Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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To determine the locations of nonresidential out-of-hospital cardiac arrests (OHCAs) in the City of Pittsburgh and to determine whether there are "high-risk" locations that might benefit from placement of automated external defibrillators (AEDs). ⋯ The majority of nonresidential OHCAs occur as singular, isolated events. Other than nursing homes and dialysis centers, there were no identifiable high-risk locations for nonresidential OHCA within the City of Pittsburgh.
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Approximately 1,000 people in the United States suffer cardiac arrest each day, most often as a complication of acute myocardial infarction (AMI) with accompanying ventricular fibrillation or unstable ventricular tachycardia. Increasing the number of patients who survive cardiac arrest and minimizing the clinical sequelae associated with cardiac arrest in those who do survive are the objectives of emergency medical personnel. In 1990, the American Heart Association (AHA) suggested the chain of survival concept, with four links--early access, cardiopulmonary resuscitation (CPR), defibrillation, and advanced care--as the way to approach cardiac arrest. ⋯ This paper addresses a number of the issues associated with each of the links of the chain of survival, the evidence that exists, and what should be done to achieve the clinical evidence needed for true clinical significance. Also included in this paper are the consensus statements developed from small discussion groups held after the main presentation. These comments provide another perspective to the problems and to possible approaches to deal with them.
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To delineate the present characteristics of emergency medical services (EMS) on the island of Madagascar. ⋯ This study shows that urban EMS is more organized, has a better-developed infrastructure, and has more personnel than its counterparts in rural areas. Future work will determine the impact of a rising population shift from rural to urban areas on this evolving EMS system.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of perceived pain with different immobilization techniques.
To compare the locations and severities of pain generated by a hard wooden spine board vs a soft vacuum mattress splint on immobilized volunteers. ⋯ The hard-board method of spinal immobilization generates higher self-reported pain scale scores than the two vacuum mattresses.