Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Comparative Study
Comparison of bag-valve-mask, manually triggered ventilator, and automated ventilator devices used while ventilating a nonintubated mannikin model.
To determine whether there were differences in tidal volume (Vt), minute volume (MV), average mask leak per breath (ML), gastric insufflation (GI), and peak airway pressure (PAP) when ventilating a nonintubated mannikin with a bag-valve-mask (BV), manually triggered ventilator (MTV), and automated ventilator (AV). The authors' hypothesis was that there would be no differences among the devices for any of these variables. ⋯ All three devices delivered similar volumes when used by EMTs, but the BV was associated with higher PAP, ML, and GI.
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Controversy exists as to the effectiveness of defibrillation by emergency medical technicians (EMT-Ds) in reducing mortality from cardiac arrest in two-tiered EMS systems. This study was performed to assess the impact of EMT-Ds on outcome of sudden cardiac death in a small, urban, modified two-tiered EMS system. ⋯ EMT defibrillation had no impact on outcome of sudden cardiac death in this small, urban, two-tiered EMS system. Survival rates were similar to those reported for other such systems. However, power to detect significant differences was low, and further study is indicated. Controlled multicenter trials are recommended.
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Emergency medical services systems and MCOs must cooperate and educate each other in order to effect delivery of reliable, high-quality emergency health care to the entire community. Shared goals are rapid access, medically appropriate care, and operational efficiency. ⋯ EMS systems serve as a safety net for patients with perceived emergencies. Changes in form and function should be guided by outcome studies that ensure the continued delivery of quality emergency health care services.
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To measure the accuracy of lead II rhythm strip interpretations performed by advanced life support (ALS) emergency medical technicians (EMTs) in a rural emergency medical services (EMS) system. ⋯ In this EMS system, ECG interpretations are generally accurate, with tachydysrhythmias and AV blocks being the source of most discrepancies.