Endotracheal tube placement by EMT-Basics in a rural EMS system.

Objective: To evaluate the effectiveness of an intubation-training module and special-waiver project in which Emergency Medical Technician (EMT)-Basics were trained to perform endotracheal intubations in a rural community.

Methods: This was a prospective observational study over a four-year period (July 1998 through May 2002) of all intubation attempts by EMT-Basics in the field. The authors observed intubation data, training methods, and quality-assurance methods of a special-waiver project agreed to by the State Department of Public Health to train and allow EMT-Basics to intubate patients.

Virtual TeleStroke support for the emergency department evaluation of acute stroke.

Objectives: Telemedicine-enabled acute stroke consultation (TeleStroke) may be useful to determine eligibility for treatment with tissue plasminogen activator (tPA) and provide support to emergency departments without on-site stroke expertise.

Methods: Emergency physicians consulted with stroke neurologists via two-way videoconferencing in the evaluation of patients with possible acute stroke. History, neurologic examination, and computed tomography of the head were reviewed to determine eligibility for treatment with tPA.

Providing telephone advice from the emergency department.

Emergency departments frequently receive telephone calls from the general public. Callers sometimes request detailed instruction or medical advice. The growth of managed care produced expanded use of telephone-based medical information as a part of managed care ED demand management.