Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Air medical transport has had problems with its safety record, attributed in part to human error. Flight crew members (FCMs) must be able to focus on critical safety tasks in the context of a stressful environment. Flight crew members' cognitive readiness (CR) to perform their jobs may be affected by sleep deprivation, personal problems, high workload, and use of alcohol and drugs. ⋯ Performance by FCMs on a simple, rapid, computer-based psychological test correlates well with self-reported sleep, rest, life satisfaction, and irritability. Although further studies are warranted, these findings suggest that assessment of the performance of FCMs on a simple, rapid, computer-based, multitasking battery is feasible as an approach to determine their readiness to perform critical safety tasks through the SYNWIN task battery.
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OBJCTIVE: The objectives were to evaluate the safety and efficacy of ondansetron in the out-of-hospital treatment of undifferentiated nausea or vomiting. ⋯ Ondansetron is safe and effective for out-of-hospital treatment of nausea and vomiting when administered by paramedics via the IV, IM, or oral route. When available to paramedics, ondansetron is used frequently.
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Comparative Study
Assessing the impact of prehospital intubation on survival in out-of-hospital cardiac arrest.
There is a developing body of literature documenting adverse survival outcome of out-of-hospital endotracheal intubation for critical multiple trauma and head injury patients. ⋯ This observational study in an unselected population shows that patients in VF/VT arrest who underwent out-of-hospital intubation were less likely to survive to discharge than those not intubated. Out-of-hospital intubation of patients with non-VF arrest was associated with an increased rate of survival to admission, but not survival to discharge. Future prospective studies are needed to define the role of out-of-hospital endotracheal intubation in cardiac arrest patients.
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This study was undertaken to characterize the carbon emissions from a broad sample of North American emergency medical services (EMS) agencies, and to begin the process of establishing voluntary EMS-related emission targets. ⋯ EMS operations produce substantial carbon emissions, primarily from vehicle-related fuel consumption. The 75th percentiles from our data suggest 106.5 pounds of CO(2)e per unit response and/or 11.2 pounds of CO(2)e per service-area resident as preliminary maximum emission targets. Air medical services can anticipate higher per-flight but lower population-based emissions.
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In 2006, the Centers for Disease Control and Prevention (CDC) released a revised Field Triage Decision Scheme. It is unknown how this modified scheme will affect the number of patients identified by emergency medical services (EMS) for transport to a trauma center. ⋯ Use of the 2006 Field Triage Decision Scheme would have resulted in a significant decrease in the number of patients identified as needing the resources of a trauma center. These changes reduced overtriage while causing a small increase in the number of patients who would have been undertriaged.