Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
-
Randomized Controlled Trial
Effectiveness of self-applied tourniquets in human volunteers.
Tourniquets are not commonly used in routine extremity trauma, but can be vital for hemorrhage control in austere conditions. ⋯ Some commercially available tourniquets do not reliably occlude arterial blood flow and may not be successful in preventing extremity exsanguination in a trauma patient. Potential purchasers of such devices should bear this in mind when selecting a device for clinical use.
-
Ipratropium bromide has demonstrated efficacy when added to albuterol for the treatment of reactive airways disease (RAD). Its prehospital use has not been explored. ⋯ The addition of ipratropium bromide to albuterol for the prehospital treatment of RAD does not appear to result in clinical outcome improvements. A substantial number of patients enrolled in the study were diagnosed as having cardiac disease.
-
To determine the short-term outcome of patients refusing transport after emergency medical services (EMS) evaluation at an international airport. ⋯ Most patients who refused transport after EMS evaluation at an international airport had good short-term outcomes. These results may assist paramedics and MCPs to manage refusals in this setting and to allow patients to make informed decisions.
-
Patient measurements that do not require monitoring equipment may be the only way to evaluate casualties in austere conditions to determine treatment and transport priority. Objective. To test the hypothesis that palpable pulse characteristics in the radial artery would estimate systolic blood pressure (SBP) and predict outcome in trauma patients. ⋯ These preliminary data suggest that a weak radial pulse may be an acceptable method for initial rapid evaluation of trauma patients. This simple and rapid method of pulse evaluation should be considered for the triage of trauma patients in field conditions with limited instrumentation.
-
Comparative Study
Occupational injuries among emergency medical services personnel.
Emergency medical services (EMS) personnel treat 22 million patients a year in the United States, yet little is known of their injury risks. ⋯ The injury rates for EMS workers are higher than rates reported by DOL for any industry in 2000. Funding and additional research are critical to further defining the high risks to EMS workers and developing interventions to mitigate this serious problem.