Ambulance Equipment Research Articles

Prehospital Midthigh Trauma and traction splint use: Recommendations for treatment protocols

The present study was completed to establish an epidemiologic database defining the prehospital occurrence of midthigh trauma/suspected femoral shaft fractures, and the use of/need for traction splints (TS) in hope of developing recommendations for further treatment protocols. On review of 4,513 paramedic run reports for the 12-month period from January 1999 through December 1999, from a low-volume urban emergency medical services (EMS) system, 16 persons (0.35% total patients) presented with midthigh injuries. Data collected included patient chief complaint/injury, mechanism of injury, clinical findings, splint application, additional interventions, iatrogenic complications, patient age, and ambulance field time. Paramedics noted injuries suspicious for femoral shaft fractures in 5 patients (31.25% study patients, 0.11% total patients). TSs were applied successfully only twice (12.50% study patients, 0.04% total patients). Fourteen patients (87.50% study patients) were managed with long backboard immobilization, rigid splinting, and/or patient transportation in a position of comfort. No sequelae as a result of such care occurred. No inappropriate use, point estimate (PE) [(0)/(16) (0.00% to 20.60%)] or unmet need, PE [(0)/(4), 497) (0.00% to 0.08%)] of care was noted. The data presented in this study suggest that given similar EMS system characteristics, prehospital midthigh injuries/suspected femoral shaft fractures occur on an extremely rare basis, and treatment with long backboard immobilization, rigid splinting, and/or patient transportation in a position of comfort may constitute an acceptable course of care. Including TSs as essential ambulance equipment may be unnecessary.

Pediatric emergencies in the office, hospital, and community: organizing systems of care.

* Abbreviation: EMS-C = : emergency medical services for children The second edition of the “Blue Book” entitled Childhood Emergencies in the Office, Hospital, and Community: Organizing Systems of Care has been published by the Committee on Pediatric Emergency Medicine of the American Academy of Pediatrics.1 Although pediatric emergency medicine is now a recognized subspecialty, most children present for emergency care in physicians offices, clinics, and community emergency departments. All children should have access to high-quality emergency medical services. This book will help the pediatrician examine the state-of-the-art in pediatric emergency care nationally and will provide a resource to evaluate the services available in their own offices and communities. A seamless system of care from problem identification through out-of-hospital and hospital care and reintegration into the community can only be provided through advanced planning and preparation. This commentary will summarize the content of the 7 sections of the new “Blue Book” emphasizing new and expanded content. Because of page limitations, this commentary will present only a summary and readers are referred to the publication for more detail. The first section is devoted to individual preparation—the most basic component of emergency medical services for children (EMS-C). The many important roles of the primary care physician are defined and described. There is a new chapter on … Address correspondence to Jane F. Knapp, MD, Children's Mercy Hospital, 2401 Gillham Rd, Kansas City, MO 64108.

The Contribution of Ergonomics to the Prevention of Musculo-Skeletal Lesions among Ambulance Technicians

The Association pour la santé et la sécurité, secteur affaires sociales duQuébec (ASSTSAS) has worked with three ambulance companies to develop and implement a training program for Québec's ambulance technicians on patient handling strategies that are respectful of both the needs of the patients and the biomechanical limitations of the technicians. The lifting strategies used by the ambulance technicians to transfer patients from one surface to another were questioned and new strategies, based on sliding techniques, were developed. Further research is required to design ambulance equipment that is not only better suited to the patients' needs, but also more appropriate for the ambulance technicians' work, in order to help prevent workplace accidents.

Guidelines for pediatric equipment and supplies for basic and advanced life support ambulances: Committee on ambulance equipment and supplies, national emergency medical services for children resource alliance

Guidelines for pediatric equipment and supplies for basic and advanced life support ambulances: Committee on ambulance equipment and supplies, national emergency medical services for children resource alliance

Emergency medical services preparedness for pediatric emergencies

The study objective was to examine emergency medical services (EMS) equipment and training preparedness for pediatric emergencies in Oklahoma. The participants were 202 administrators of licensed EMS agencies in the state of Oklahoma. A mailed questionnaire was used to obtain data from EMS agencies regarding emergency ambulance run characteristics, medical control, equipment, and personnel training. There were 130 questionnaires returned (response rate, 64%). Overall, 4% of EMS emergency runs were for children under 12 years. Family medicine and emergency medicine were the most frequent specialties of medical directors. Fewer services allow personnel to perform endotracheal intubation on children (35 services) than on adults (45 services). Fewer services allow personnel to start intravenous lines on children (40 services) than on adults (47 services). Equipment for pediatric care routinely stocked on ambulances was tabulated. Most services provided intraagency continuing education, but only 71 (54%) included pediatric topics in continuing education. Deficiencies in equipment and training for pediatric emergencies are a common problem for EMS agencies in Oklahoma. Barriers to preparedness include: 1) relative infrequency of pediatric runs and difficulty with maintenance of technical skills, 2) costs associated with increased equipment and training, and 3) hesitancy to allow personnel to perform advanced life support procedures on children.

Hazardous Materials Incidents: A One-Year Retrospective Review in Central California

AbstractObjective:This study describes the epidemiology of hazardous materials (hazmat) incidents in Fresno County, California, and analyzes the emergency medical services (EMS) response to these incidents.Setting:The study area has a population of 635,000 people living in an area of 6,004 square miles.Design:All Hazmat Emergency Response Team (HERT) reports and related prehospital, emergency department, and inpatient records from ljuly 1988 through 30 June 1989 were reviewed retrospectively.Results:There were 107 hazmat incidents involving 156 materials consisting of pesticides (24.4%), miscellaneous chemicals (17.3%), corrosives (16.7%), petroleum products (13.5%), airborne toxins (10.2%), organic solvents (7.7%), unidentified chemicals (5.1%), infectious medical waste (1.9%), empty containers with radioactive warning symbols but without detectable radiation (1.3%), heavy metals (1.3%), and alkali metals (0.6%). In ten (9%) of the 107 incidents, 68 patients required on-scene evaluation and 26 patients were transported to emergency departments. Four of these patients required admission, three because of injuries due to vehicular accidents, and one because of a coincidental cere-brovascular accident. Five incidents produced multiple victims from exposures to airborne toxins, accounting for 63 (93%) of 68 patients. Spills of solid or liquid pesticides occurred in four incidents involving patients. Ambulance personnel and/or equipment became contaminated in three of these four incidents.Conclusions:1) Ambulances should be dispatched selectively to hazmat incidents because only 9% of incidents involved patients. 2) training should emphasize personnel protection and proper patient decontamination to help prevent contamination of EMS personnel and equipment. 3) Preparation of EMS personnel should emphasize exposure to airborne toxins because these produced 93% of patients.

Recurrent Themes in Ambulance Critique Review Sessions over Eight Years

For 8 years biweekly ambulance critique review sessions have evaluated performance and discussed management of cases brought to our hospital by ambulance. Over 500 cases reviewed have centered primarily on evaluation and care at the scene and its possible relation to outcome. Problems which have recurred on the scene include whether the patient would have benefited from less time in stabilization and immobilization; manipulation of deformed fractures for splinting; use of tourniquets; techniques of airway maintenance; and management of infrequently seen problems such as hypothermia and drowning. Interaction problems with physicians on the scene and in the Emergency Room (ER) come from questioning physician authority even without specific knowledge of the appropriate techniques of emergency care. A related problem is lack of ER staff familiarity with Emergency Medical Technician (EMT) procedures and ambulance equipment. The value of critique review sessions has been seen in improved rapport and interaction among ER staff and ambulance personnel. Improved outcome needs to be assessed in a carefully controlled study. The enthusiasm and attendance of ER staff and ambulance personnel has grown and endured over 8 years. The review sessions have spread to other area hospitals with some success.

Pre-mixed nitrous oxide-oxygen analgesia in the ambulance service.

AnaesthesiaVolume 27, Issue 4 p. 459-460 Free Access Pre-mixed nitrous oxide-oxygen analgesia in the ambulance service C. J. Wright MB, ChB, DA, FFARCS, C. J. Wright MB, ChB, DA, FFARCS Senior Registrar in Anaesthesia Chief Ambulance Officer: The University Department of Anaesthesia, University of Leeds; The General Infirmary at Leeds; Leeds (St James's) University Hospital, and the City of Leeds Ambulance ServiceSearch for more papers by this authorD. G. McDowall MD, FFARCS, D. G. McDowall MD, FFARCS Professor of Anaesthesia Chief Ambulance Officer: The University Department of Anaesthesia, University of Leeds; The General Infirmary at Leeds; Leeds (St James's) University Hospital, and the City of Leeds Ambulance ServiceSearch for more papers by this authorJ. Wilson MB, ChB, DObstRCOG, FFARCS, J. Wilson MB, ChB, DObstRCOG, FFARCS Consultant Anaesthetist Chief Ambulance Officer: The University Department of Anaesthesia, University of Leeds; The General Infirmary at Leeds; Leeds (St James's) University Hospital, and the City of Leeds Ambulance ServiceSearch for more papers by this authorW. R. Hain MB, BS, FFARCS, W. R. Hain MB, BS, FFARCS Senior Registrar in Anaesthesia Chief Ambulance Officer: The University Department of Anaesthesia, University of Leeds; The General Infirmary at Leeds; Leeds (St James's) University Hospital, and the City of Leeds Ambulance ServiceSearch for more papers by this authorR. Furness MB, ChB, FFARCS, R. Furness MB, ChB, FFARCS Senior Registrar in Anaesthesia Chief Ambulance Officer: The University Department of Anaesthesia, University of Leeds; The General Infirmary at Leeds; Leeds (St James's) University Hospital, and the City of Leeds Ambulance ServiceSearch for more papers by this authorJ. H. Daykin FIOA, LMRSH, J. H. Daykin FIOA, LMRSH Chief Ambulance Officer: The University Department of Anaesthesia, University of Leeds; The General Infirmary at Leeds; Leeds (St James's) University Hospital, and the City of Leeds Ambulance ServiceSearch for more papers by this author C. J. Wright MB, ChB, DA, FFARCS, C. J. Wright MB, ChB, DA, FFARCS Senior Registrar in Anaesthesia Chief Ambulance Officer: The University Department of Anaesthesia, University of Leeds; The General Infirmary at Leeds; Leeds (St James's) University Hospital, and the City of Leeds Ambulance ServiceSearch for more papers by this authorD. G. McDowall MD, FFARCS, D. G. McDowall MD, FFARCS Professor of Anaesthesia Chief Ambulance Officer: The University Department of Anaesthesia, University of Leeds; The General Infirmary at Leeds; Leeds (St James's) University Hospital, and the City of Leeds Ambulance ServiceSearch for more papers by this authorJ. Wilson MB, ChB, DObstRCOG, FFARCS, J. Wilson MB, ChB, DObstRCOG, FFARCS Consultant Anaesthetist Chief Ambulance Officer: The University Department of Anaesthesia, University of Leeds; The General Infirmary at Leeds; Leeds (St James's) University Hospital, and the City of Leeds Ambulance ServiceSearch for more papers by this authorW. R. Hain MB, BS, FFARCS, W. R. Hain MB, BS, FFARCS Senior Registrar in Anaesthesia Chief Ambulance Officer: The University Department of Anaesthesia, University of Leeds; The General Infirmary at Leeds; Leeds (St James's) University Hospital, and the City of Leeds Ambulance ServiceSearch for more papers by this authorR. Furness MB, ChB, FFARCS, R. Furness MB, ChB, FFARCS Senior Registrar in Anaesthesia Chief Ambulance Officer: The University Department of Anaesthesia, University of Leeds; The General Infirmary at Leeds; Leeds (St James's) University Hospital, and the City of Leeds Ambulance ServiceSearch for more papers by this authorJ. H. Daykin FIOA, LMRSH, J. H. Daykin FIOA, LMRSH Chief Ambulance Officer: The University Department of Anaesthesia, University of Leeds; The General Infirmary at Leeds; Leeds (St James's) University Hospital, and the City of Leeds Ambulance ServiceSearch for more papers by this author First published: October 1972 https://doi.org/10.1111/j.1365-2044.1972.tb08257.xCitations: 5AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL References 1 Report by the Working Party on Ambulance Training and Equipment (1967). London : HMSO. 2 Basket, P.J.F. & Withnell, A. (1970). The use of Entonox in the Ambulance Service. British Medical Journal, 2, 41. 3 Department of Health and Social Security Circular LHAL 50/71. 4 Nunn, J.F. & Freeman, J. (1964). Problems of oxygenation and oxygen transport during haemorrhage. Anaesthesia, 19, 206. Citing Literature Volume27, Issue4October 1972Pages 459-460 ReferencesRelatedInformation

Ambulance Design and Equipment for Mobile Intensive Care

Our experience with ambulance design and equipment over the past 14 years indicates (1) the established national recommendations could be implemented at the local level; (2) existing assembly-line vehicles could be further transformed into mobile intensive care units at relatively low cost, and (3) the equipment recommended and described has proved valuable in actual practice. Features of vehicles should be evaluated in this order of importance: portable and stationary life-support equipment, working space, riding quality, vehicle performance, and cost. No presently feasible modification of existing vehicle types is ideal in all these features.

Ambulance Design and Equipment for Resuscitation

IMPROVED emergency care for the critically ill or injured requires physician leadership in community-wide teaching and organization of (1) first aid; (2) ambulance transportation; and (3) hospital emergency room coverage. Airway obstruction, respiratory depression, and cardiac arrest from unconsciousness per se (eg, head injury, poisoning) and from such conditions as drowning, coronary occlusion, electric shock, and others can often be prevented or reversed if the rescuer is trained in the proper techniques, begins resuscitation immediately, and continues resuscitation during transportation to the hospital. 1-5 Modern inhalation therapy and resuscitation during transportation are often hampered by inadequate ambulance design and equipment. Personal experience with the deficiencies of existing ambulance design, experience with many resuscitations outside of ambulances, established principles of resuscitation, and successful use abroad of some of the modifications recommended 1,5 prompted us to write this paper. Locally, appropriate modifications were made on a model ambulance* (Fig 1 and 2),

AMBULANCE DESIGN AND EQUIPMENT FOR RESUSCITATION.

IMPROVED emergency care for the critically ill or injured requires physician leadership in community-wide teaching and organization of (1) first aid; (2) ambulance transportation; and (3) hospital emergency room coverage. Airway obstruction, respiratory depression, and cardiac arrest from unconsciousness per se (eg, head injury, poisoning) and from such conditions as drowning, coronary occlusion, electric shock, and others can often be prevented or reversed if the rescuer is trained in the proper techniques, begins resuscitation immediately, and continues resuscitation during transportation to the hospital. 1-5 Modern inhalation therapy and resuscitation during transportation are often hampered by inadequate ambulance design and equipment. Personal experience with the deficiencies of existing ambulance design, experience with many resuscitations outside of ambulances, established principles of resuscitation, and successful use abroad of some of the modifications recommended 1,5 prompted us to write this paper. Locally, appropriate modifications were made on a model ambulance* (Fig 1 and 2),

Mayo Clinic Diet Manual

Mayo Clinic Diet Manual Affiliation Alice H. Smith CopyRight https://doi.org/10.2105/AJPH.44.10.1370-a Published Online: August 29, 2011