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
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.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Use of emergency medical services for suspected acute cardiac ischemia among demographic and clinical patient subgroups: the REACT trial. Rapid Early Action for Coronary Treatment.
Barriers to the use of emergency medical services (EMS) and patient delay in seeking care can limit the receipt or effectiveness of reperfusion therapies and the availability of prehospital emergency cardiac care. The Rapid Early Action for Coronary Treatment (REACT) trial was designed to determine the impact of a community intervention on use of EMS among demographic and clinical subgroups of patients with suspected acute cardiac ischemia. ⋯ The REACT trial demonstrated a significant impact on the use of EMS among patients admitted to the hospital for suspected acute myocardial infarction, with greater increases among patients with chronic or other cardiac ICD-9 discharge diagnoses, those presenting with lower SBP, and retired persons.
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Multicenter Study
Medication calculation skills of practicing paramedics.
To assess the medication calculation skills among a group of practicing paramedics, the types of computations they find most difficult, and the relationship between drug calculation skills and various demographic characteristics. ⋯ Similar to findings among other allied health professions, medication calculation skills were found to be lacking among a group of practicing paramedics. In addition, the paramedics reported infrequent opportunities to perform this skill in the clinical setting and that medication calculations were not a routine part of EMS continuing education programs.