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PubMed1987

EMT-defibrillation.

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PubMed1988

EMT-defibrillation: a recipe for saving lives.

Sudden cardiac death is the number-one cause of death in this country. It has long been known that most of these deaths occur outside of the hospital, therefore necessitating an approach to the problem involving prehospital care. The development of advanced life support emergency medical systems has had a dramatic impact on improving survival in selected communities. Most of the country continues to see little result because of our inability to provide timely defibrillation. Automatic external defibrillators now provide a safe, reliable, proven method to increase the number of "saves" in rural, urban, and suburban communities. This new tool, if widely used, will allow us to save scores of "hearts too good to die."

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PubMed2006

Comparison of EMT and MST approaches in studying linear acoustics in bubbly liquid.

Two kinds of approaches have been used in literature to study the linear acoustics in a liquid-bubble mixture: The effective medium theory approach and the multiple scattering theory approach. Theoretical comparisons of mathematical formulations and intrinsic relations between these two approaches are given in this paper and show their consistency in dealing with the linear acoustics in bubbly liquids. Possible applications of these two methods are also generally discussed.

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PubMed1985

EMT defibrillation.

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PubMed1988

New perspectives on rural EMT defibrillation.

In recent years, several studies have produced contradictory data regarding the impact of emergency medical technicians trained in defibrillation on hospital admission and dismissal survival rates in rural areas. Fourteen communities (service area populations, 4,000 to 36,000) in rural south-eastern Minnesota participated in a two-year crossover study to further define the factors necessary for success. Automatic external defibrillators were used to defibrillate and record patient rhythms in the treatment group and to only record in the control group. Although six of 36 patients (17%) in ventricular fibrillation who experienced a witnessed arrest survived in communities using automatic external defibrillators, compared with one of 27 (4%) in the control group, five of the six survivors were from a single large community with a 911 system, full-time emergency medical technicians, police first-responders, and a well-equipped emergency facility. Our data suggest that certain prerequisites, especially CPR prior to ambulance arrival and collapse to defibrillation times of less than ten minutes, are clearly essential to produce significant benefits from emergency medical technicians trained in defibrillation in rural communities.

Aged↗
PubMed1998

EMT defibrillation does not increase survival from sudden cardiac death in a two-tiered urban-suburban EMS system.

OBJECTIVE: The use of automatic external defibrillators (AEDs) by EMS initial responders is widely advocated. Evidence supporting the use of AEDs is based largely on the experience of one metropolitan area, with effect on survival in many systems not yet proved. We conducted this study to determine whether the addition of AEDs to an EMS system with a response time of 4 minutes for first-responder emergency medical technicians (FREMTs) and 10 minutes for paramedics would affect survival from cardiac arrest. METHODS: This prospective, controlled, crossover study (AED versus no AED) of consecutive cardiac arrests managed by 24 FREMT fire companies took place from 1992 to 1995 in Charlotte, North Carolina, a city of 455,000. Patients were stratified using the Utstein criteria. The primary endpoint was survival to hospital discharge among patients with bystander-witnessed arrests of cardiac origin. RESULTS: Of the 627 patients, 243 were bystander-witnessed arrests of cardiac origin. Survival to hospital discharge was accomplished in 5 of 110 patients (4.6%; 95% confidence interval [CI] 0.6% to 8.4%) with AED compared with 7 of 133 (5.3%, 95% CI 1.5% to 9.1%) without AED (P = .8). Both groups were comparable with regard to age, gender, history of myocardial infarction, congestive heart failure or diabetes, arrest at home, bystander CPR, and whether or not ventricular fibrillation (VF) was the initial rhythm. For arrests of any cause, witnessed by bystanders or EMS personnel, with an initial rhythm of VF or ventricular tachycardia (VT), 5 of 77 (6.5%, 95% CI 1.0% to 12.0%) with AED survived compared with 8 of 105 patients (7.6%, 95% CI 2.5% to 12.7%) without AED (P = .8). Statistically significant differences were noted in race and EMS response times between the two groups, which did not affect survival. CONCLUSION: Addition of AEDs to this EMS system did not improve survival from sudden cardiac death. The data do not support routinely equipping initial responders with AEDs as an isolated enhancement, and raise further doubt about such expenditures in similar EMS systems without first optimizing bystander CPR and EMS dispatching.

Aged↗
PubMed2001

Estimation of pediatric patient weight by EMT-PS.

To determine paramedics' experience, comfort, and accuracy in the estimation of pediatric weights, paramedics were surveyed regarding their experience and training in estimating pediatric weights and then were presented with four children and asked to estimate their weights and to calculate the first round of i.v. epinephrine dose for asystole according to protocol. Twenty paramedics participated, with 55% stating they were uncomfortable on pediatric calls; 15 of 20 (75%) stated they were uncomfortable estimating children's weights. The majority of estimations were within 50% of the actual weights. Based on weight estimations, the epinephrine doses were calculated correctly in 88% of all cases. In 10% of cases, the epinephrine dose was incorrect by a factor of 10 times the appropriate dose. The weight range using the Broselow tape was determined correctly by all participants, with 95% correctly reporting the correct dose of epinephrine. Overall, paramedics were accurate in estimating pediatric weights, and use of the Broselow tape improved the precision of these estimations.

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