Prehospital Medical Research Articles

Prehospital Medical Treatment in the County of Östergötland, Sweden

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Survey of Out-of-hospital Emergency Intubations in the French Prehospital Medical System: A Multicenter Study

Study Objective: To determine the clinical characteristics of endotracheal intubation in the French emergency prehospital medical system and compare these data with those of other systems. Methods: This study was performed in Ile de France (Paris Region) in mobile ICUs staffed by physicians. This prospective, descriptive study involved completion of a questionnaire by the operator just after endotracheal intubation was performed. Results: Six hundred eighty-five (99.1%) of 691 consecutive prehospital intubations were performed successfully in the field. The orotracheal route was used in 96.0%, and no surgical approaches such as cricothyroidotomy were used. Mechanical complications occurred in 84 patients, at a rate of 15.9% for nonarrest patients and 8.1% for arrest patients. A wide variety of sedation protocols were used. Difficult intubations (10.8%) were comparable in incidence to the number seen in US emergency departments, not US prehospital systems. By the same token, intubation success rates (99.1%) were comparable to US EDs and much higher than US prehospital results. Conclusion: The characteristics of French prehospital airway management differ significantly from those of other countries. These differences may be explained by differences in approach to prehospital management rather than differences of skill. [Adnet F, Jouriles NJ, Le Toumelin P, Hennequin B, Taillandier C, Rayeh F, Couvreur J, Nougière B, Nadiras P, Ladka A, Fleury M: Survey of out-of-hospital emergency intubations in the French prehospital medical system: A multicenter study. Ann Emerg Med October 1998;32:454-460.]

I.5 Prehospital Medical Care in Disasters in Lithuania: Cooperation Between Military and Civilian Services

I.5 Prehospital Medical Care in Disasters in Lithuania: Cooperation Between Military and Civilian Services

032. Prehospital Medical Care in Disasters in Lithuania: When to Use Special Medical Rescue Groups?

032. Prehospital Medical Care in Disasters in Lithuania: When to Use Special Medical Rescue Groups?

990-49 Inadequate Pre-Hospital Medical Therapy in Patients Undergoing Percutaneous Coronary Revascularization: Results from the CAVEAT Trial

Patients with known coronary artery disease rnay be receiving inadequate medical therapy prior to referral for percutaneous coronary revascularization. To examine the medical treatment of patients referred for percutaneous coronary revascularization, we analyzed pre-hospital treatment data and concomitant medical conditions from the CAVEAT I trial. Of the 1,012 patients referred for revascularization 68.3% had unstable angina, 17.6% had stable angina, 9.8% had chest pain after myocardial infarction, and 4.3% were asymptomatic with a positive functional study. Prior to PTCA or directional atherectomy (DCA), patients had low rates of treatment with aspirin, nitrates, calcium channel blockers, beta-blockers, and anti-lipid agents (Table). Pre-hospital medications were associated with the following conditions: aspirin-none, nitrates-none, calcium channel blockershypertension (p = 0.004) and absence of unstable angina (p = 0.046), beta blockers-hypertension (p = 0.01), and anti-lipid agents-hyperlipidemia (p = 0.0001) and number of diseased vessels (p = 0035). These data strongly indicate that patients referred for percutaneous coronary revascularization have inadequate pre-hospital medical treatment. PTCA (N = 500) DCA (N = 512) Aspirin 60.4% 58.6% Nitrates 53.8% 51.8% Ca Blockers 49.0% 45.7% Beta Blockers 32.2% 34.8% Anti-lipid Agents 11.0% 11.1%

The Feasibility of Prehospital Medical Response Teams for Foreign Disaster Assistance

Disasters are defined as events caused either by natural or technological occurrences, that overwhelm the resources that are immediately available to manage or mitigate the impact of the event. Disasters, by their very nature, are newsmakers. With the improvement in telecommunications, the barriers of distance are reduced to the extent that the people of the world all are members of what Marshall MacLuhan called the “global village.” It now is a common practice to watch the effects of a disaster on the other side of the world, from the safety and comfort of the living room, live on television. The capacity to empathize with the victims, and to feel almost a part of the incident, results in tremendous public attention and an urging of governments, not directly affected by the event, to get involved and “do something!”