Prehospital and disaster medicine
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Prehosp Disaster Med · Oct 1994
Emergencies in the school setting: are public school teachers adequately trained to respond?
This study attempted to determine the extent of training and emergency care knowledge of public school teachers in midwestern states. A secondary purpose was to assess the frequency of injury and illness in the school setting requiring the teacher to first-respond. ⋯ Public school teachers represent a potentially effective first-response component during disasters and isolated emergencies in the school environment. Overall, most of public school teachers in this study were deficient in both training and knowledge of emergency care and BLS modalities. Lack of effective, formal emergency care training in teacher preparation programs coupled with no continuing education requirement is a possible explanation of these results. Emergency medical services providers should seek opportunities to help with first-responder training and continuing education in their schools.
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Prehosp Disaster Med · Oct 1994
Outcome of patients after air medical transport for management of nontraumatic acute intracranial bleeding.
Patients with acute, intracranial bleeding (ICB), particularly from intracranial aneurysms, are believed to be at high risk for rebleeding or neurologic deterioration if subjected to noise, motion, or stress, but are transported by helicopter with increasing frequency. This study was undertaken to examine the characteristics, safety, and outcomes of air transport for patients with acute subarachnoid hemorrhage (SAH) or other forms of acute ICB in an air medical system. ⋯ Emergency air medical transfer of patients with acute ICB for definitive neurosurgical care appears to be both safe and effective, and facilitates early definitive diagnosis and operative intervention.
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Nationwide data were collected concerning serious, disabling injuries requiring hospitalization (SDIH) or deaths among urban emergency medical services (EMS) providers. ⋯ Occupational injuries of EMS personnel are at a serious level. Fire-based EMS systems experienced a higher rate of hand SDIHs despite the provision of protective equipment. Few nonfire-EMS staff are provided with safety equipment, which may have resulted in a relatively high number of head and hand SDIHs. Fire-EMS medical directors need to take an active role in verifying that protective equipment is adequate and appropriate to allow the performance of field EMS duties without being too cumbersome. Medical directors of nonfire-EMS must be advocates for the provision of basic protective equipment aimed at mitigating SDIHs of EMS staff.
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Prehosp Disaster Med · Oct 1994
Teaching basic EMTs endotracheal intubation: can basic EMTs discriminate between endotracheal and esophageal intubation?
Advanced airway intervention techniques are being considered for use by basic emergency medical technicians (EMTs). It was hypothesized that basic EMTs would be able to discriminate reliably between intratracheal and esophageal endotracheal tube placement in a mannequin model. ⋯ Basic EMTs had difficulty assessing endotracheal tube placement in a mannequin model. The 27% miss rate for identifying esophageal intubations suggests that basic EMTs will require additional training for safe field use of any airway that requires assessment of tube placement.
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Prehosp Disaster Med · Oct 1994
System implications of the ambulance arrival-to-patient contact interval on response interval compliance.
In some emergency medical services (EMS) system designs, response time intervals are mandated with monetary penalties for noncompliance. These times are set with the goal of providing rapid, definitive patient care. The time interval of vehicle at scene-to-patient access (VSPA) has been measured, but its effect on response time interval compliance has not been determined. ⋯ The addition of the VSPA interval to the traditional time intervals impacts system response time compliance. Using 9-1-1 call-to-scene compliance as a basis for measuring system performance underestimates the time for the delivery of definitive care. This must be considered when response time interval compliances are defined.