Articles: emergency-medical-services.
-
Multicenter Study Comparative Study Clinical Trial
Call-to-needle times for thrombolysis in acute myocardial infarction in Victoria.
To determine the proportion of patients in Victoria treated within the British Heart Foundation 90-minute call-to-needle (CTN) time benchmark for thrombolysis of ST-elevation myocardial infarction (STEMI), and to validate the British Heart Foundation 90-minute benchmark with respect to mortality. ⋯ The British Heart Foundation CTN time benchmark is being met for 61% of eligible STEMI patients in Victoria. Strategies to reduce CTN time should be region-specific, and should include attempts to reduce DTN and to enhance ambulance-hospital communication. Prehospital thrombolysis may be appropriate for some regions.
-
Multicenter Study
Impact of NHS walk-in centres on the workload of other local healthcare providers: time series analysis.
To assess the impact of NHS walk-in centres on the workload of local accident and emergency departments, general practices, and out of hours services. ⋯ It will be necessary to assess the impact of walk-in centres in a larger number of sites and over a prolonged period, to determine whether they reduce the demand on other local NHS providers.
-
Multicenter Study
Effect of NHS walk-in centre on local primary healthcare services: before and after observational study.
To assess the effect of an NHS walk-in centre on local primary and emergency healthcare services. ⋯ The NHS walk-in centre did not greatly affect the workload of local general practitioners. However, the workload of the local minor injuries unit increased significantly, probably because it was in the same building as the walk-in centre.
-
Multicenter Study Comparative Study
Multicenter Canadian study of prehospital trauma care.
To evaluate whether the type of on-site care a trauma patient receives affects outcome. ⋯ In urban centers with highly specialized level I trauma centers, there is no benefit in having on-site ALS for the prehospital management of trauma patients.
-
Multicenter Study
Multicenter prospective validation of prehospital clinical spinal clearance criteria.
Spine immobilization is one of the most frequently performed prehospital procedures. If trauma patients without significant risk for spine injury complications can be identified, spine immobilization could be selectively performed. The purpose of this study was to evaluate five prehospital clinical criteria-altered mental status, neurologic deficit, spine pain or tenderness, evidence of intoxication, or suspected extremity fracture-the absence of which identify prehospital trauma patients without a significant spine injury. ⋯ Absence of the study criteria may form the basis of a prehospital protocol that could be used to identify trauma patients who may safely have rigid spine immobilization withheld. Evaluation of such a protocol in practice should be performed.