Search results for "emergency medical services"
showing 10 items of 68 documents
Checking the carotid pulse check: diagnostic accuracy of first responders in patients with and without a pulse.
1996
International guidelines for cardiopulmonary resuscitation (CPR) in adults advocate that cardiac arrest be recognized within 5-10 s, by the absence of a pulse in the carotid arteries. However, validation of first responders' assessment of the carotid pulse has begun only recently. We aimed (1) to develop a methodology to study diagnostic accuracy in detecting the presence or absence of the carotid pulse in unresponsive patients, and (2) to evaluate diagnostic accuracy and time required by first responders to assess the carotid pulse. In 16 patients undergoing coronary artery bypass grafting, four groups of first responders (EMT-1: 107 laypersons with basic life support (BLS) training; EMT-2…
Emergency radiology: straightening of the cervical spine in MDCT after trauma--a sign of injury or normal variant?
2016
To evaluate whether straightening of the cervical spine (C-spine) alignment after trauma can be considered a significant multidetector CT (MDCT) finding.160 consecutive patients after C-spine trauma admitted to a Level 1 trauma centre received MDCT according to Canadian Cervical Spine Rule and National Emergency X-Radiography Utilization Study indication rule; subgroups with and without cervical collar immobilization (CCI +/-) were compared with a control group (n = 20) of non-traumatized patients. Two independent readers evaluated retrospectively the alignment, determined the absolute rotational angle of the posterior surface of C2 and C7 (ARA C2-7) and grouped the results for lordosis (-1…
Comparison of bystander trauma care for moderate versus severe injury.
2003
At the scene of an accident, the most severely injured patients need trauma care urgently. Bystanders are often present before the emergency medical service arrives and may be able to limit trauma-related damage by providing trauma care at the scene. The aim of this prospective study conducted in Mainz, Germany, and Vienna, Austria, was to compare the frequency and quality of bystander trauma care in moderately versus severely injured patients. Five specific measures (making the scene readily visible for oncoming traffic, extrication and positioning of the trauma patient, control of haemorrhage, and hypothermia protection) were assessed in a questionnaire and evaluated statistically. Bystan…
Artificial ventilation for basic life support leads to hyperventilation in first aid providers.
2003
The 'Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care - International Consensus on Science' recommend an artificial ventilation volume of 10 ml/kg bodyweight (equivalent to a tidal volume of 700-1000 ml) without the use of supplemental oxygen in adults with respiratory arrest. For first aid providers using the mouth-to-mouth or mouth-to-nose-ventilation technique, respectively, a ventilation volume of approximately 9.6 l/min results. Additionally, a deep breath is recommended before each ventilation to increase the end-expiratory oxygen concentration of the air exhaled by the first aid provider. To investigate the effects of these recommendations in health…
Emergency medical triage decisions are swayed by computer-manipulated cues of physical dominance in caller’s voice
2016
AbstractIn humans as well as other animals, displays of body strength such as power postures or deep masculine voices are associated with prevalence in conflicts of interest and facilitated access to resources. We conduct here an ecological and highly critical test of this hypothesis in a domain that, on first thought, would appear to be shielded from such influences: access to emergency medical care. Using acoustic manipulations of vocal masculinity, we systematically varied the perceived level of physical dominance of mock patients calling a medical call center simulator. Callers whose voice were perceived as indicative of physical dominance (i.e. those with low fundamental and formant fr…
I VOLI SANITARI
2018
The article concerns medical air transport, with particular reference to the rights of illness or injured passengers carried by air. Aspects concerning the european legal system on the medical emergency health service by aircraft and the requirements provisions of EMS and HEMS are examinated. Finally there is a part regarding the level of risk associated with health flight operations.
Multicentre observational study on practice of prehospital management of hypotensive trauma patients: the SPITFIRE study protocol
2022
IntroductionMajor haemorrhage after injury is the leading cause of preventable death for trauma patients. Recent advancements in trauma care suggest damage control resuscitation (DCR) should start in the prehospital phase following major trauma. In Italy, Helicopter Emergency Medical Services (HEMS) assist the most complex injuries and deliver the most advanced interventions including DCR. The effect size of DCR delivered prehospitally on survival remains however unclear.Methods and analysisThis is an investigator-initiated, large, national, prospective, observational cohort study aiming to recruit >500 patients in haemorrhagic shock after major trauma. We aim at describing the current p…
Cardiac arrest and coronavirus disease 2019
2022
The impact of the coronavirus disease 2019 (COVID-19) on the cardiovascular system has been highlighted since the very first weeks after the severe acute respiratory syndrome coronavirus 2 identification. We reviewed the influence of COVID-19 pandemic on cardiac arrest, both considering those occurred out of the hospital (OHCA) and in the hospital (IHCA).An increase in OHCA incidence occurred in different countries, especially in those regions most burdened by the COVID-19, as this seems to be bounded to the pandemic trend. A change of OHCA patients' characteristics, with an increase of the OHCA occurred at home, a decrease in bystander cardiopulmonary resuscitation and automated external d…
What is the impact of rerouting a cancer diagnosis from emergency presentation to GP referral on resource use and survival? Evidence from a populatio…
2018
Background Studies on alternative routes to diagnosis stimulated successful policy interventions reducing the number of emergency diagnoses and associated mortality risk. A dearth of evidence on the costs of such interventions might prevent new policies from achieving more ambitious targets. Methods We conducted a retrospective cohort study on the population of colorectal (88,051), breast (90,387), prostate (96,219), and lung (97,696) cancer patients diagnosed after a GP referral or an emergency presentation and reported in the Cancer Registry of England. Resource use and survival were compared 1 year before and 5 years after diagnosis (3 years for lung), including the costs of GP referrals…
Carbon dioxide levels during pre-hospital active compression–decompression versus standard cardiopulmonary resuscitation
1998
Abstract In a prospective randomised study we investigated end-tidal carbon dioxide levels during standard versus active compression–decompression (ACD) cardiopulmonary resuscitation (CPR) assuming that the end-tital carbon dioxide reflects cardiac output during resuscitation. In each group 60 patients with out-of-hospital cardiac arrest were treated either with the standard or the ACD method. End-tidal CO 2 ( p et CO 2 , mmHg) was assessed with a side-stream capnometer following intubation and then every 2 min up to 10 min or restoration of spontaneous circulation (ROSC). There was no difference in p et CO 2 between both patient groups. However, CO 2 was significantly higher in patients wh…