Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Multicenter Study Comparative Study
Correlation of capillary and venous blood glucometry with laboratory determination.
During resuscitation in the Singapore Armed Forces, blood glucose samples are often obtained for analysis using the capillary glucometer. A drop of venous blood from the intravenous cannula is sometimes used to ascertain the patient's blood glucose level. Venous samples may be sent to a commercial laboratory, but this does not allow immediate results. ⋯ Capillary whole-blood glucose values best approximated venous plasma glucose values from the laboratory. Measuring the venous whole-blood glucose using the glucometer resulted in an overestimation of the venous plasma glucose compared with the laboratory result by about 0.97 mmol/L (17.46 mg/dL). This may result in the withholding of intravenous glucose for patients who are actually hypoglycemic.
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Randomized Controlled Trial Comparative Study Clinical Trial
A laboratory comparison of emergency percutaneous and surgical cricothyrotomy by prehospital personnel.
To compare the speeds and success rates of placement for percutaneous cricothyrotomy versus surgical or open cricothyrotomy. ⋯ In an animal model, surgical cricothyrotomy appeared to be a preferable method for establishing a definitive airway over the percutaneous method. Further research is required to define the optimal approach in the prehospital setting for the invasive airway.
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Randomized Controlled Trial Clinical Trial
Ability of laypersons to use the Cincinnati Prehospital Stroke Scale.
Early stroke recognition optimizes patients' opportunities to benefit from therapeutic options. Prehospital stroke recognition is suboptimal. If 9-1-1 dispatchers used stroke-identification tools, prehospital stroke recognition might occur more rapidly and accurately. The Cincinnati Prehospital Stroke Scale (CPSS) is a brief, effective tool used by emergency medical services and hospital personnel to identify stroke. The study's goal was to determine whether laypersons could be instructed to use the CPSS over the telephone. ⋯ Laypersons correctly administered and interpreted the CPSS when directed to do so over the telephone by a trained investigator. These findings suggest that the CPSS may be a useful tool in early prehospital detection of stroke by dispatchers.
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To determine whether patients suffering from electric shock without significant symptoms at the point of an emergency call could be appropriately assigned a nonemergency ambulance response using the Medical Priority Dispatch System (MPDS). ⋯ The findings of this study do not justify allocating a low-priority response to victims of electric shock without significant symptoms at the point of the emergency call, since 25% require hospital admission. Further research is required to determine whether the addition of questions to the MPDS about burns and pregnancy might allow safe allocation of a nonemergency response to other asymptomatic electric shock patients.
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Most cardiopulmonary resuscitation (CPR) trainees are young, and most cardiac arrests occur in private residences witnessed by older individuals. ⋯ Using these assumptions, current CPR training strategy is not a cost-effective intervention for home cardiac arrests. The high rate of elders witnessing CPR mandates focused CPR interventions for this population.