Articles: emergency-medical-services.
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The Boston Emergency Medical Service system was studied to determine the effects of Advanced Life Support (ALS) prehospital trauma care compared to Basic Life Support (BLS) treatment. The severity of injury and clinical status of patients was defined and monitored using the Trauma Score (TS) described by Champion. ⋯ Furthermore, a positive change in prehospital TS was significantly related to an increased chance of long-term survival for any given severity of injury (p = 0.0002). From these data we conclude that the TS is useful for prehospital triage and that appropriate field ALS resuscitation results in more favorable outcomes following major trauma.
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Emergency Medical Aid (AMU) has existed on an organized basis in France for ten years. Considering that every call for medical assistance requires an answer the SAMU (Emergency Medical Aid Service) acts as a switchboard. Its implantation in a hospital and its powerful centralized telecommunications make it possible to adapt responses to the type of case: serious ones require sophisticated equipment, whereas non-serious ones come under a General Practitioner. ⋯ The SAMU also have other missions such as: teaching, prevention, disasters. The French system is aimed at reducing inequality in emergency situations and guaranteeing the whole population permanent medical care. Its cost to the public, however, is only +1 per inhabitant per year.
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Evaluation of the burned patient in the emergency department and fluid resuscitation of burned patients are discussed in detail.
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A surveillance system identified all out-of-hospital cardiac patients under the age of 18 who received emergency care in suburban King County, Washington. The etiology, cardiac rhythm, and outcome were identified for each case. During a 6 1/2-year period, 119 cardiac arrests occurred (annual incidence, 12.7/100,000 among individuals less than 18). ⋯ Six percent of patients treated with basic EMT care were discharged, compared with 7% of patients treated with EMT and paramedic care. In contrast to resuscitation from cardiac arrest in adults, the likelihood of successful resuscitation in children is very poor. This is due to different etiologies and the higher proportion of asystole seen in pediatric cardiac arrest as compared with adults.