A centralized system for providing dispatcher assisted CPR instructions to 9-1-1 callers at multiple municipal public safety answering points.

Background: Dispatcher CPR instruction increases the odds of survival. However, many communities do not provide this lifesaving intervention, often citing the barriers of limited personnel, funding, and liability.

Objective: Describe the implementation of a novel centralized dispatcher CPR instruction program that serves seven public safety answering points (PSAPs).

A Novel Use of a Metronome in Dispatcher-assisted Cardiopulmonary Resuscitation.

Abstract Early, high-quality cardiopulmonary resuscitation (CPR) is the key to increasing the likelihood of successful resuscitation in cardiac arrest. The use of dispatch-assisted (DA) CPR can increase the likelihood of bystander CPR. We describe a case in which a metronome was introduced to guide DA-CPR.

A consensus-based gold standard for the evaluation of mass casualty triage systems.

Introduction: Accuracy and effectiveness analyses of mass casualty triage systems are limited because there are no gold standard definitions for each of the triage categories. Until there is agreement on which patients should be identified by each triage category, it will be impossible to calculate sensitivity and specificity or to compare accuracy between triage systems.

Objective: To develop a consensus-based, functional gold standard definition for each mass casualty triage category.

A consensus-based criterion standard for trauma center need.

Background: In civilian trauma care, field triage is the process applied by prehospital care providers to identify patients who are likely to have severe injuries and immediately need the resources of a trauma center. Studies of the efficacy of field triage have used various measures to define trauma center need because no "criterion standard" exists, making cross-study comparisons difficult. This study aimed to develop a consensus-based functional criterion standard definition of trauma center need.

Effect of emergency medical technician-placed Combitubes on outcomes after out-of-hospital cardiopulmonary arrest.

Objective: While emergency medical technicians-basic (EMT-Bs) in select emergency medical services (EMS) agencies use the Esophageal Tracheal Combitube (ETC) for the airway management of out-of-hospital cardiopulmonary arrests, the effect of this intervention on patient outcomes is not known. We compared the associations between initial EMT ETC placement and initial paramedic endotracheal intubation (ETI) on patient survival after out-of-hospital cardiopulmonary arrest.

Methods: We utilized data on adult (age > 21 years), out-of-hospital cardiopulmonary arrests from a large, urban, county-based, two-tiered (EMT-B first responder, paramedic ambulance) EMS system for the years 1997-2005.

The effect of Combitube use on paramedic experience in endotracheal intubation.

Objective: To determine the change in number of endotracheal intubations per paramedic after the implementation of Combitube use and to explore consequences.

Methods: Before-and-after study; urban/suburban EMS system; population 1 million. Number of patients 16 years and older, type of airway used, attempts, and successes were abstracted for time periods before and after the use of Combitubes.

Lessons learned from an emergency medical services fire safety intervention.

Objective: The authors conducted a pilot study, finding that many households that experienced fires had received prior emergency medical services (EMS) visits, but few had operational smoke alarms. The study hypothesis is that dwellings that received smoke alarms and/or batteries during an EMS call were more likely to have an operational alarm, less property dollar loss, and decreased morbidity and mortality at the time of a subsequent fire.

Methods: Smoke detectors and batteries were provided to an urban fire department for placement in unprotected homes at the time of an EMS call from March 1, 1999, through January 31, 2001.