Articles: emergency-medical-services.
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Emergency medical service systems in Norway are based on equity and equality. A toll free number (113) and criteria based dispatch are crucial components. The establishment of an emergency medical system (EMS) manned by an air and ground emergency physician (EP) has challenged the role of the general practitioner (GP) in emergency medical care. We investigated whether there were any geographical differences in the use of 113, alerts to GPs by the emergency medical dispatch centres (EMDCs), and of the presence of GPs on scene in medical emergencies leading to a turnout of the EP manned EMS. ⋯ We found geographical differences in the involvement of GPs in pre-hospital emergency medical situations, probably caused by a specialised emergency medical service system including an EMDC and an air and ground EP manned EMS. There were geographical differences in public use of the toll free 113, and alerts to GPs by the EMDCs, which is likely to result from geographical conditions and proximity to medical resources. Future organisation of the EMS has to reflect this to prevent unplanned and unwanted autonomously emerging EMS systems.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
A randomized, double-blind study comparing morphine with fentanyl in prehospital analgesia.
The aim of this study was to compare, by a randomized double-blind method, morphine (M) and fentanyl (F) in a prehospital setting. ⋯ This study demonstrates that M and F were comparable in treating severe, acute pain in a prehospital setting during the first 30 minutes in spontaneous breathing patients.
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We determine the interval between stroke symptom onset and time to emergency department (ED) arrival and factors associated with delays in presentation. ⋯ There are considerable delays between stroke symptom onset and ED arrival. Programs to improve awareness of patients with stroke to seek medical help immediately may reduce unnecessary delays to ED arrival.
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A postal survey of the 38 Ambulance Services in the United Kingdom was undertaken to find out what equipment is provided for paramedic crews to aid tracheal intubation and to confirm tracheal placement. The response rate to our survey was 100%. Fourteen (37%) ambulance services provided neither stylet nor bougie to facilitate difficult intubation. ⋯ Twenty-nine (76%) ambulance services had no type of device other than a stethoscope to confirm tracheal tube placement. This survey showed wide variations in the equipment for airway management available to paramedic crews in the United Kingdom. We recommend provision of a standard set of airway management equipment to all paramedic crews in the United Kingdom together with introduction of appropriate training programmes.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Public defibrillation: increased survival from a structured response system.
The Public Access Defibrillation (PAD) trial was a prospective, randomized, controlled study designed to compare the number of persons surviving to hospital discharge after experiencing an out-of-hospital cardiac arrest (OOH-CA) among "community units" randomized to receive cardiopulmonary resuscitation (CPR) only or CPR plus an automated external defibrillator (AED). In 24 centers across the United States and Canada, 993 community units, composed of 1260 individual facilities, trained more than 19,000 layperson responders in CPR-only or CPR+AED. ⋯ Use of an AED within this structured response system can increase the number of survivors to hospital discharge after OOH-CA. Trained nonmedical responders can use AEDs safely and effectively.