Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Use of emergency medical services for suspected acute cardiac ischemia among demographic and clinical patient subgroups: the REACT trial. Rapid Early Action for Coronary Treatment.
Barriers to the use of emergency medical services (EMS) and patient delay in seeking care can limit the receipt or effectiveness of reperfusion therapies and the availability of prehospital emergency cardiac care. The Rapid Early Action for Coronary Treatment (REACT) trial was designed to determine the impact of a community intervention on use of EMS among demographic and clinical subgroups of patients with suspected acute cardiac ischemia. ⋯ The REACT trial demonstrated a significant impact on the use of EMS among patients admitted to the hospital for suspected acute myocardial infarction, with greater increases among patients with chronic or other cardiac ICD-9 discharge diagnoses, those presenting with lower SBP, and retired persons.
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In 1996, when the Food and Drug Administration (FDA) approved use of thrombolytic therapy for ischemic stroke, interfacility transport of stroke patients assumed increasing urgency. ⋯ Helicopter EMS transport is playing an increasing role in interfacility transfer of patients with ischemic stroke. Earlier HEMS activation is associated with decreased time lapse between referral and receiving hospital arrival.
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Meta Analysis
Nontrauma helicopter emergency medical services transport: annotated review of selected outcomes-related literature.
While helicopter emergency medical services (HEMS) has its roots in military transport of wounded soldiers, rotor-wing transport is also used for a wide variety of nontrauma indications. Despite this common use of HEMS for noninjured patients, a Medline search found little systematic review of the literature pertinent to HEMS use for nontrauma. ⋯ The paper's goal is to provide a useful resource for those interested in pursuing more focused review of various sectors of the nontrauma HEMS literature. As such, the main objective of the article summaries is to provide a brief outline of study design and results; there is also limited editorial comment included after each summary.
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To evaluate the utilization and impact of ambulance diversion in the metropolitan area of Syracuse, New York. ⋯ This study demonstrated that, in Syracuse, New York, ambulance diversion was once a seasonal phenomenon, but is increasingly occurring throughout the year because of staff and resource limitations. It also demonstrated that ambulance diversion can be employed to reduce numbers of incoming transports.
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To evaluate the existing prehospital trauma care system in Tehran, Iran. ⋯ The prolonged response, scene, and dispatch-beginning-to-hospital-arrival intervals compared with those for a developed EMS system indicate one potential area for improvement. Furthermore, significant differences in the field of prehospital care (conducting no ALS procedure) showed that ambulance equipment and training of EMS personnel are two other potential sites for improvement.