• See also Injury and Emergency

• See also Stroke Section

• See also Automatic External Defibrillator, Sudden Cardiac Death & CPR 

• See also Cost-Effectiveness

• See also Auto Accidents

• See also Trauma

• See also Fires  

• See also Medical and Emergency Links  

• See also Rural Emergency Medicine

• See also Site Map  
  

Is there a Golden Hour?  not able to find a reference in medical literature added 12/31/01

Rural Medicine 4 abstracts  added 12/31/01  see also Rural

EMS Best Practices  a nice on-line publication of Merginet
Article titles as of 10/25/01

EMS is slower in the suburbs - where 40% of US now live.  added 11/01/01

Rural EMS - EMS Directors organization look at costs of vehicles, etc.   June 2000   added 11/03/01 see also Rural

Ambulance Equipment (pdf file) from American College of Emergency Physicians  added 10/08/01

National Emergency Number Organization (NENA) - highlights @ Skyaid: 100,000 in 911 groups - with up to 200 in a group of dispatchers  added 10/17/01

Globestar cell phones are one of the very few which can use both cell-towers AND satellites - but it must have a clear view of the satellite (no buildings, roofs, trees, cliffs, etc in the way) when in satellite mode.  added 10/15/01

National Emergency Number Organization - www.nena.org  National 9-1-1 Day was September 11, 2001 That web site says: "It is estimated that of the 150 million calls that were made to 9-1-1 in 2000, 45 million of them were made by wireless telephone users—that’s 30 percent." Their Oct 2000 thoughts about what 911 could be in the future    Also they have a list of tragedies due to lack of E911. added 10/16/01

Paramedics May UnderTriage  - but not often  added 10/15/01

EMS Dispatch - describing the Medical Priority Dispatch System, below   added 10/15/01

Medical Priority Dispatch System  is the world’s most widely used 911-type Pre-Arrival Instruction and Dispatch Life Support protocol.  It is available in many languages: English (American, UK, Australian) French Canadian, Spanish (North American and European) German, Italian, and Finnish.  Is it available in two formats: Software (ProQA) and 3’x5” card-pairs (dispatch card + information card). The information is certified by the National Academy of Emergency Dispatch SM. It has evolved over the past 20 years and is currently in version 11.  added 10/14/01

Automatic Collision Notification   highlights of notes by Henry Lahore: The system to automatically notify 911 dispatchers of rural auto crashes worked well, except in areas with poor or no cellular coverage.  added 10/14/01

Emergency Medicine in Rural America  highlights of notes by Henry Lahore: the 25% of US population in rural areas get poor emergency medical care.   added 10/14/01  see also Rural

Emergency Medicine in Japan    Highlights of notes by Henry Lahore: Japanese clinics and hospitals may refuse to accept patients, “The prehospital care in unfortunately nothing more than poor compared with that in western countries”.   added 10/14/01

Emergency Medicine in China - Highlights of notes by Henry Lahore:

Emergency Medicine Links at American Academy of Emergency Medicine added 10/14/01

Emergency Medical Treatment and Active Labor Act: "Hospital that offers services for emergency medical conditions agrees to maintain a list of physicians who are on-call for duty after the initial examination to provide treatment necessary to stabilize an individual with an emergency medical condition."   2nd web site  added 10/14/01

Rural EMS links web site  same site has links on U.S. Rural Demographics added 11/14/01

Rural EMS bibliography  added 10/14/01  see also Rural

Emergency Medical Dispatch: A Changing Profession  magazine article Aug 1998 added 10/14/01

E9-1-1 brief review. Enhanced 9-1-1 in the U.S. of the 80's added calling number and address [ANI = Automatic Number Identification & ALI = Automatic Location Identification]. Now up to 40% of the 9-1-1 phone calls are made from cell phones.  So, despite FCC mandates, 9-1-1 dispatchers can not automatically determine the location about 40% of the current U.S. emergencies. This percentage will increase past 50% as the use of cell-phones and Voice over the Internet (VoIP) increase.  9-1-1 calls:  40% already come from wireless phones  added 10/12/01

How Well Do Paramedics Recognize and Treat Patients With Acute Myocardial Infarction.
This is abstract number 53 printed in Oct 2001  Annals of Emergency Medicine   added 10/14/01
The study looked at 1,173 patients who called 911 with chest pain and were more than 14 years old. These patients were put into 3 subgroups: AMI 7%, other cardiac 13% and non-cardiac 80%. - Note: only 20% of 911 calls for chest pain involve cardiac problems. 

911 Wireless phones issues - good discussion  added 10/11/01 

Ambulance deliver patients to hospitals which pay them   added 07/19/01
private ambulances in NY are >10X more likely to bring passengers to hospitals which pay them   

Top air medical emergencies  
added 07/03/01

Death Rate vs. age chart- US males 1900 and 1996
from http://www.prb.org/pubs/population_bulletin/bu53-3/fig4.gif
added 06/30/01

Chest pain is a result of heart problems in less than half of the emergency room admissions added 07/03/01

Scoop and Run ongoing debate by EMS and Hospitals
how much should be done at the emergency scene, vs. how quickly to get to the hospital
Skyaid will enable 'scoop and fly'  added 07/03/01

E911 cell-phone location  Three technologies are trying to meet the FCC-US location requirement deadline.  It appears doubtful that any will. The Skyaid Watch will not require the E911 capability.  No indication of what, if anything, is happening elsewhere around the world.  added 07/01/01

No national Poison Control Center phone number This could be part of the Skyaid triage  added 5/13/01

Reducing ambulance response time to 5 minutes 
could almost double survival rates for heart attacks, however this is too expensive to do.  added 06/07/01
   Same information - but from British Medical Journal

Summary table of Emergencies and Skyaid

Algae can stop a person bleeding quickly - will be used this year in Emergency rooms and battlefields.  
Perhaps can be used soon by paramedics   Ref1   Ref2   Ref3  added 5/19/01 

Medic One around Seattle consists of both Basic and Advanced Life Support units added 5/14/01

911 is not an international emergency phone number.  
If fact, while 23 countries have a single number for ambulance, fire, and police,
911 is the uniform emergency phone number for only 4 countries    added 5/06/01

Emergency numbers around the world 
from www.rcc.com/services.html
added 06/30/01

Potential years of life lost prior to age 70  added 5/11/01
Potential life years lost to injury death is more than the total of life years lost due to 
heart disease and AIDS and stroke (since injuries tend to happen to younger people).

Risk statistics from a 1994 book  added 5/12/01
Example: "Questionnaire research shows that 
most people suppose that the chances of their dying of a heart attack to be about 1 in 20; 
in fact the risk is closer to 1 in 3.

Air Ambulance Services listed at Google. added 5/12/01

International Ambulances - short descriptions of ambulance services in many countries:
- funded/volunteer: often volunteer- sometimes they pay for the medical supplies
- training: typically 120 hours
- support level: sometimes not allowed to any drug other than Oxygen
- vehicles - truck typically, but sometimes car or motorcycle
- number of people in vehicle: typically 2 or 3
- connection to red cross, government or fire, etc.   added 4/29/01
     see also Ambulance diversion  Ambulance economics  Ambulance slow response time

Injuries are the 9th largest cause of disability now.  
Injuries are expected to be the 3rd largest cause of disability worldwide by 2020.
Many injuries are to the head in auto accidents   added 4/28/01

Of the 17 million annual car crashes, less than a quarter occur on rural stretches of the nation's 4 million miles of roadways.  But these isolated accidents account for nearly 60% of the fatalities. ''Trying to find out which 250,000 people out of the 5 million car crashes are at risk of dying is like finding a needle in a haystack,'' says Howard Champion, who worked as a trauma surgeon for 30 years before becoming a crash researcher. ''Most people who die early die from bleeding to death. You've got a window of opportunity there that is quite limited.''    from a USA Today article     added 4/29/01

Speed is important, but the destination is also important.
Far fewer deaths at  high volume trauma centers than at low-volume trauma centers      
from JAMA March 2001   added 4/18/01

Air Methods - brief overview of the #1 airborne Healthcare company  added 12/05/00