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 whether paramedics can identify patients contacting 9-1-1 who do not require emergency department (ED) care. ⋯ In this urban system, paramedics cannot reliably predict which patients do and do not require ED care.
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The interval from collapse to electrical rescue shock is a critical determinant of successful defibrillation in cardiac arrest. In order to achieve the earliest possible defibrillation, many emergency medical services (EMS) systems equip first-responding units with an automated external defibrillator (AED). ⋯ The findings suggest that a 1-minute goal and a 90-second minimum standard for time to first shock are appropriate for EMT AED defibrillation in the field.
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Multicenter Study Comparative Study
Automated external defibrillator (AED) utilization rates and reasons fire and police first responders did not apply AEDs.
To determine the rate at which fire and police first responders (FRs) apply automated external defibrillators (AEDs) and to ascertain reasons for not applying them. ⋯ Fire and police FRs did not apply AEDs to a significant number of OHCA patients. Use of the transport ambulance defibrillator was the primary reason given for not applying the FR AED. Given low AED application rates by FRs, future studies are needed to determine the characteristics of communities in which equipping FRs with AEDs is the most beneficial deployment strategy, and how to increase AED application by FRs in communities with FR AED programs.
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To determine the acceptance by family members regarding nontransport of patients in cardiac arrest following unsuccessful resuscitation occurring in private residences. ⋯ In this small sample, family members accept the nontransport of patients by trained EMS personnel after asystolic nontraumatic cardiac arrest occurring in private residences. This may positively impact emergency department resources for other critically ill patients.
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To obtain medical follow-up and determine reasons why elderly patients access paramedics via 9-1-1 and then refuse transport. ⋯ The majority of patients who were 65 years of age and older and refused transport received follow-up care, with a significant number requiring admission to the hospital at the time of their follow-up.