EMT domestic violence knowledge and the results of an educational intervention Steven J Weiss, Amy A Ernst, Don Blanton, David Sewell, Todd G Nick
DOI: http://dx.doi.org/10.1016/S0735-6757(00)90011-1
The American Journal of Emergency Medicine , Vol. 18 , Issue 2 ,
Published in issue: March 2000
x The objective of this study was to determine levels of knowledge regarding domestic violence (DV), and the effectiveness of formal instruction about DV. A general knowledge survey of DV was given before and approximately 4 to 6 months after 3 hours of instruction given by Emergency Medicine and Law Enforcement faculty. A Emergency medical service (EMS) consisting of 73% paramedic-level providers in a metropolitan urban/suburban area. Differences in DV knowledge before and after the instruction were the main outcome measures.
Mass-gathering medicine: a descriptive analysis of a range of mass-gathering event types Samuel Locoh-Donou, Yan Guofen, Melanie Welcher, Thomas Berry, Robert E. O'Connor, William J. Brady
DOI: http://dx.doi.org/10.1016/j.ajem.2013.01.016
The American Journal of Emergency Medicine , Vol. 31 , Issue 5 ,
Published online: February 28 2013
x To identify and evaluate the volume, nature, and severity of patient presentations encountered by emergency medical services (EMS) at all mass-gathering events held at or near a southeastern US university. In addition, to compare the existing literature base (single mass-gathering event held in large urban population centers) with a broader variety of events varying in crowd size and locations.
Ambulance diversion reduction: the Sacramento solution Pankaj B. Patel, Robert W. Derlet, David R. Vinson, Michael Williams, Jonathan Wills
DOI: http://dx.doi.org/10.1016/j.ajem.2005.09.005
The American Journal of Emergency Medicine , Vol. 24 , Issue 2 ,
Published in issue: March 2006
x The diversion of ambulances away from their intended emergency departments (EDs) in the United States has become commonplace and may compromise patient care. Although ambulance diversion resulting from ED overcrowding has been well described in the literature, little is known about how to reduce the incidence of ambulance diversion on a regional level. We describe the development, implementation, and impact of a region-wide program to reduce ambulance diversion.
Designing a prehospital system for a developing country: Estimated cost and benefits Mark Hauswald, Ernest Yeoh
DOI: http://dx.doi.org/10.1016/S0735-6757(97)90167-4
The American Journal of Emergency Medicine , Vol. 15 , Issue 6 ,
Published in issue: October 1997
x Many of the costs associated with prehospital care in developed countries are covered in budgets for fire suppression, police services, and the like. Determining these costs is therefore difficult. The costs and benefits of developing a prehospital care system for Kuala Lumpur, Malaysia, which now has essentially no emergency medical services (EMS) system, were estimated. Prehospital therapies that have been suggested to decrease mortality were identified. A minimal prehospital system was designed to deliver these treatments in Kuala Lumpur.
Paroxysmal supraventricular tachycardia: Outcome after ED care Samuel Luber, William J. Brady, Thomas Joyce, Andrew D. Perron
DOI: http://dx.doi.org/10.1053/ajem.2001.20030
The American Journal of Emergency Medicine , Vol. 19 , Issue 1 ,
Published in issue: January 2001
x The objective of this study was to investigate the outcome and rate of symptomatic recurrence of paroxysmal supraventricular tachycardia (PSVT) in an emergency department (ED) patient population, after ED management and disposition. A retrospective descriptive review of ED records and state death registry was performed. The study took place at a University hospital ED with 60,000 annual patient volume. The subjects were all patients presenting to the ED in PSVT from January 1993 to December 1996.
Physicians at the roadside: Pre-hospital emergency care in the United Kingdom Paul P. Silverston
DOI: http://dx.doi.org/10.1016/0735-6757(85)90172-X
The American Journal of Emergency Medicine , Vol. 3 , Issue 6 ,
Published in issue: November 1985
x In some parts of the United Kingdom (UK), family doctors (or “general practitioners” as they are called in the UK) are routinely called upon by the emergency medical services (EMS) system to attend road accidents. The doctors are volunteers and travel to the scene of the accident in their own cars. Members of one such general practitioner accident service operating in Mid-Anglia complete an accident report form after attending each incident. In 1983, the Mid-Anglia General Practitioner Accident Service (MAGPAS) received 1,715 calls for medical assistance, and in 95% of these a doctor was sent immediately.
Duration of well-controlled core temperature correlates with neurological outcome in patients with post-cardiac arrest syndrome Koichiro Shinozaki, Shigeto Oda, Tomohito Sadahiro, Masataka Nakamura, Yo Hirayama, Eizo Watanabe, Yoshihisa Tateishi, Kasuya Nakanishi, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2012.03.024
The American Journal of Emergency Medicine , Vol. 30 , Issue 9 ,
Published online: July 16 2012
x Detailed procedures for optimal therapeutic hypothermia (TH) have yet to be established. We examined how duration of well-controlled core temperature within the first 24 hours after cardiac arrests (CA) correlated with neurological outcomes of successfully resuscitated out-of-hospital CA (OHCA) patients.
Adverse lighting condition effects on the assessment of capillary refill Lawrence H. Brown, N.Heramba Prasad, Theodore W. Whitley
DOI: http://dx.doi.org/10.1016/0735-6757(94)90196-1
The American Journal of Emergency Medicine , Vol. 12 , Issue 1 ,
Published in issue: January 1994
x In 1989, Champion et al1 recommended revising the Trauma Score to exclude capillary refill because it is “difficult to assess at night…” However, a literature search produced no studies evaluating the effect of lighting conditions on the assessment of capillary refill. This study was undertaken to determine if any such effect exists. Three hundred nine participants at an emergency medical services (EMS) seminar were asked to assess each others' capillary refill in both light and dark environments.
Effectiveness of mechanical versus manual chest compressions in out-of-hospital cardiac arrest resuscitation: A pilot study Edward T Dickinson, Vincent P Verdile, Robert M Schneider, Richard F Salluzzo
DOI: http://dx.doi.org/10.1016/S0735-6757(98)90105-X
The American Journal of Emergency Medicine , Vol. 16 , Issue 3 ,
Published in issue: May 1998
x A prospective, randomized effectiveness trial was undertaken to compare mechanical versus manual chest compressions as measured by end-tidal CO2 (etco 2 ) in out-of-hospital cardiac arrest patients receiving advanced cardiac life support (ACLS) resuscitation from a municipal third-service, emergency medical services (EMS) agency. The EMS agency responds to approximately 6,700 emergencies annually, 79 of which were cardiac arrests in 1994, the study year. Following endotracheal intubation, all cardiac arrest patients were placed on 100% oxygen via the ventilator circuit of the mechanical cardiopulmonary resuscitation (CPR) device.
Standards and limits: Emergency physicans' attitude toward prehospital resuscitation Kenneth V. Iserson, Carol Stocking
DOI: http://dx.doi.org/10.1016/0735-6757(93)90008-Y
The American Journal of Emergency Medicine , Vol. 11 , Issue 6 ,
Published in issue: November 1993
x The attitudes of emergency physicians toward using medical techniques in out-of-hospital medical cardiac arrest scenarios were assessed. The physicians' willingness to further limit the use of these techniques through prehospital Do Not Attempt Resuscitation (DNAR) protocols and their personal use of advance directives were also assessed. Questionnaires were distributed to the 1990 Council of the American College of Emergency Physicians, San Francisco, CA, to elicit demographic and clinical information.
Can melatonin improve adaptation to night shift? Mark James, Michael O Tremea, Jeffrey S Jones, Jon R Krohmer
DOI: http://dx.doi.org/10.1016/S0735-6757(98)90129-2
The American Journal of Emergency Medicine , Vol. 16 , Issue 4 ,
Published in issue: July 1998
x This study was undertaken to determine whether melatonin (N -acetyl-5-methoxytryptamine) is effective in helping emergency medical services (EMS) personnel who work rotating night shifts reset their biological clocks and minimize circadian rhythm disruption. A double-blinded, randomized, crossover study was performed using 22 volunteers. Participants were working a span of consecutive night (2300 to 0700 hours) shifts and received either a melatonin capsule (6 mg) or placebo to be taken before each of the consecutive day sleeps.
Success rates for initiation of intravenous therapy en route by prehospital care providers Corey M. Slovis, Elizabeth W. Herr, Donald Londorf, Teresa D. Little, Benjie R. Alexander, Ricky J. Guthmann
DOI: http://dx.doi.org/10.1016/0735-6757(90)90080-J
The American Journal of Emergency Medicine , Vol. 8 , Issue 4 ,
Published in issue: July 1990
x The optimal extent of prehospital care, including intravenous (IV) therapy for critically III patients, remains unclear. The authors evaluated the success rate for IV cannulation in a moving ambulance by trained emergency medical technicians and paramedics in 641 adult medical- and trauma-related cases. At least one IV line was started in 80% of medical patients and 92% of trauma patients, regardiess of blood pressure. In hypotensive patients, the success rates for at least one IV in medical and trauma patients were 80% and 95%, respectively.
Intravenous adenosine as first-line prehospital management of narrow-complex tachycardias by EMS personnel without direct physician control Richard Furlong, Robert T Gerhardt, Pamela Farber, Kathleen Schrank, Regina Willig, Juan Pittaluga
DOI: http://dx.doi.org/10.1016/0735-6757(95)90119-1
The American Journal of Emergency Medicine , Vol. 13 , Issue 4 ,
Published in issue: July 1995
x This study was conducted to evaluate the safety and efficacy of intravenous adenosine therapy for prehospital treatment of narrow-complex tachycardias with a presumptive field diagnosis of paroxysmal supraventricular tachycardia (PSVT) by paramedics without direct physician control. A ten-month prospective case series was designed in an urban EMS system that has paramedics operating under standing orders before physician radio contact. All patients with PSVT field diagnosis were included. Diagnosis of PSVT was made by regular, narrow-complex tachycardia with a heart rate greater than 160 beats/min by field ECG.
Surgical delays and outcomes in patients treated with pneumatic antishock garments: A population-based study Steven B Karch, Terry Lewis, Sandy Young, Chih-Hsiang Ho
DOI: http://dx.doi.org/10.1016/0735-6757(95)90123-X
The American Journal of Emergency Medicine , Vol. 13 , Issue 4 ,
Published in issue: July 1995
x Until mid-1991, our emergency medical services (EMS) system required the routine application of pneumatic antishock garments (PASGs) in all trauma cases, and inflation of the garment if the patient was hypotensive (systolic blood pressure < 90 mm Hg). The findings in 398 trauma patients who underwent emergency surgery when PASG was still being routinely applied were compared with the findings in 590 trauma patients who underwent emergency surgery after routine PASG application had been discontinued.
A comparison of rural and urban ambulance crashes Steven J. Weiss, Randall Ellis, Amy A. Ernst, Richard F. Land, Austin Garza
DOI: http://dx.doi.org/10.1053/ajem.2001.20001
The American Journal of Emergency Medicine , Vol. 19 , Issue 1 ,
Published in issue: January 2001
x Ambulance crashes are a significant safety issue both to the EMTs and to patients transported in the vehicle. Safety issues are dependent on the environment and may be different in rural and urban settings. Ambulance crashes reported to the State EMS bureau during the years of 1993 to 1997 were evaluated. Counties with >250,000 population were considered urban. State population was 2 million urban and 2.8 million rural. Two investigators determined first if the crash was urban or rural. Outcome information was extracted on the degree of injury, citations given, and information on the ambulance and other vehicle condition.
Exertional heat illness and hyponatremia in hikers Howard D Backer, Ellen Shopes, Sherrie L Collins, Howard Barkan
DOI: http://dx.doi.org/10.1016/S0735-6757(99)90191-2
The American Journal of Emergency Medicine , Vol. 17 , Issue 6 ,
Published in issue: October 1999
x We compared clinical presentation and course of exercise-associated hyponatremia with heat exhaustion among summertime hikers in Grand Canyon National Park. Cases were selected from among hikers who requested medical help from the National Park Service Emergency Medical Service (EMS) or who presented to the medical clinic on the rim of the canyon with complaints related to exercise in the heat. Of 44 patients who had serum samples analyzed, 7 had hyponatremia with clinically significant symptoms and serum sodium levels <130 mmol/L: 3 had grand mal seizures, 2 had other major central nervous system disorders, and 2 had minor neurological symptoms.
One-year survival after prehospital cardiac arrest: The Utstein style applied to a rural-suburban system Lawrence E. Kass, David R. Eitel, Nancy K. Sabulsky, Cynthia S. Ogden, Dean R. Hess, Kristi L. Peters
DOI: http://dx.doi.org/10.1016/0735-6757(94)90190-2
The American Journal of Emergency Medicine , Vol. 12 , Issue 1 ,
Published in issue: January 1994
x To evaluate the recently published Utstein algorithm (Ann Emerg Med 1991;20:861), the authors conducted a retrospective review of all advanced life support (ALS) trip sheets and hospital records of patients with prehospital cardiac arrests between January 1988 and December 1989. Telephone follow-up was used to determine 1-year survival rates. Of 713 arrests in the 24-month study period, 601 were of presumed cardiac etiology. Approximately 599 of these charts were available for analysis. One hundred ninety-three (32.2%) of these had return of spontaneous circulation (ROSC), 36 (6.0%) survived to hospital discharge, and 24 were alive at 1-year follow-up (4.0% of total or 67% of survivors to discharge).
Comparison of a vacuum splint device to a rigid backboard for spinal immobilization David R Johnson, Mark Hauswald, Cy Stockhoff
DOI: http://dx.doi.org/10.1016/S0735-6757(96)90051-0
The American Journal of Emergency Medicine , Vol. 14 , Issue 4 ,
Published in issue: July 1996
x In this study, comparison of a vacuum splint device to a rigid backboard was made with respect to comfort, speed of application, and degree of immobilization. The study was a prospective, nonblinded comparative study conducted at a statewide emergency medical services (EMS) training facility and included a convenience sample of emergency medical technician (EMT) and paramedic students. The vacuum splint was judged to be significantly more comfortable on a 10-point scale than the rigid backboard after subjects had been lying on each device for 30 minutes (P < .001).
Vomiting is not associated with poor outcomes in pediatric victims of unintentional submersions Kimberley M. Farr, Elizabeth A. Camp, Shabana Yusuf, Rohit P. Shenoi
DOI: http://dx.doi.org/10.1016/j.ajem.2015.01.055
The American Journal of Emergency Medicine , Vol. 33 , Issue 5 ,
Published online: February 4 2015
x The outcome of submersion victims depends on submersion duration and the availability of timely and effective resuscitation. The prognostic implication of vomiting during resuscitation of submersion victims is unclear. The study sought to determine whether vomiting during resuscitation in children treated for unintentional submersion injuries adversely impacts outcome.
In-flight oral endotracheal intubation Timothy Harrison, Stephen H Thomas, Suzanne K Wedel
DOI: http://dx.doi.org/10.1016/S0735-6757(97)90156-X
The American Journal of Emergency Medicine , Vol. 15 , Issue 6 ,
Published in issue: October 1997
x This study's goal was to analyze aeromedical emergency medical services (EMS) endotracheal intubation (ETI) success rates for in-flight intubations, and to retrospectively compare in-flight ETI success rates with those achieved in hospital and trauma scene settings. Patients undergoing flight crew ETI during a 3-year study period were reviewed, and flight team-performed intubations were classified as in-flight, hospital (at referring hospital), or ground (at trauma scene). Flight crews attempted ETI in 302 patients, with success in 291 patients (96.4%).
