Prehospital clinical clearance of the cervical spine: a prospective study.

Physician clinical clearance of the cervical spine after blunt trauma is practiced in many trauma centers. Prehospital clinical clearance of the cervical spine (c-spine) performed by emergency medical services (EMS) personnel can decrease cost, improve patient comfort, decrease complications, and decrease prehospital time. The purpose of this study was to assess whether EMS personnel can effectively clinically clear the c-spine of injury in the prehospital setting.

EMS relocation in a rural area using a geographic information system can improve response time to motor vehicle crashes.

Objective: To assess whether repositioning of ambulance stations in a rural county of Alabama can improve emergency medical services (EMS) response time to motor vehicle crashes (MVCs) without adversely affecting response time to non-MVC-related emergencies.

Methods: Using geographical information system software, locations of MVCs during a 9-month period in a rural county of Alabama were plotted on a map. A single ambulance station provided EMS for the entire county.

Rural EMS en route IV insertion improves IV insertion success rates and EMS scene time.

Background: Emergency medical service (EMS) personnel are trained to insert intravenous (IV) lines at trauma scenes if the time for insertion does not prolong scene time. However, EMS providers continue to insert IV lines on scene.

Methods: A rural EMS provider provided trauma patient EMS IV insertion data for a 1-year period.

Clinical examination in complement with computed tomography scan: an effective method for identification of cervical spine injury.

Objective: The purpose of this study was to prospectively evaluate a protocol that assesses the efficacy and sensitivity of clinical examination in complement with computed tomographic (CT) scan in screening for cervical spine (c-spine) injury.

Methods: During the 26-month period from March 2005 to May 2007, blunt trauma patients older than 13 years were prospectively entered into a study protocol. If patients were awake and alert with Glasgow Coma Score (GCS) >or=14, clinical examination of the neck was performed.

Improving rural emergency medical service response time with global positioning system navigation.

Objective: Rural emergency medical services (EMS) often serves expansive areas that many EMS personnel are unfamiliar with. EMS response time is increased in rural areas, which has been suggested as a contributing factor to increased mortality rates from motor vehicle crashes (MVCs) and nontraumatic emergencies. The purpose of this study was to assess the effect of a global positioning system (GPS) on rural EMS response time.

On-scene intravenous line insertion adversely impacts prehospital time in rural vehicular trauma.

Fatality rates from rural vehicular trauma are almost double those found in urban settings. Increased emergency medical services (EMS) prehospital time has been implicated as one of the causative factors for higher rural fatality rates. Advanced Trauma Life Support guidelines suggest scene time should not be extended to insert an intravenous catheter (IV).

Does increased emergency medical services prehospital time affect patient mortality in rural motor vehicle crashes? A statewide analysis.

Background: Fatality rates from rural vehicular trauma are almost double those found in urban settings. It has been suggested that increased prehospital time is a factor that adversely affects fatality rates in rural vehicular trauma. By linking and analyzing Alabama's statewide prehospital data, emergency medical services (EMS) prehospital time was assessed for rural and urban vehicular crashes.

Increased rural vehicular mortality rates: roadways with higher speed limits or excessive vehicular speed?

Objective: The purpose of this study was to assess whether higher roadway speed limits and excessive vehicular speed were contributing factors to increased rural vehicular mortality rates in the State of Alabama.

Methods: During a 2-year period from January 2001 through December 2002, data were collected from Alabama police crash reports and EMS patient care reports. Police crash reports and EMS patient care reports were linked utilizing an imputational methodology.