Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Endotracheal intubation (ETI) remains the "gold standard" for securing a patient's airway. In recent years, the use of pharmacologic agents to assist paramedics achieve successful intubation of problematic airways has become more common. This study was done to determine the efficacy of intravenous midazolam, a short-acting benzodiazepine, as a drug to facilitate intubation in patients resistant to conventional ETI. ⋯ The prehospital use of single-dose IV midazolam is generally effective in accomplishing facilitated ETI in patients resistant to conventional (nonpharmacologic) ETI.
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The authors have previously shown that San Francisco paramedics without specific training in stroke recognition identified acute stroke victims with a 61% sensitivity and a 77% positive predictive value (PPV). The authors implemented an educational program on stroke to improve paramedic accuracy in stroke recognition. ⋯ Institution of an educational stroke program was associated with a significant increase in sensitivity in stroke identification by the paramedics; however, educational influences outside this training program may have contributed to the increased sensitivity. Better education for paramedics, combined with rapid response to stroke victims once identified, may result in improved care for victims of acute stroke.