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Accelerated hearing loss in urban emergency medical services firefighters   总被引:1,自引:0,他引:1  
A group of 192 firefighters serving in a busy urban emergency medical services (EMS) system was randomly selected for hearing tests. Total number of hours of siren noise exposure was calculated for each man and was compared to the outcome of hearing tests. Hearing loss was defined by the amount of sound intensity required to sense both midfrequency and high-frequency tones. Results indicated a correlation between hearing loss and the duration of siren noise exposure. The loss could not be attributed to non-job-related sources. In addition, the rate of hearing loss over time was 150% of that expected in age-matched, non-noise-exposed men. These findings confirm the observations of others that EMS personnel are at risk for hearing loss beyond that expected from aging alone, and they document that the hearing loss correlates with the duration of intense siren noise exposure.  相似文献   

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To determine the cost of an emergency medical services (EMS) system, researchers, policymakers, and EMS providers need a framework with which to identify the components of the system that must be included in any cost calculations. Such a framework will allow for cost comparisons across studies, communities, and interventions. The objective of this article is to present an EMS cost framework. This framework was developed by a consensus panel after analysis of existing peer-reviewed and non-peer-reviewed resources, as well as independent expert input. The components of the framework include administrative overhead, bystander response, communications, equipment, human resources, information systems, medical oversight, physical plant, training, and vehicles. There is no hierarchical rank to these components; they are all necessary. Within each component, there are subcomponents that must be considered. This framework can be used to standardize the calculation of EMS system costs to a community. Standardizing the calculation of EMS cost will allow for comparisons of costs between studies, communities, and interventions.  相似文献   

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An emergency medical services curriculum for emergency medicine residencies   总被引:1,自引:0,他引:1  
Knowledge and experience in emergency medical services (EMS) are essential objectives for residency training in emergency medicine (EM). Although a need exists for competent physician EMS leaders, opportunities for educating emergency physicians in this aspect of emergency care have been few. We describe a curriculum for training EM residents in EMS. The purpose of this training is to assure competency in both on-line and off-line medical control. The former requires a working knowledge of the local system policies and the ability to respond appropriately to paramedic radio calls. Additional education prepares the resident for a much broader role in EMS, including off-line medical control.  相似文献   

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Utilization prediction for helicopter emergency medical services   总被引:2,自引:0,他引:2  
As the number of helicopter emergency medical services (HEMS) programs continues to expand rapidly, the need for an accurate, readily obtainable, inexpensive method of utilization prediction for these services has become apparent. Accurate volume and case mix prediction for these services are increasingly important as financial constraints become more severe. All previous methods of utilization prediction based on experiences of individual services or accident statistics have been either inaccurate, costly, or difficult to obtain in a relatively short period of time. Prediction of HEMS utilization requires consideration of many significant, simultaneous factors, in addition to patient needs based on population statistics. Through use of a survey of all hospital-based helicopter emergency service programs and published census data, this study analyzed factors relating to helicopter program volume and case mix, providing insight as to why previous methods utilizing total population were inaccurate. A more accurate yet simple and inexpensive method of utilization prediction for HEMS was developed.  相似文献   

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The national disaster medical system is a new program established in 1981 to develop and implement a national policy to improve emergency preparedness for large-scale disasters. This article describes the background and purpose of this activity and delineates the elements of the system, which include a rapid medical response, patient evacuation, and definitive medical care. The program is designed to involve resources at the federal, state, and community levels. This article describes how local communities may participate in this initiative.  相似文献   

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A large California county uses an audit of its advanced life support (ALS) base hospitals to maintain medical control of prehospital care and to improve the county emergency medical services. The audit is a rigorous, semi-annual evaluation of ALS base hospital performance using objective, written criteria. The county emergency medical service district and the base hospitals have benefited from the data that have resulted from the audits. The base hospital audit is an excellent method of assessing medical control in an emergency medical services system.  相似文献   

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Emergency physicians have a duty to advance the care of pediatric patients in the emergency medical services (EMS) system. This policy resource and education paper, designed to support the American College of Emergency Physicians policy paper "The Role of the Emergency Physician in Emergency Medical Services for Children," describes the development of the federal EMS for Children Program, the importance of the integration of EMS for children into EMS systems, and the role of the emergency physician in EMS for children.  相似文献   

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The ten-year malpractice experience of a large urban EMS system   总被引:11,自引:0,他引:11  
Malpractice is a recognized and growing problem for physicians and hospitals, but it is difficult to ascertain the risk of malpractice in the prehospital arena. Dade County, Florida (greater Miami), with a population of 1.7 million, currently is served by 339 certified paramedics. During the decade of 1972 to 1982, Dade County Fire Rescue handled 265,060 incidents; 16 claims were filed with the Risk Management Division of Dade County. The claims were produced by 11 incidents, which yields a rate of one per 24,096 incidents. The two greatest problems identified were inadequate record keeping and "gray zone" patients who do not fit any particular protocol.  相似文献   

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