Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Comparative Study
Response interval comparison between urban fire departments and ambulance services.
To measure the response intervals of fire departments compared with ambulance services in three urban centers to determine whether defibrillators should be added to fire vehicles. ⋯ The shorter response interval of fire departments suggests placing defibrillators on fire response vehicles in an effort to decrease the time to defibrillation for cardiac arrest victims in this EMS system.
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Although death education is a standard component in most medical schools and nursing programs, few include instruction on dealing with sudden death. Typically, death education courses overlook instruction in areas germane to emergency medicine, e.g., making death notifications, interacting with survivors during the immediate grief period, and reducing professional stress innate to working with newly bereaved persons. ⋯ Topics include death perspectives and awareness, death typology, cultural and religious considerations, communicating with bereaved persons, making death notifications, and dealing with initial grief reactions. Units of instruction are outlined, including educational goals, descriptions of units, teaching strategies, and supplemental readings.
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The authors have successfully implemented automated external defibrillation (AED) training in police departments that function as first responders. The initial elements are to think the project through, and to develop clear policies and procedures for the police as they relate to dispatching so there is timeliness of notification, because response time is such a critical element. ⋯ A system to evaluate training, compliance with protocol, and efficacy must be developed and closely monitored. While this is a tremendous amount of work and a large time investment, the result can be a dramatic increase in patient survival.
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The need for valid and reliable emergency medical services (EMS) data has long been recognized. EMS data are useful for monitoring resources and operations, documenting patient care and outcome, and evaluating injury prevention strategies. The goal of this project was to develop a computerized data set with the capability to generate a patient care record (PCR) to overcome some of the current EMS data limitations. ⋯ This computerized approach overcomes many limitations inherent with using paper-based systems for research. Linked with emergency department, hospital discharge, and mortality data, EMS data can be used in systems analyses related to patient outcome.
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One of the highest priorities for prehospital emergency personnel is airway management. Several rescuer positions for intubation on the ground have been published. ⋯ Using four case reports, situations in which inverse intubation may be an important tool for successful airway management are discussed. Other uses of the method are listed.