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
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 Comparative Study
Correlation of capillary and venous blood glucometry with laboratory determination.
During resuscitation in the Singapore Armed Forces, blood glucose samples are often obtained for analysis using the capillary glucometer. A drop of venous blood from the intravenous cannula is sometimes used to ascertain the patient's blood glucose level. Venous samples may be sent to a commercial laboratory, but this does not allow immediate results. ⋯ Capillary whole-blood glucose values best approximated venous plasma glucose values from the laboratory. Measuring the venous whole-blood glucose using the glucometer resulted in an overestimation of the venous plasma glucose compared with the laboratory result by about 0.97 mmol/L (17.46 mg/dL). This may result in the withholding of intravenous glucose for patients who are actually hypoglycemic.
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Multicenter Study
Factors associated with the use of pharmacologic agents to facilitate out-of-hospital endotracheal intubation.
To identify a set of clinical factors most strongly associated with the use of drug-facilitated intubation (DFI) in the out-of-hospital setting. ⋯ The authors identified a set of predictors strongly associated with DFI. These data offer insight into the current use of DFI and support the development of consensus-based guidelines for this procedure.
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Multicenter Study Comparative Study
A comparison of first-responder automated external defibrillator (AED) application rates and characteristics of AED training.
To determine whether there were associations between the characteristics of first-responder automated external defibrillator (AED) training and AED application rates. ⋯ Use of a national AED training curriculum, training to the level of Certified First Responder or higher, and the ability for each first responder to apply the AED during continuing training were associated with higher AED application rates. Continuing training within the first year did not appear to be as important as actually using the AED during the training.
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Multicenter Study Comparative Study
Automated external defibrillator (AED) utilization rates and reasons fire and police first responders did not apply AEDs.
To determine the rate at which fire and police first responders (FRs) apply automated external defibrillators (AEDs) and to ascertain reasons for not applying them. ⋯ Fire and police FRs did not apply AEDs to a significant number of OHCA patients. Use of the transport ambulance defibrillator was the primary reason given for not applying the FR AED. Given low AED application rates by FRs, future studies are needed to determine the characteristics of communities in which equipping FRs with AEDs is the most beneficial deployment strategy, and how to increase AED application by FRs in communities with FR AED programs.