Guidelines recommend implementing prehospital electrocardiograms (PH ECG) into systems of care for patients with suspected ST-elevation–myocardial infarction to reduce door-to-balloon time (DTB). We developed a PH ECG protocol with an affiliated emergency medical service, combining 4 features: (1) PH ECG acquisition; (2) emergency medical service interpretation without PH ECG transmission; (3) ...

Road traffic crash-related death, injury, and chronic disability continue to be a major worldwide burden to drivers, pedestrians, and users of mass transit, especially in low- and middle-income countries (LMIC). Projections predict worsening of this burden, and while motorization of LMIC increases exponentially, a corresponding improvement in prehospital and acute in-hospital trauma care has no...

OBJECTIVE Preclinical actions in the primary assessment of victims of blunt trauma may prolong the time to definitive clinical care. The aim of this study was to examine the duration of performed interventions and to study the effect of on-scene time (OST) and interventions performed before admission to hospital on hospital resuscitation time. METHODS 147 consecutive patients with high-energy...

In acute ischemic stroke, time from symptom onset to intervention is a decisive prognostic factor. In order to reduce this time, prehospital thrombolysis at the emergency site would be preferable. However, apart from neurological expertise and laboratory investigations a computed tomography (CT) scan is necessary to exclude hemorrhagic stroke prior to thrombolysis. Therefore, a specialized ambu...

IMPORTANCE Implementation of prehospital stroke triage is a public policy intervention that can have an immediate impact on acute stroke care in a region. OBJECTIVE To evaluate the impact that a citywide policy recommending prehospital triage of patients with suspected stroke to the nearest primary stroke center had on intravenous tissue plasminogen activator (tPA) use in Chicago, Illinois. D...

background: stroke is a major cause of death and disability in the world and these complications can be decreased by competent emergency care. emergency medical service (ems) transfer half of the stroke patients to hospitals. this study aimed to determine diagnosis of status and transfer time of stroke patients by ems to a main hospital (valiasr) in arak city. materials and methods: this study ...

BACKGROUND The human dive reflex (HDR), a physiological phenomenon similar to the bradycardia reflex used by marine mammals during prolonged submersion, can be employed in managing paroxysmal supraventricular tachycardia (PSVT). This review aims to identify a standardised HDR technique for haemodynamically stable PSVT, to determine the effectiveness of the HDR and to define its usefulness in th...

OBJECTIVES Recent events have reiterated the need for well-coordinated planning for mass-casualty events, including those that involve children. The objective of this study was to document the preparedness of prehospital emergency medical services agencies in the United States for the care of children who are involved in mass-casualty events. METHODS A national list of all licensed prehospita...

Introduction: Pain may be described as a feeling of hurt or strong discomfort and is the body's way of sending a message to the brain that an injury has occurred. Pain medicine blocks these messages or reduces their effect on the brain. Timely administration of analgesia affects the entire emergency medical experience and can have a lasting effect on a child’s and family’s reaction to current a...

To the editor: As medicine has progressed over the past decade, prehospital care in Ontario has largely remained stagnant. The failure to implement evidence-based best practices means that Ontarians are not receiving an appropriate level of prehospital care. Paramedics are dependent on the Ministry of Health and Long-Term Care to provide clinical standards through the Basic Life Support (BLS) P...