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 a case-based educational module would increase prehospital care providers' short-term and long-term knowledge about stroke and to compare the educational impact when the module was moderated by a physician versus an advanced cardiac life support (ACLS) instructor. ⋯ This case-based approach to EMS stroke education is effective and can achieve equal benefit when administered by a physician or an ACLS instructor.
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Randomized Controlled Trial Clinical Trial
Paramedic use of the endotracheal tube introducer in a difficult airway model.
To determine whether advanced life support (ALS)-level prehospital providers can be taught to effectively use the Flex-Guide (FG) Endotracheal Tube (ETT) introducer in a difficult airway model by comparing success of styleted ETT intubation with Flex-Guide-assisted intubation. ⋯ Prehospital care providers were as successful intubating a difficult airway model using the newly learned bougie technique as they were using the more familiar styleted ETT technique.
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Critical incident stress management (CISM) has become a common practice in modern emergency services. Described in 1983 as critical incident stress debriefing (CISD), CISM was originally marketed to help emergency personnel deal with ostensibly stressful situations they would encounter as a part of their work. ⋯ Despite the limitations of the existing literature base, several meta-analyses and RCTs found CISM to be ineffective in preventing PTSD. Several studies found possible iatrogenic worsening of stress-related symptoms in persons who received CISM. Because of this, CISM should be curtailed or utilized only with extreme caution in emergency services until additional high-quality studies can verify its effectiveness and provide mechanisms to limit paradoxical outcomes. It should never be a mandatory intervention.
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Review Practice Guideline Guideline
The use of automated external defibrillators in children.
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A prospective time-motion study of radio communication between inbound ambulances and emergency department (ED) triage personnel was conducted to assess hospital triage staff time utilized, and how often radio reports result in actions taken in the ED to prepare for patient arrival. The study hypothesis was that reports for "priority 2" (P2, nonemergent) patients rarely provide information that is acted upon in the ED prior to the patient's arrival. ⋯ In the system studied, P2 reports rarely provide information that is acted on prior to the patient's arrival. The time spent giving a radio report is frequently duplicated in the ED. Radio reports for low-priority patients may not be an efficient or productive use of providers' or nurses' time.