BACKGROUND Telemedicine is currently mainly applied as an in-hospital service, but this technology also holds potential to improve emergency care in the prehospital arena. We report on the safety, feasibility and reliability of in-ambulance teleconsultation using a telemedicine system of the third generation. METHODS A routine ambulance was equipped with a system for real-time bidirectional a...

BACKGROUND Prehospital ultrasound has been shown to aid in the diagnosis of multiple conditions that do not generally change prehospital management. On the other hand, the diagnoses of cardiac tamponade, tension pneumothorax, or cardiac standstill may directly impact patient resuscitation in the field. STUDY OBJECTIVE To determine if prehospital care providers can learn to acquire and recogni...

The practice of emergency medicine (EM) has been intertwined with emergency medical services (EMS) for more than 40 years. In this commentary, we explore the practice of translating hospital based evidence into the prehospital setting. We will challenge both EMS and EM dogma-bringing hospital care to patients in the field is not always better. In providing examples of therapies championed in ho...

BACKGROUND Indonesia is a huge, diverse, and developing country that until recently had no public ambulance service let alone a system of prehospital care. It commonly experiences many natural disasters, manmade conflicts, and violence as well as the daily emergencies seen worldwide. CURRENT SYSTEM Hospitals of varying standards are widespread but have no system of emergency ambulance or pati...

BACKGROUND Errors in the decision-making process are probably the main threat to patient safety in the prehospital setting. The reason can be the change of focus in prehospital care from the traditional "scoop and run" practice to a more complex assessment and this new focus imposes real demands on clinical judgment. The use of Clinical Guidelines (CG) is a common strategy for cognitively suppo...

Ambulance personnel today are highly trained and perform specialized care. There are high expectations with respect to knowledge and competence of the Registered Nurses, RNs, in ambulance care, as they possess a medical responsibility for patient care in this setting. The overall aim of this thesis was to explore the training for RNs in ambulance care in Sweden and Europe, and to study the alig...

BACKGROUND Prehospital care of combat casualties is a critical phase of emergency medical practice on the battlefield. The Joint Theater Trauma Registry (JTTR) was developed to standardize a system of data collection for combat casualty care; however, the degree of population and granularity of prehospital data were unknown. METHODS This is a retrospective comparative study of all US military...

Simulation-based training for prehospital emergency care is characterized by high degrees of complexity. Thorough knowledge of both the work and the setting is crucial and it is therefore important to involve both end-users and other stakeholders during the whole design process. This paper investigates a design process by focusing on how project participants experience the work process and part...