Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
-
Emergency medical technician-basic (EMT-B) providers are not trained to establish vascular or intraosseous (IO) access on critically ill patients. This study was conducted to examine the feasibility of training EMT-B students to correctly place a commercial sternal IO infusion device (FAST-1). ⋯ EMT-B students with minimal training demonstrated limited success with applying a commercial sternal IO device. Clinical application by EMT-Bs on critically ill patients may be possible with more intensive training.
-
Comparative Study
Discontinuation of droperidol for the control of acutely agitated out-of-hospital patients.
To identify the effects of the removal of droperidol as a treatment option for sedation of agitated out-of-hospital patients. ⋯ Since the removal of droperidol as a treatment option for out-of-hospital agitated patients, the authors have observed an increased frequency of continuous pulse oximetry monitoring, intubation, ED critical care management, and intensive care unit admission in patients requiring chemical sedation for control of agitation in the out-of-hospital setting.
-
Comparative Study
HEMS vs. Ground-BLS care in traumatic cardiac arrest.
To assess whether a top-level type of prehospital care, made of helicopter, physician, and advanced life support (ALS) procedures, improves the outcome of blunt trauma victims found in cardiac arrest (CA) as compared with a simpler type, composed of ground ambulance, nurse, and expanded basic life support (BLS). ⋯ A top-level type of prehospital care had significantly more chances to resuscitate blunt trauma victims found in CA as compared with a simpler level. No significant benefit on long-term outcome was found, but more cases might be needed in future studies because of the inevitably low number of survivors.
-
Comparative Study
The impact of a new CPR assist device on rate of return of spontaneous circulation in out-of-hospital cardiac arrest.
The San Francisco Fire Department deployed an automated, load-distributing-band chest compression device (AutoPulse, Revivant Corporation) to evaluate its function in a large urban emergency medical services (EMS) service. A retrospective chart review was undertaken to determine whether the AutoPulse had altered short-term patient outcome, specifically, return of spontaneous circulation (ROSC). ⋯ The AutoPulse may improve the overall likelihood of sustained ROSC and may particularly benefit patients with nonshockable rhythms. A prospective randomized trial comparing the AutoPulse with manual CPR in the setting of out-of-hospital sudden cardiac arrest is under way.
-
Comparative Study
Association of heat index and patient volume at a mass gathering event.
In 1999, a department of emergency medicine was asked to provide medical care at a football stadium with a capacity of 61,625. Over four seasons, the department's experience has been that the number of patients seen during a game correlates closely with game-time heat and humidity (heat index). ⋯ In this retrospective study, the heat index was strongly associated with the volume of patients who would be seen at a mass gathering event.