Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Paramedics provide a substantial proportion of care at mass gatherings but do not typically release patients without physician assessment. ⋯ Treat-and-release medical directives for paramedics at mass gatherings may help divert patients from requiring care at a medical facility. Future research is needed to determine the safety (morbidity and mortality) of these directives.
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Airway management, including endotracheal intubation, is considered one of the most important aspects of prehospital medical care. This concept paper proposes a systematic algorithm for performing prehospital airway management. The algorithm may be valuable as a tool for ensuring patient safety and reducing errors as well as for training rescuers in airway management.
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This article describes emergency medical services (EMS) systems in Connecticut, beginning with a historical perspective. The discussion of statewide oversight of the EMS system includes legislative and regulatory mandates as well as recent external reviews of the system. ⋯ Most of the 169 cities and towns in the State maintain or contract for local EMS, and have traditionally resisted regionalization. This snapshot of the EMS system in Connecticut can serve as a reference for comparison of EMS systems in other jurisdictions.
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Prehospital providers are often involved in the resuscitation of apparent sudden infant death syndrome (SIDS) victims; however, data are few on the presentation and outcome of these patients. ⋯ Apparent SIDS victims have a dismal prognosis; all infants presenting with apparent SIDS died, even the 30% whose final diagnosis was not SIDS. Given that there were no survivors, new prehospital policies are needed governing the use of lights and sirens, resuscitation decisions including termination of resuscitation, provision of grief support to families, and incident stress debriefing for prehospital personnel.
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The preparation of emergency medicine practitioners occurs at a variety of levels, via individuals with various levels of experience and training, and through a variety of oversight organizations. The purpose of this study was to quantify the characteristics of those recognized as prehospital emergency medical services (EMS) educators, the type and amount of infrastructure available to facilitate the learning process, and what attributes and common practices the profession values. ⋯ The respondents were a senior group of educators committed to the training of new providers who will comprise the foundation of future EMS educational efforts at the national level.