UNLABELLED Indications and evidence are limited, multiple and complex for emergency tourniquet use. Good recent outcomes challenge historically poor outcomes. Optimal tourniquet use in trauma care appears to depend on adequate devices, modern doctrine, refined training, speedy evacuation, and performance improvement. Challenges remain in estimation of blood loss volumes, lesion lethality, and c...

OBJECTIVE This study evaluates the effect of early administration of an empirical (1 mEq/kg) sodium bicarbonate dose on survival from prehospital cardiac arrest within brief (<5 minutes), moderate (5-15 minutes), and prolonged (>15 minutes) down time. METHODS Prospective randomized, double-blinded clinical intervention trial that enrolled 874 prehospital cardiopulmonary arrest patients manage...

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. METH...

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...