Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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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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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of perceived pain with different immobilization techniques.
To compare the locations and severities of pain generated by a hard wooden spine board vs a soft vacuum mattress splint on immobilized volunteers. ⋯ The hard-board method of spinal immobilization generates higher self-reported pain scale scores than the two vacuum mattresses.
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Randomized Controlled Trial Clinical Trial
Training prehospital personnel in saphenous vein cutdown and adult intraosseous access techniques.
To compare the success rates, complication rates, and times required for paramedic students to perform saphenous vein cutdown and adult intraosseous infusion using the bone injection gun (BIG). ⋯ In a group of inexperienced paramedic students working on a preserved human cadaver model, intravenous access was gained more rapidly, with a higher success rate, and with fewer complications using the bone injection gun than by the saphenous vein cutdown procedure. Further study is needed to evaluate these procedures in the field setting and to compare their feasibility with other alternative venous access techniques such as femoral, external jugular, and central venous cannulation.
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Randomized Controlled Trial Clinical Trial
A comparison of biphasic and monophasic shocks for external defibrillation. Physio-Control Biphasic Investigators.
The ability of a shock to defibrillate the heart depends on its waveform and energy. Past studies of biphasic truncated exponential (BTE) shocks for external defibrillation focused on low energy levels. This prospective, randomized, double-blind clinical trial compared the first-shock efficacies of 200-joule (J) BTE, 130-J BTE, and 200-J monophasic damped sine wave shocks. ⋯ Biphasic shocks of 200 J provide better first-shock defibrillation efficacy for short-duration VF than 200-J monophasic and 130-J biphasic shocks and thus may allow earlier termination of VF in cardiac arrest patients.
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Randomized Controlled Trial Comparative Study Clinical Trial
The utility of traditional prehospital interventions in maintaining thermostasis.
Hypothermia can have a negative effect on the metabolic and hemostatic functions of patients with traumatic injuries. Multiple methods of rewarming are currently used in the prehospital arena, but little objective evidence for their effectiveness in this setting exists. The purpose of this study was to assess the relative effectiveness of traditional prehospital measures in maintaining thermostasis in trauma patients. ⋯ Most traditional methods of maintaining trauma patient temperature during prehospital transport appear to be inadequate. Aggressive use of hot packs, a simple, inexpensive intervention to maintain thermostasis, deserves further study as a potential basic intervention for trauma patients.