Articles: emergency-medical-services.
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Multicenter Study
Factors associated with the use of pharmacologic agents to facilitate out-of-hospital endotracheal intubation.
To identify a set of clinical factors most strongly associated with the use of drug-facilitated intubation (DFI) in the out-of-hospital setting. ⋯ The authors identified a set of predictors strongly associated with DFI. These data offer insight into the current use of DFI and support the development of consensus-based guidelines for this procedure.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Impact of time to treatment on mortality after prehospital fibrinolysis or primary angioplasty: data from the CAPTIM randomized clinical trial.
CAPTIM was a randomized trial comparing prehospital thrombolysis with transfer to an interventional facility (and, if needed, percutaneous intervention) with primary percutaneous coronary intervention (PCI) in patients with ST-segment-elevation myocardial infarction (STEMI). Because the benefit of thrombolysis is maximal during the first 2 hours after symptom onset, and because prehospital thrombolysis can be implemented earlier than PCI, this analysis studied the relationship between the effect of assigned treatment and the time elapsed from symptom onset. ⋯ Time from symptom onset should be considered when one selects reperfusion therapy in STEMI. Prehospital thrombolysis may be preferable to primary PCI for patients treated within the first 2 hours after symptom onset.
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Prehosp Disaster Med · Oct 2003
Multicenter StudyMeasurement of pain in the prehospital setting using a visual analogue scale.
The aim of this study was to use a visual analogue scale (VAS) to measure the adequacy of prehospital pain management. Patients reported pain severity at two points in time during treatment and transport by ambulance paramedics. The change in pain score was compared with a benchmark reduction of 20 mm that has been shown to correspond with the minimum clinically significant change in pain perception reported by patients. ⋯ The results suggest that inadequate analgesia is an issue in this study setting. Effective analgesia requires formal protocols or guidelines supported by effective analgesic therapies along with education that addresses attitudes that may inhibit pain assessment or management by paramedics. Regular audits form part of clinical quality assurance programs that assess analgesic practice. However, such audits must have access to data obtained from patient self-reporting of pain using a valid and reliable pain measurement tool.
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Multicenter Study Comparative Study
A comparison of first-responder automated external defibrillator (AED) application rates and characteristics of AED training.
To determine whether there were associations between the characteristics of first-responder automated external defibrillator (AED) training and AED application rates. ⋯ Use of a national AED training curriculum, training to the level of Certified First Responder or higher, and the ability for each first responder to apply the AED during continuing training were associated with higher AED application rates. Continuing training within the first year did not appear to be as important as actually using the AED during the training.
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Journal of women's health · Sep 2003
Randomized Controlled Trial Multicenter Study Clinical TrialPrehospital cardiac arrest and the adverse effect of male gender, but not age, on outcome.
To analyze the incidence and outcome of prehospital cardiac arrest as it correlated to gender and age as a secondary end point in an interventional clinical trial. ⋯ Male gender, but not age, is associated with both an increased incidence and a worsened outcome in prehospital cardiac arrest.