Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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To assess the appropriateness of ambulance use in patients presenting to a pediatric emergency department (ED), with regard to both medical necessity and insurance status. ⋯ Inappropriate use of ambulance transportation is common in this pediatric population, with Medicaid patients accounting for a significant majority of the misuse.
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The authors have previously shown that San Francisco paramedics without specific training in stroke recognition identified acute stroke victims with a 61% sensitivity and a 77% positive predictive value (PPV). The authors implemented an educational program on stroke to improve paramedic accuracy in stroke recognition. ⋯ Institution of an educational stroke program was associated with a significant increase in sensitivity in stroke identification by the paramedics; however, educational influences outside this training program may have contributed to the increased sensitivity. Better education for paramedics, combined with rapid response to stroke victims once identified, may result in improved care for victims of acute stroke.
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To determine whether a course in emergency medical services (EMS) impacts on the perceived ability of medical students to render care in emergencies such as choking and cardiac arrest, and affects their choice of emergency medicine as a career. ⋯ A course in EMS has significant impact on the perceived ability and career choice of medical students. Further study of an EMS curriculum design is needed to determine what information is critical to medical students' education and valuable in their career choice decisions.
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To determine whether EMS educational programs in North Carolina adequately prepare paramedics, and whether there is additional value to an associate of applied science (AAS) degree education in EMS when compared with traditional certificate training programs. ⋯ While administrators and paramedics believe the current EMS educational programs in North Carolina adequately prepare students to function as paramedics, there are identifiable areas that require additional emphasis. There appears to be additional value to an AAS education when compared with traditional certificate EMS educational programs.
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Comparative Study
The effectiveness of lights and siren use during ambulance transport by paramedics.
To determine whether lights and siren (L&S) use during transport in the authors' EMS system results in reduced transport time to the hospital. Second, to determine whether L&S use results in any emergency department critical interventions in the time saved. ⋯ Use of L&S significantly shortens transport time. In this series of patients transported under the care of a paramedic, the time saved by the use of L&S was not usually associated with immediately apparent clinical significance.