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
Hospital variability of out-of-hospital cardiac arrest survival.
Previous literature has identified patient and emergency medical services (EMS) system factors that are associated with survival of out-of-hospital cardiac arrest patients. ⋯ Survival to discharge of resuscitated adult out-of-hospital cardiac arrest patients may vary by receiving hospital. A hospital's ratio of beds to nurse and several patient/case f actors are correlated with survival. Further research is warranted to investigate how this may affect resuscitation care, EMS transport policy, and research design.
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Multicenter Study
Derivation of clinical predictors of failed rescue shock during out-of-hospital ventricular fibrillation.
Failed rescue shocks have been shown to decrease the likelihood of survival in the treatment of out-of-hospital ventricular fibrillation (VF). Avoidance of failed shocks may improve survival. ⋯ Unwitnessed collapse, response time>6 minutes, and absence of BCPR may be useful in predicting which VF patients are likely to have failed first shocks and would thereby benefit from a CPR-first strategy. Stacked rescue shocks most often fail, and this outcome can also be predicted.
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Multicenter Study
Emergency medical services education, community outreach, and protocols for stroke and chest pain in North Carolina.
Prehospital care of stroke and chest pain patients is dependent on adequate emergency medical services (EMS) education and evidence-based protocols. We sought to describe the amount of education offered, community outreach implemented, and protocols established for stroke and for chest pain among North Carolina EMS agencies and personnel. ⋯ In North Carolina, primary EMS agencies appear to have stroke and chest pain protocols in approximately the same frequency, yet their personnel receive only one-half as much education about stroke as they do about chest pain. Many stroke protocols were lacking basic components and would benefit from standardization across the state. Community outreach programs for both stroke and chest pain are minimal.
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Multicenter Study
Accuracy of stroke recognition by emergency medical dispatchers and paramedics--San Diego experience.
Prehospital personnel in Emergency Medical Service (EMS) systems have varying levels of accuracy in stroke recognition. Identifying the accuracy of emergency medical dispatcher using Medical Priority Dispatch Systems (MPDS) stroke protocol and paramedics may help understand the accuracy of stroke recognition in about 3000 emergency medical dispatch systems and prehospital systems world wide. ⋯ In our EMS system, EMD using MPDS Stroke protocol with a high compliance has a higher sensitivity than paramedics using CSS.