Prehospital midthigh trauma and traction splint use: Recommendations for treatment protocols Neal Robert Abarbanell
DOI: http://dx.doi.org/10.1053/ajem.2001.21302
The American Journal of Emergency Medicine , Vol. 19 , Issue 2 ,
Published in issue: March 2001
x The present study was completed to establish an epidemiologic database defining the prehospital occurrence of midthigh trauma/suspected femoral shaft fractures, and the use of/need for traction splints (TS) in hope of developing recommendations for further treatment protocols. On review of 4,513 paramedic run reports for the 12-month period from January 1999 through December 1999, from a low-volume urban emergency medical services (EMS) system, 16 persons (0.35% total patients) presented with midthigh injuries.
Photograph documentation of motor vehicle damage by EMTs at the scene: A prospective multicenter study in the United States Richard C Hunt, Theodore W Whitley, E.Jackson Allison Jr, Richard V Aghababian, Jon R Krohmer, Fred Landes, John B McCabe, N.Heramba Prasad, and others
DOI: http://dx.doi.org/10.1016/S0735-6757(97)90003-6
The American Journal of Emergency Medicine , Vol. 15 , Issue 3 ,
Published in issue: May 1997
x The purpose of this study was to determine if emergency medical service (EMS) personnel could take instant photographs of motor vehicle damage at crash scenes depicting the area and severity of damage of the crash under adverse weather conditions, in different lighting, and quickly enough so as not to interfere with patient care. This prospective multicenter trial involved 35 ambulances responding to motor vehicle crash scenes in rural, suburban, and urban areas in five centers in four states. Emergency medical technicians (EMTs) reported their experience implementing a protocol for use of an instant camera to photograph vehicle damage at crash scenes.
An algorithm for identification of ST-elevation myocardial infarction patients by emergency medicine services Ryan E. Wilson, Herman S. Kado, Robert F. Percy, Ryan C. Butterfield, Joseph Sabato Jr, Joel A. Strom, Lyndon C. Box
DOI: http://dx.doi.org/10.1016/j.ajem.2013.04.013
The American Journal of Emergency Medicine , Vol. 31 , Issue 7 ,
Published online: May 24 2013
x ST-elevation myocardial infarction (STEMI) identification by emergency medicine services (EMS) leading to pre-hospital catheterization laboratory (CL) activation shortens ischemic time and improves outcomes. We examined the incremental value of addition of a screening clinical tool (CT), containing clinical information and a Zoll electrocardiogram (ECG)-resident STEMI identification program (ZI) to ZI alone.
Emergency medical systems in Czechoslovakia Kenneth Elam, Richard A. Harvey
DOI: http://dx.doi.org/10.1016/0735-6757(92)90192-Z
The American Journal of Emergency Medicine , Vol. 10 , Issue 6 ,
Published in issue: November 1992
x The year 1987 witnessed the “velvet revolution” of Vaclav Havel and the beginning of democratic reform in Czechoslovakia. As the country struggles to build a market-based economy, it maintains a well-developed socialist system of health care that is patterned after the former Soviet system and is free to all (Am J Emerg Med 1984;2:455–456). Formal private medical practice does not exist. Non-emergency care is provided by multispecialty, primary-care oriented clinics (polyklinka) where afterhours visits are possible due to the presence of on-call physicians.
The influence of urban, suburban, or rural locale on survival from refractory prehospital cardiac arrest Rade B Vukmir, The Sodium Bicarbonate Study Group
DOI: http://dx.doi.org/10.1016/j.ajem.2003.12.008
The American Journal of Emergency Medicine , Vol. 22 , Issue 2 ,
Published in issue: March 2004
x There are many variables that can have an effect on survival in cardiopulmonary arrest. This study examined the effect of urban, suburban, or rural location on the outcome of prehospital cardiac arrest as a secondary end point in a study evaluating the effect of bicarbonate on survival. The proportion of survivors within a type of EMS provider system as well as response times were compared. This prospective, randomized, double-blind clinical intervention trial enrolled 874 prehospital cardiopulmonary arrest patients encountered by prehospital urban, suburban, and rural regional EMS area.
Outcome of patients who refused out-of-hospital medical assistance Jonathan L Burstein, Mark C Henry, Jeanne Alicandro, David Gentile, EMT-D, Henry C Thode Jr, Judd E Hollander
DOI: http://dx.doi.org/10.1016/S0735-6757(96)90007-8
The American Journal of Emergency Medicine , Vol. 14 , Issue 1 ,
Published in issue: January 1996
x Activation of the emergency medical services (EMS) system does not always result in transport of a patient to the hospital. This study assessed the outcomes of patients who refused medical assistance in the field, to determine if refusal of medical assistance (RMA) is associated with poor outcomes. Four high-volume suburban volunteer ambulance corps participated in the study. Consecutive patients who refused medical assistance were prospectively enrolled. Medical and identifying data were collected for each patient.
The effect of interhospital transfers, emergency medical services, and distance on ischemic time in a rural ST-elevation myocardial infarction system of care James R. Langabeer II, Sapna Prasad, Munseok Seo, Derek T. Smith, Wendy Segrest, Theophilus Owan, Daniela Gerard, Michael D. Eisenhauer
DOI: http://dx.doi.org/10.1016/j.ajem.2015.04.009
The American Journal of Emergency Medicine , Vol. 33 , Issue 7 ,
Published online: April 9 2015
x Regional myocardial infarction systems of care have been shown to improve timely access to primary percutaneous coronary intervention (PCI). However, there is a relatively sparse research on rural “frontier” regions. Arrival mode, high rates of interhospital transfers, long transport times, low population density, and mostly volunteer emergency medical services (EMS) distinguish this region from metropolitan systems of care. We sought to assess the effect of interhospital transfers, distance, and arrival mode on total ischemic times for patients with ST-elevation myocardial infarctions undergoing primary PCI.
Trauma care systems Leo Uzych
DOI: http://dx.doi.org/10.1016/0735-6757(90)90300-O
The American Journal of Emergency Medicine , Vol. 8 , Issue 1 ,
Published in issue: January 1990
x Injury is a major cause of disability and death in the United States. The effective development and implementation of trauma care systems has the potential to reduce substantially the level of morbidity and mortality otherwise suffered by trauma and injury victims. However, extant trauma care systems have been strongly affected by disruptive forces, particularly uncompensated care of the indigent. The passage of proposed federal legislation (S 15 and HR 1602) may serve to relieve some of the more financially stressed trauma centers and construct a framework for trauma care systems having a viable future.
Emergency medicine in Ukraine: Challenges in the post-Soviet era Seth W. Wright, Lawrence B. Stack, Brian R. McMurray, Sergei Bolyukh
DOI: http://dx.doi.org/10.1053/ajem.2000.18110
The American Journal of Emergency Medicine , Vol. 18 , Issue 7 ,
Published in issue: November 2000
x The practice of emergency medicine in Ukraine is markedly different from the practice in North America. The emergency physician counterpart in Ukraine attends 6 years of medical school then 18 months of prehospital physician training at an EMS base station. Once trained, prehospital physicians work 160 hours/month in 24-hour shifts at the base station as part of a physician-nurse team which answers ambulance requests. Most patients are seen and treated on site of the ambulance call. Patients are transported to the hospital only 20% of the time.
Emergent cricothyroidotomies for trauma: training considerations David R. King, Michael P. Ogilvie, George Velmahos, Hasan B. Alam, Marc A. deMoya, Susan R. Wilcox, Ali Y. Mejaddam, Gwendolyn M. Van Der Wilden, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2011.10.026
The American Journal of Emergency Medicine , Vol. 30 , Issue 8 ,
Published online: December 28 2011
x Emergent cricothyroidotomy remains an uncommon, but life-saving, core procedural training requirement for emergency medicine (EM) physician training. We hypothesized that although most cricothyroidotomies for trauma occur in the emergency department (ED), they are usually performed by surgeons.
Is 15 minutes an appropriate resuscitation duration before termination of a traumatic cardiac arrest? A case-control study Cheng-Yu Chien, Yi-Chia Su, Chi-Chun Lin, Chan-Wei Kuo, Shen-Che Lin, Yi-Ming Weng
DOI: http://dx.doi.org/10.1016/j.ajem.2015.12.004
The American Journal of Emergency Medicine , Vol. 34 , Issue 3 ,
Published online: December 11 2015
x Previous guidelines suggest up to 15 minutes of cardiopulmonary resuscitation (CPR) accompanied by other resuscitative interventions before terminating resuscitation of a traumatic cardiac arrest. The current study evaluated the duration of CPR according to outcome using the model of a county-based emergency medical services (EMS) system in Taiwan.
The effect of Combitube use on paramedic experience in endotracheal intubation Charles E. Cady, Ronald G. Pirrallo
DOI: http://dx.doi.org/10.1016/j.ajem.2005.07.013
The American Journal of Emergency Medicine , Vol. 23 , Issue 7 ,
Published in issue: November 2005
x To determine the change in number of endotracheal intubations per paramedic after the implementation of Combitube use and to explore consequences.
Outcomes in severely ill patients transported without prehospital ALS Sheng-Chuan Hu, Wei-Fong Kao
DOI: http://dx.doi.org/10.1016/S0735-6757(96)90023-6
The American Journal of Emergency Medicine , Vol. 14 , Issue 1 ,
Published in issue: January 1996
x Because of the debate regarding the impact of advanced life support (ALS) care on the outcome of prehospital patients, we monitored the influence of lack of sophisticated prehospital treatment in cases of severe illness arriving by ambulance to the emergency department (ED). A prospective cohort study to examine and compare the outcome of trauma- and nontrauma-induced “ALS-eligible” cases in the setting of no prehospital care was carried out from August 1, 1993 through May 31, 1994. On arriving at the ED, patients meeting the criteria for ALS cases and sent by EMS public prehospital personnel were assessed for subjective and objective status and change in severity by triage nurses as well as being followed up for neurological status until discharged from the hospital.
Prehospital management of rapid atrial fibrillation: Recommendations for treatment protocols Neal Robert Abarbanell, Mary Ann Marcotte, Beata A. Schaible, Glenn E. Aldinger
DOI: http://dx.doi.org/10.1053/ajem.2001.18124
The American Journal of Emergency Medicine , Vol. 19 , Issue 1 ,
Published in issue: January 2001
x The present study was completed to establish an epidemiological database defining prehospital rapid atrial fibrillation (RAF) and interventions given such patients in the hope of developing recommendations for further treatment protocols. On review of 4,749 paramedic run reports from a low-volume urban emergency medical services (EMS) system, 33 persons (0.69%) presented with RAF. Data collected included vital signs/ventricular rate, patient age, ambulance field times, patient chief complaint, prehospital interventions, efficacy of interventions, additional cardiac rhythms, iatrogenic complications, and patient past medical history.
Efficiency and cost-effectiveness of advanced EMS in West Germany G. Riediger, Thomas Fleischmann-Sperber
DOI: http://dx.doi.org/10.1016/0735-6757(90)90301-F
The American Journal of Emergency Medicine , Vol. 8 , Issue 1 ,
Published in issue: January 1990
x A model study was performed by an economist in Lower Frankonia (a mostly rural area of West Germany with several urban centers) to examine the efficiency and cost-effectiveness of the emergency medical service that included prehospital physician presence.‡ To perform this examination about $3.5 million were spent to improve organization and communication within the local emergency medical service, to purchase additional equipment and further emergency vehicles, and to install pre-hospital emergency physician service.
Seroprevalence of hepatitis B and hepatitis C among rural emergency medical care personnel Howard A Werman, Robert Gwinn
DOI: http://dx.doi.org/10.1016/S0735-6757(97)90006-1
The American Journal of Emergency Medicine , Vol. 15 , Issue 3 ,
Published in issue: May 1997
x To identify the prevalence of serologic markers of hepatitis B and hepatitis C among rural prehospital providers, a prospective descriptive study was conducted of a rural county emergency medical services (EMS) system. Participants included 107 prehospital care providers: 102 EMT-Bs, 1 paramedic, and 4 law enforcement first responders. Blood samples taken from prehospital care providers were tested for hepatitis B surface antigen (HBsAg), antibody to HBsAg (HBsAb), antibody to hepatitis B core antigen (HBcAb), and antibody to hepatitis C (anti-HC).
Factors contributing to paramedic onscene time during evaluation and management of blunt trauma Jerris R. Hedges, Stan Feero, Brian Moore, Bette Shultz, Dennis W. Haver
DOI: http://dx.doi.org/10.1016/0735-6757(88)90242-2
The American Journal of Emergency Medicine , Vol. 6 , Issue 5 ,
Published in issue: September 1988
x Prehospital patient management decisions are complex because the traumatized patient population is heterogeneous with respect to demographics, mechanism of injury, physiological response to injury, and time from injury to medical care. One hundred and nine blunt trauma patient evaluations by paramedics in a county-wide semirural emergency medical services (EMS) system were analyzed to determine paramedic time on the scene and the factors that might influence onscene time. Onscene time linearly correlated with a prolonged transport time.
Factors associated with sudden death of individuals requiring restraint for excited delirium Samuel J. Stratton, Christopher Rogers, Karen Brickett, Ginger Gruzinski
DOI: http://dx.doi.org/10.1053/ajem.2001.22665
The American Journal of Emergency Medicine , Vol. 19 , Issue 3 ,
Published in issue: May 2001
x The purpose of this article is to identify and rank factors associated with sudden death of individuals requiring restraint for excited delirium. Eighteen cases of such deaths witnessed by emergency medical service (EMS) personnel are reported. The 18 cases reported were restrained with the wrists and ankles bound and attached behind the back. This restraint technique was also used for all 196 surviving excited delirium victims encountered during the study period. Unique to these data is a description of the initial cardiopulmonary arrest rhythm in 72% of the sudden death cases.
Out-of-hospital use of an automated chest compression device: facilitating access to extracorporeal life support or non–heart-beating organ procurement Jean Marc Agostinucci, Mirko Ruscev, Michel Galinski, Serge Gravelo, Tomislav Petrovic, Cyril Carmeaux, Hakim Haouache, France Roussin, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2010.06.029
The American Journal of Emergency Medicine , Vol. 29 , Issue 9 ,
Published online: October 18 2010
x The aim of the study was to assess the ease-of-use, safety, and usefulness of an automated external chest compression device for cardiopulmonary resuscitation.
Response times and outcomes for cardiac arrests in las vegas casinos Steven B Karch, Jon Graff, Sandra Young, Chih-Hsiang Ho
DOI: http://dx.doi.org/10.1016/S0735-6757(98)90094-8
The American Journal of Emergency Medicine , Vol. 16 , Issue 3 ,
Published in issue: May 1998
x This study was conducted to measure emergency medical services (EMS) response times in sudden out-of-hospital cardiac arrests and relate those times to probability of survival in cardiac arrest victims in Las Vegas casino-hotels from January 1993 to June 1996. Times from 911 activation to casino arrival and casino arrival to arrival at patient's side (time to first defibrillatory shock), as well as survival to hospital discharge, were studied with regression analysis. Sixty patients survived (29.3%).
