Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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In many emergency medical services (EMS) systems, personnel without advanced life support (ALS) training are authorized to cancel responding ALS units before the ALS personnel arrive and examine the patient. This study was conducted to examine these cancellations in major U.S. cities. ⋯ Fewer than half of the surveyed EMS systems that permit non-ALS personnel to cancel responding ALS units use written protocols to guide these decisions, and only half of those protocols utilize specific medical criteria. Medical oversight review of these calls is highly variable, with many systems reviewing few or none of these cancellations.
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Multicenter Study
Medication calculation skills of practicing paramedics.
To assess the medication calculation skills among a group of practicing paramedics, the types of computations they find most difficult, and the relationship between drug calculation skills and various demographic characteristics. ⋯ Similar to findings among other allied health professions, medication calculation skills were found to be lacking among a group of practicing paramedics. In addition, the paramedics reported infrequent opportunities to perform this skill in the clinical setting and that medication calculations were not a routine part of EMS continuing education programs.
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Clinical Trial Controlled Clinical Trial
Ability of EMT-Bs to determine which wounds can be repaired in the field.
In certain emergency medical services (EMS) systems, emergency medical technicians-paramedics (EMT-Ps) repair lacerations in the field. This practice is supported by studies showing equivalence between nonphysicians and physicians regarding infection rates and cosmetic outcomes. ⋯ Basic EMTs can accurately identify wounds eligible for prehospital repair and/or requiring tetanus prophylaxis.
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To investigate emergency medical services (EMS) providers' experience with weapons encountered while working, and evaluate the training they have received regarding searching for and confiscating weapons in the field. ⋯ These data suggest that weapons encountered in the field are a widespread problem for EMS providers. Although many EMS providers search for and find weapons on their patients, most of them feel they have been inadequately trained in this area. Prospective studies are needed to document the actual incidence of weapon encounters in the prehospital setting. Multidisciplinary discussions are needed to address the above issues.
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Pain and its control have been studied extensively in the emergency department. Numerous studies indicate that inadequate treatment of pain is common, despite the availability of myriad analgesics. It has been suggested that oligoanesthesia is also a common practice in the prehospital setting. ⋯ Administration of analgesics to prehospital patients with suspected fractures was rare. Prehospital identification and treatment of pain for patients with musculoskeletal trauma could be improved.