Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Centralized emergency medical services (EMS) data collection is critical to evaluating EMS system effectiveness, yet a general lack of EMS data persists at local, state, and national levels. ⋯ While EMS data systems exist in the majority of states, continued attention and resources are needed for state-level EMS data system development to improve capacity for evaluation of emergency medical services.
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The authors have demonstrated that 28% of children cared for by paramedics are not transported to hospital by ambulance. ⋯ Most nontransported children did not require immediate or urgent medical care. Both parents and paramedics gave input into the nontransport decision, and the short-term outcome of this population appeared to be good. Paramedic documentation for the reasons for nontransport should be improved.
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To determine the safety and effectiveness of fentanyl administration for prehospital pain management. ⋯ This study showed that fentanyl was effective in decreasing pain scores without causing significant hypotension, respiratory depression, hypoxemia, or sedation. Thus, fentanyl citrate can be used safely and effectively for pain management in the out-of-hospital arena.
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Comparative Study Clinical Trial Controlled Clinical Trial
A comparison of rapid-sequence intubation and etomidate-only intubation in the prehospital air medical setting.
To compare laryngoscopy conditions produced by etomidate-only intubation (EOI) with those produced by rapid-sequence intubation (RSI) in the prehospital air medical setting. ⋯ Patients receiving RSI had better laryngoscopy conditions and were easier to intubate than patients receiving EOI. Intubation success rate was higher with RSI.
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Randomized Controlled Trial Comparative Study
A randomized, controlled comparison of cardiopulmonary resuscitation performed on the floor and on a moving ambulance stretcher.
Recent studies have demonstrated that cardiopulmonary resuscitation (CPR) of poor quality is associated with worsened outcomes. ⋯ Chest compression and ventilation quality of CPR performed on the floor was superior to that of CPR performed on a moving stretcher in this manikin model. The quality of CPR while moving was significantly compromised.