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 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.
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Randomized Controlled Trial Clinical Trial
The effects of neutral positioning with and without padding on spinal immobilization of healthy subjects.
To compare the incidences and severities of pain experienced by healthy volunteers undergoing spinal immobilization in the neutral position with and without occipital padding. To compare the incidence of pain when immobilized in the neutral position with the incidence in a nonneutral position. ⋯ Pain is frequently reported by healthy volunteers following spinal immobilization. Occipital padding does not appear to significantly decrease the incidence or severity of pain. Alignment of the cervical spine in the neutral position may reduce the incidence of pain, but further studies should be conducted to substantiate this observation.
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Randomized Controlled Trial Comparative Study Clinical Trial
A new method for rapid fluid bolus infusion into a peripheral vein.
To compare the flow rates achieved by a new short-tubed infusion device with those obtained with a conventional apparatus, using gravity, manual pressure, and pneumatic inflation as the driving forces. ⋯ Flow of crystalloid under pressure into a peripheral vein is markedly increased with the new STP setup as compared with the CON setup. Incorporation of this new setup in prehospital care would allow EMS personnel to infuse fluid more rapidly and conveniently during transport.