Articles: emergency-medical-services.
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Ann. N. Y. Acad. Sci. · Jan 1982
Community-based cardiopulmonary resuscitation: what have we learned?
During the past 9 years, more than 175,000 residents of Seattle have received basic training in cardiopulmonary resuscitation (CPR). On the basis of experience in that city and of observations from three other communities, there is little doubt that early initiation of CPA by a bystander is associated with a substantially improved survival. In one year, 43% of patients (47/109) found in a state of ventricular fibrillation survived to hospital discharge when bystanders initiated CPR. ⋯ In patients with out-of-hospital ventricular fibrillation, the factors that determine survival are predominantly related to the rapidity with which care is provided, namely, the time from collapse to initiation of CPR and the time to provision of advanced life-support measure. In many communities a 50% survival rate from ventricular fibrillation is probably attainable. Further improvement might accrue from the extensive deployment of inexpensive defibrillators capable of detecting ventricular fibrillation and suitable for use by the general public.
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The major objective of this research project was to apply the scientific discipline of decision-making to the problem of identifying the appropriate receiving hospital for persons injured in accidents. This problem, which is usually referred to as the prehospital triage process, is enormously important in terms of maximizing the critically injured patient's chances for survival. The long term objective of this research program, for which this project was a pilot study, is to develop an interactive computer system to support decisions regarding triage of patients at the scene of medical emergencies. The completed system will offer guidance to the paramedic in deciding whether to transport the emergency victim to the nearest hospital for stabilization and further evaluation or directly to the hospital best equipped to deal with the specific conditions of the victim.
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Historical Article
The conceptual development of EMS systems in the United States, Part I.
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Pediatric triage algorithms which were prospectively and retrospectively validated in a pediatric acute care facility serve as the basis for the development of a simplified pediatric triage checklist. This checklist is used by minimally trained nonprofessionals to assign safely the care urgency categories of the chief complaints of pediatric "walk-in" patients. This article describes the background of the pediatric triage checklist and its adaptation to a computerized triage system. This system not only allows for safe triage, but also creates a mechanism for rapid, organized retrieval of data from individual and group patient triage encounters that is useful for the study and planning of health care delivery.