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Showing papers in "Prehospital Emergency Care in 2002"


Journal ArticleDOI
TL;DR: It is unclear whether current EMS system design may adversely impact administration of PA, and further work is needed to clarify whether patient need or EMS practice patterns result in low rates of PA.

106 citations


Journal ArticleDOI
TL;DR: This longitudinal study examines various attributes and demographic characteristics of emergency medical technicians (EMTs) and paramedics to identify factors that influence their careers, to identify trends in emergency medical services (EMS), and to provide data on why individuals report leaving the EMS career field.

98 citations


Journal ArticleDOI
TL;DR: Pain is a common condition among prehospital patients: 20% reported moderate to severe pain, and given the use of narcotic analgesics among those for whom pain information was not reported, this is likely a conservative estimate.

95 citations


Journal ArticleDOI
TL;DR: Emergency medical services providers in some areas are at substantial risk for encountering violence in the prehospital setting and certain situational factors may be used to predict the risk of encountering violence.

91 citations


Journal ArticleDOI
TL;DR: Intranasal naloxone may provide a safe, rapid, effective way to manage suspected opioid overdoses in the field and should be considered as an initial therapy for suspected opioid abusers.

90 citations


Journal ArticleDOI
TL;DR: In this urban system, paramedics cannot reliably predict which patients do and do not require emergency department (ED) care, and patients enrolled in this study were not designated as requiring ED care.

87 citations


Journal ArticleDOI
TL;DR: Whether paramedics can safely decide which patients do not require ambulance transport or emergency department (ED) care is determined by a prospective survey and linked medical record review.

87 citations


Journal ArticleDOI
TL;DR: A rapidly deployable first-responder service permits early defibrillation minutes before arrival of EMS personnel, which positively impacts the return of spontaneous circulation and survival to hospital discharge after cardiac arrest at Boston's Logan International Airport.

77 citations


Journal ArticleDOI
TL;DR: The use of ALS by prehospital personnel for children with out-of-hospital cardiac arrest did not improve survival to discharge from the hospital when compared with the use of basic life support (BLS).

77 citations



Journal ArticleDOI
TL;DR: Based on available data, the liberal use of fluid infusions for presumed uncontrolled internal hemorrhage, such as that usually occurring after penetrating abdominal and thoracic injuries, is no longer advised.

Journal ArticleDOI
TL;DR: One helicopter emergency medical services (HEMS) program's 15-year experience with interfacility transport of patients with suspected stroke is described, with emphasis on reporting changing patterns seen after the advent of thrombolytic therapy for stroke.

Journal ArticleDOI
TL;DR: This study shows that over time, standard immobilization causes a false-positive exam for midline vertebral tenderness, and recommends that, initially on arrival to the emergency department, immediate evaluation occur of all immobilized patients.

Journal ArticleDOI
TL;DR: It is recommended that EMS medical directors consider specific error audits to decrease sources of errors and to be better able to identify EMS providers who would benefit from retraining.

Journal ArticleDOI
TL;DR: A compendium of available outcomes-related literature covering noninjured patients as well as papers assessing outcome in mixed trauma-nontrauma HEMS study groups is reviewed.

Journal ArticleDOI
TL;DR: In this paper, a descriptive study involving retrospective analysis of an occupational injury database was conducted to determine the nature and frequency of injuries resulting from assaults on paramedics and firefighters in a large, fire department-based emergency medical services (EMS) system.

Journal ArticleDOI
TL;DR: There is very little evidence to support the effect of the prioritization of emergency ambulances on patient outcome, and two high-quality papers support the concept that criteria-based dispatch improves clinical outcome.

Journal ArticleDOI
TL;DR: Whether tools to aid dispatchers and paramedics in stroke diagnosis, assessment, and management can improve stroke patients' outcomes requires further study, as does the value of designated stroke centers.

Journal ArticleDOI
TL;DR: An EMS-based program may represent one approach to limitingNonurgent ED use by patients with nonurgent concerns who use 911 by appropriately identifying and triaging them to alternate care destinations.

Journal ArticleDOI
TL;DR: Although this study suggests that even very young, untrained children can successfully perform automated external defibrillation, training does significantly decrease the time to delivery of first shock.

Journal ArticleDOI
TL;DR: A change in protocol that permits trained paramedics to administer morphine without physician approval reduces time to analgesia administration without influencing the amount of morphine delivered per patient or the rate of prehospital morphine use.

Journal ArticleDOI
TL;DR: In this small sample, family members accept the nontransport of patients by trained EMS personnel after asystolic nontraumatic cardiac arrest occurring in private residences, which may positively impact emergency department resources for other critically ill patients.

Journal ArticleDOI
TL;DR: Emergency medical services professionals must actively participate with the broader health care community in creating performance measurements to ensure that high-quality care is delivered consistently.

Journal ArticleDOI
TL;DR: The National Association of State EMS Directors is working with its federal partners at the National Highway Traffic Safety Administration (NHTSA) and the Trauma and EMS program of the Health Resources and Services Administration's (HRSA) Maternal and Child Health Bureau to develop a national EMS database.

Journal ArticleDOI
TL;DR: The prolonged response, scene, and dispatch-beginning-to-hospital-arrival intervals compared with those for a developed EMS system indicate one potential area for improvement.

Journal ArticleDOI
TL;DR: Some ATLS interventions ( BLOOD, TRAN, and TRAN-GCS ) are associated with improved survival for selected high-risk subgroups in these 21 rural Level III trauma hospitals.

Journal ArticleDOI
TL;DR: It is suggested that prehospital fluid resuscitation of blunt injured trauma patients with systolic blood pressure ≤90 increases systolics blood pressure but has no effect on survival or length of hospital stay.

Journal ArticleDOI
TL;DR: Use of EMS telemedicine could result in an approximately 15% decrease in ambulance transports when it alone is added to the prehospital care provider's armamentarium.

Journal ArticleDOI
TL;DR: Until more EMS systems enact specific palliative care protocols, physicians treating the terminally ill should educate patients and families about appropriate use of the EMS system, and that EMS professionals may be required to provide more than supportive care.

Journal ArticleDOI
TL;DR: This study demonstrated that, in Syracuse, New York, ambulance diversion was once a seasonal phenomenon, but is increasingly occurring throughout the year because of staff and resource limitations, and demonstrated that ambulance diversion can be employed to reduce numbers of incoming transports.