27%; nonelderly, 5%; P less than .001). Independent predictors of poor medical outcome included age greater than or equal to 65 (P less than .009) and functional impairment at baseline (P less than .022).(ABSTRACT TRUNCATED AT 250 WORDS)
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Because of discontinuation of base hospital participation, paramedics in a large urban zone of a California emergency medical services (EMS) system serving 1.1 million persons went on emergency standing orders for nearly all calls requiring advanced life support. Subsequently, the base hospital resumed medical control function under limited standing orders. ⋯ There were significant differences in total prehospital care times and at-scene times between the control group and the two standing order groups (P less than .01). There are important implications to EMS systems that use extensive base hospital contact.