CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
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Multicenter Study Controlled Clinical Trial
The OPALS Major Trauma Study: impact of advanced life-support on survival and morbidity.
To date, the benefit of prehospital advanced life-support programs on trauma-related mortality and morbidity has not been established ⋯ The OPALS Major Trauma Study showed that systemwide implementation of full advanced life-support programs did not decrease mortality or morbidity for major trauma patients. We also found that during the advanced life-support phase, mortality was greater among patients with Glasgow Coma Scale scores less than 9. We believe that emergency medical services should carefully re-evaluate the indications for and application of prehospital advanced life-support measures for patients who have experienced major trauma.
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Asthma accounts for considerable burden on health care, but in most cases, asthma can be controlled. Quality-of-care indicators would aid in monitoring asthma management. We describe the quality of asthma care using a set of proposed quality indicators. ⋯ Suboptimal asthma management would be improved through increased use of inhaled corticosteroids and preventer medications, and reduced reliance on short-acting beta-agonist medications as recommended by consensus guidelines.