Study objective: This study associated survival from prehospital cardiac arrest to patient historical variables including presenting complaint, medications used, and medical history as a secondary end point in a trial evaluating the effect of bicarbonate administration. This raises issues concerning extensive prehospital historical assessment that may potentially delay care and transport. Metho...

A gap between guidelines or protocols and clinical practice often exists, which may result in patients not receiving appropriate care. Therefore, the objectives of this systematic review were (1) to give an overview of professionals' adherence to (inter)national guidelines and protocols in the emergency medical dispatch, prehospital and emergency department (ED) settings, and (2) to explore whi...

Aggressive reperfusion therapy for myocardial infarction (MI) characterized by acute ST-segment elevation leads to improved patient outcome. Furthermore, use of thrombolytic therapy is highly time-dependent: reperfusion therapy is beneficial within 12 h, but the earlier it is administered, the more beneficial it is. Thus, the focus of both prehospital and emergency department management of pati...

BACKGROUND In Japan, helicopters have rarely been used for emergency medical services. The use of helicopters not only ensures rapid evacuation but may also serve to provide emergency management to patients with life-threatening injuries in the prehospital setting. OBJECTIVES To evaluate a Japanese helicopter-based emergency medical system including an onboard physician, particularly in terms...

INTRODUCTION Back problems are a major occupational health issue for prehospital emergency care professionals. The goals of this article are to: 1) provide descriptive data about the prevalence and the severity of lower back and upper back disorders in EMTs and paramedics; 2) identify some individual and collective strategies used by EMTs and paramedics to protect their health as they perform p...

Background Acute pain is one of the most common problems faced in prehospital emergency medicine. Sufficient prehospital pain therapy reduces psychological and emotional stress. Other clinical benefits include optimized conditions for patient transport, increased patient satisfaction and a better chance of timely and proper analgesia at the emergency department. Unfortunately, undertreatment of...

BACKGROUND AND PURPOSE Emergency medical services routing of patients with acute stroke to designated centers may increase the proportion of patients receiving care at facilities meeting national standards and augment recruitment for prehospital stroke research. METHODS We analyzed consecutive patients enrolled within 2 hours of symptom onset in a prehospital stroke trial, before and after re...

BACKGROUND Sonography is an established diagnostic procedure in hospitals, but is not routinely used in prehospital emergency medicine. Several studies have addressed the use of ultrasound during helicopter flights and in emergency rooms, few in prehospital settings, but most focused on abdominal blunt trauma. Several case reports describe crucial decisions distinguished by ultrasound. METHOD...

The disciplines of paramedicine and emergency medicine have evolved synchronously over the past four decades, linked by emergency physicians with expertise in prehospital care. Ambulance offload delay (OD) is an inevitable consequence of emergency department overcrowding (EDOC) and compromises the care of the patient on the ambulance stretcher in the emergency department (ED), as well as parame...

OBJECTIVES Activated charcoal is now the mainstay of non-specific treatment for self poisoning in accident and emergency (A&E) departments and should be administered within one hour of ingestion of an overdose. This study aimed to investigate if compliance with treatment guidelines may be improved by the prehospital administration of activated charcoal. METHOD Ambulance report forms and case ...