[Pre-hospital management of adults with life-threatening emergencies].
1
Citation
0
Reference
10
Related Paper
Citation Trend
Keywords:
First aid
Life support
Electrocution
Cite
First aid
Life support
Electrocution
Cite
Citations (1)
This controlled trial was performed in London and compared outcomes of patients treated by ambulance staff using either basic life support alone or an automated external defibrillator (AED) as an adjunct to basic life support. Five of the 212 (2%) patients were successfully resuscitated by crews using basic life support alone, compared with seven of 186 (4%) patients treated by crews equipped with the AED. Neurological outcomes in the AED group were better. However, meaningful statistical comparisons are not possible with so few survivors. The AED used (Lifepak 200, PhysioControl Corp) was found to be sensitive and specific, and ambulance staff operated the defibrillator correctly. The use of AEDs is an option to maximize the provision of defibrillators in the community and could readily be incorporated into basic ambulance training.
Automated external defibrillator
Ambulance service
Life saving
Advanced Life Support
First aid
Cite
Citations (16)
Abstract In general, preparations for disasters which result in mass casualties do not incorporate a modern resuscitation approach. We explored the life-saving potential of, and time limits for life-supporting first aid (LSFA), advanced trauma life support (ATLS), resuscitative surgery, and prolonged life support (PLS: intensive care) following the earthquake in Armenia on 7 December 1988. We used a structured, retrospective interview method applied previously to evaluation of emergency medical services (EMS) in the United States. A total of 120 survivors of, and participants in the earthquake in Armenia were interviewed on site (49 lay eyewitnesses, 20 search-rescue personnel, 39 medical personnel and records, and 12 administrators). Answers were verified by crosschecks. Preliminary results permit the following generalizations: 1) a significant number of victims died slowly as the result of injuries such as external hemorrhage, head injury with coma, shock, or crush syndrome; 2) early search and rescue was performed primarily by uninjured covictims using hand tools; 3) many lives potentially could have been saved by the use of LSFA and ATLS started during extrication of crushed victims. 4) medical teams from neighboring EMS systems started to arrive at the site at 2-3 hours and therefore, A TLS could have been provided in time to save lives and limbs; 5) some amputations had to be performed in the field to enable extrication; 6) the usefulness of other resuscitative surgery in the field needs to be clarified; 7) evacuations were rapid; 8) air evacuation proved essential; 9) hospital intensive care was well organized; and 10) international medical aid, which arrived after 48 hours, was too late to impact on resuscitation. Definitive analysis of data in the near future will lead to recommendations for local, regional, and National Disaster Medical Systems (NDMS).
Life support
First aid
Mass Casualty
Mass-casualty incident
Trauma care
Advanced Life Support
Major trauma
Crush syndrome
Cite
Citations (57)
911, what's your emergency?Nearly any circumstance resulting in a call to 911 call, will involve a stressed or alarmed caller seeking help for himself or someone else. The person responsible for answering that call is assigned the crucial task of rapidly identifying the nature of the emergency, severity, and necessary resources to deploy, all while keeping the caller calm enough to answer the right questions. When specific life-threatening medical emergencies are identified, the following actions, by both the caller and recipient, can be the difference between survival or death. instruction refers to specific instructions or guidance provided by 911 dispatchers or public safety, answering point call-takers to the individuals making the emergency call.In 1974, the first organized effort to provide pre-arrival instructions was implemented in Phoenix, Arizona. Since then, numerous systems have replicated the intent of the initial program: identify the life threat and instruct the caller on appropriate and timely intervention to possibly save a life. Systems such as MDPS, CBD and Dispatch Life Support incorporate such instructions into specific call complaints. As of 1988, Emergency Medical Dispatch use of pre-arrival instructions has been the standard recommendation of the National Association of Emergency Management Service Physicians (NAEMSP). Pre-arrival instructions to patients or bystanders may include: General: safety, medication, providing access for responders. Hemorrhage control: direct pressure, elevating a bleeding extremity, possibly tourniquet application if needed. Choking: Heimlich maneuver, and recognition of cardiac arrest . Cardiac arrest: chest compressions. Respiratory arrest and drowning: airway and breathing maneuvers. Childbirth: umbilical cord tying, infant care, and resuscitation. One study published in 2000 revealed that 97% of community members surveyed would call 911 in an emergency, and 67% of respondents expected that calling 911 should result in receiving pre-arrival instructions for choking, a person not breathing, bleeding, and childbirth, when appropriate. At that time, however, many of these answering points were noted not to provide such instructions.
Choking
Life support
First aid
Advanced Life Support
Cite
Citations (2)
The ideal first response to a life-threatening pediatric emergency includes early recognition of the emergency, activation of the appropriate emergency response system, performance of basic life support (cardiopulmonary resuscitation/automated external defibrillator treatment), and initiation of advanced life support, but the extent of resuscitation training among health care providers likely to be first at the side of a critically ill or injured child is often deficient. In the past, resuscitation courses beyond basic life support focused on training advanced providers. The Pediatric Emergency Assessment, Recognition, and Stabilization course was developed by the American Heart Association to target a broad range of health care providers who are likely to be first at the side of a child requiring resuscitation. It is hoped that training of health care providers through the Pediatric Emergency Assessment, Recognition, and Stabilization course will translate into early recognition of life-threatening pediatric emergencies and greater resuscitation success, but results will depend on the availability of instruction and the maintenance of skills.
Preparedness
Advanced Life Support
Life support
First aid
Cite
Citations (16)
Multi-casualty incidents (MCIs) continue to occur throughout the world, whether they be mass shootings or natural disasters. Prehospital emergency services have done a professional job at stabilizing and transporting the victims to local hospitals. When there are multiple casualties, there may not be enough professional responders to care for the injured. Bystanders and organized volunteer first responders have often helped in extricating the victims, stopping the bleeding, and aiding in the evacuation of the victims. Magen David Adom (MDA translated as "Red Shield of David"), the national Emergency Medical Services (EMS) provider for Israel, has successfully introduced a program for volunteer first responders that includes both a mobile-phone-based application and appropriate life-saving equipment. Most of the responders, known as Life Guardians, are already medical professionals such as physicians, nurses, or off-duty medics. They are notified by a global positioning system application if there is a nearby life-threatening incident such as respiratory or cardiac arrest, major trauma, or an MCI. They are given a kit that includes a bag-valve mask device, oropharyngeal airways, tourniquets, and bandages. There are currently 17,000 Life Guardians, and in the first-half of 2017, they responded to 253 events.The Life Guardians are essentially an out-of-hospital manpower multiplier using a simple crowdsourcing application who have the necessary skills and equipment to treat those in cardiopulmonary arrest, or victims of trauma, including MCIs. Such a model can be integrated into other systems throughout the world to save lives. JaffeE, DadonZ, AlpertEA. Wisdom of the crowd in saving lives: the Life Guardians app. Prehosp Disaster Med. 2018;33(5):550-552.
Life saving
First aid
Mass-casualty incident
Advanced Life Support
Life support
First responder
Cite
Citations (14)
Automated external defibrillator
First aid
Advanced Life Support
Life saving
Sudden cardiac arrest
Life support
Cite
Citations (24)
Background: An effective ambulance is a vital requirement for providing an emergency medical service. Well-equipped ambulances with trained paramedics can save many lives during the golden hours of trauma care. The objective was to document the availability and utilization of basic life support equipment in the ambulances and to assess knowledge on first aid among the drivers.Methods: Descriptive design was used. Total of 109 ambulances linked to B.P. Koirala Institute of Health Sciences were enrolled using purposive sampling method. Self- constructed observation checklist and semi structured interview schedule was used for data collection. Results: More than half of the respondents had less than five years of experience and were not trained in first aid. About two-third of the respondents had adequate knowledge on first aid. About 90% of the ambulance had oxygen cylinder and adult oxygen mask which was ‘usually’ used equipment. More than half of ambulance had equipment less than 23% as compared to that of national guidelines. There was significant association of knowledge with the experience (p = 0.004) and training (p = 0.001). Availability of equipment was associated with training received (p = 0.007), organization (p= 0.032)and district (p = 0.023) in which the ambulance is registered.Conclusions: The study concludes that maximum ambulance linked to BPKIHS, Nepal did not have even one fourth of the equipment for basic life support. Equipment usually used was oxygen cylinder and oxygen mask. Majority of driver had adequate knowledge on first aid and it was associated with training and experience.
First aid
Ambulance service
Advanced Life Support
Life support
Cite
Citations (9)
The Israel Defense Forces Medical Corps prepares Israeli physicians for their field duty as providers of prehospital trauma care under combat conditions. Many physicians have no previous experience with emergency medicine. Military trauma education has been improving continuously to meet this challenge. In 1990, the Advanced Trauma Life Support program was launched in Israel. In 1998, a task-oriented approach to military trauma. Military Trauma Life Support, was introduced. This course is integrated in the 3-month training period of medical officers. Its objectives are to provide a comprehensive curriculum in prehospital military trauma, to simulate realistic combat scenarios and injury patterns, and to add practical skills and prehospital experience. The practical section includes definitive airway management in hospital operating rooms, emergency procedures training on cadavers, and prehospital experience on civilian emergency medical services ambulances.
Military medicine
Active duty
Life support
First aid
Cite
Citations (12)