To the Editor: Prehospital use of CPAP reduces the mortality and intubation rate for patients with acute respiratory failure especially due to acute cardiogenic pulmonary edema.1 Although it is considered in guidelines, the need for additional trained health workers, special equipment, and clinical evidence for effectiveness and cost-effectiveness limits widespread use.1,2 The Boussignac CPAP f...

The Ontario Prehospital Advanced Life Support Study represents the largest prehospital study yet conducted, worldwide. This study will involve more than 25,000 cardiac arrest, trauma, and critically ill patients over an 8-year period. The study will evaluate the incremental benefit of rapid defibrillation and prehospital Advanced Cardiac Life Support measures for cardiac arrest survival and the...

BACKGROUND To determine the frequency and characteristics of prehospital deaths compared with hospital deaths in different subpopulations with severe injuries. METHODS Population-based cohort study using person-based linkage of the Swedish nationwide hospital discharge register with death certificate data. In all, 28,715 injury deaths were identified among 419,137 cases of severe injury durin...

OBJECTIVE Prehospital care is a critical component of efforts to lower trauma mortality. In less-developed countries, scarce resources dictate that any improvements in prehospital care must be low in cost. In one Latin American city, recent efforts to improve prehospital care have included an increase in the number of sites of ambulance dispatch from two to four and introduction of the Prehospi...

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...

BACKGROUND Although early intubation to prevent the mortality that accompanies hypoxia is considered the standard of care for severe traumatic brain injury (TBI), the efficacy of this approach remains unproven. METHODS Patients with moderate to severe TBI (Head/Neck Abbreviated Injury Scale [AIS] score 3+) were identified from our county trauma registry. Logistic regression was used to explor...

BACKGROUND Trauma-related mortality can be lowered by efficient prehospital care. Less is known about whether gender influences the prehospital trauma care provided. The aim of this study was to explore gender-related differences in prehospital trauma care of severely injured trauma patients, with a special focus on triage, transportation, and interventions. METHODS We performed a retrospecti...

BACKGROUND In patients with a major cardiac event, the first priority is to minimize time-to-treatment. For many patients, the first and fastest contact with the health system is through emergency medical services (EMS). However, delay to treatment is still significant in developed countries, and international guidelines therefore recommend that EMS use prehospital electrocardiogram (ECG). Many...

Background Early access to critical care interventions may improve outcomes for severely ill and injured patients. A Cochrane review [1] in 2009 reported that evidence supporting prehospital emergency intubation is lacking, but this does not equate to lack of benefit and prehospital RSI remains controversial. South Africa faces unique challenges due to prolonged prehospital times and limited ac...

introduction this study determines the effect of prehospital time and advanced trauma life support interventions for trauma patients transported to an our trauma center. materials and methods this study was a retrospective study of trauma victims presenting to a trauma center in central iran by emergency medical services (ems) and hospitalized for more than 24 hours. demographic and injury char...