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Pragmatic Problems in Prehospital Research

Published online by Cambridge University Press:  17 February 2017

James J. Menegazzi
James J. Menegazzi*
Affiliation:
University of Pittsburgh, Center for Emergency Medicine, Pittsburgh, Penn.
*
Center for Emergency Medicine, 230 McKee Place, Suite 500, Pittsburgh, PA 15213, USA
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Extract

Emergency Medical Services (EMS) researchers face a variety of obstacles when conducting out-of-hospital investigations. This paper reviews some common problems and discusses practical solutions to facilitate the process and help avoid traps. This discussion focuses on prospective prehospital research.

One challenge to EMS research is to find new methods of improving the quality of care delivered in the field. There has been an emphasis placed on “exciting” topics, such as cardiac arrest and trauma resuscitation. Other events dominate the daily practice of prehospital medicine, but have not been well-studied. For example, what is the best way to immobilize the spine? What should be done for a patient with a suspected C-spine injury who is wearing a motorcycle helmet? No one has a scientifically proven approach to solve these common prehospital problems. There is a need to look at problems such as immobilization, asthma, overdose, and congestive heart failure to see what can be done differently in the field.

Keywords

Emergency Medical ServicesEMSResearchPrehospitalChallengesDesignPrehospital CareRandomizationSamplingBiasNuisance VariablesInclusion CriteriaExclusion CriteriaBlindingPlaceboData Collection
Type
Research Article
Information
Prehospital and Disaster Medicine , Volume 8 , supplement S1: Research in Prehospital Care Systems , March 1993 , pp. S15 - S19
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1993

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References

1. Mosesso, VN, Porter, RS, Menegazzi, JJ, et al: Comparison of prehospital cervical immobilization devices. Prehospital and Disaster Medicine 1990;5:30l. Abstract.Google Scholar
2. Meyer, RD, Daniel, W: The biomechanics of helmets and helmet removal. J Trauma 1985;25:329–332.CrossRefGoogle ScholarPubMed
3. The American Heart Association: Textbook of Advanced Cardiac Life Support, 2d ed. Dallas: American Heart Association, 1990.Google Scholar
4. Crile, G, Dolley, DH: An experimental research into the resuscitation of dogs killed by anesthetics and asphyxia. J Exp Med 1906;8:713–725.CrossRefGoogle ScholarPubMed
5. Tisherman, SA, Safar, P, Abramson, NS, et al: Feasibility of emergency cardiopulmonary bypass for resuscitation from CPR-Resistant cardiac arrest: A preliminary report. Ann Etnerg Med 1991;20:491.Google Scholar
6. Eisenberg, MS, Copass, MK, Hallstrom, AP, et al: Treatment of out-of-hospital cardiac arrests with rapid defibrillation by emergency medical technicians. N Engl J Med 1980;302:1379–1383.CrossRefGoogle ScholarPubMed
7. Eisenberg, MS, Hallstrom, AP, Copass, MK, et al: Treatment of ventricular fibrillation: Emergency medical technician defibrillation and paramedic services. JAMA 1984;251:1723–1726.Google Scholar
8. Weaver, WD, Copass, MK, Bufi, D, et al: Improved neurologic recovery and survival after early defibrillation. Circulation 1984;69:943–948.CrossRefGoogle ScholarPubMed
9. Cummins, RO, Eisenberg, MS, Litwin, PE, et al: Automatic external defibrillators used by emergency medical technicians: A controlled clinical trial. JAMA 1987;257:1605–1610.CrossRefGoogle ScholarPubMed
10. Yealy, DM, Scruggs, KS: Study design and pretrial peer review in EMS research. Prehospital and Disaster Medicine 1990;5:113–118.Google Scholar
11. Ferguson, GA: Statistical Analysis in Psychology and Education, 4th ed. New York: McGraw-Hill, 1976.Google Scholar
12. Mattox, KL, Bickell, W, Pepe, PE, et al: Prospective MAST study in 911 patients. J Trauma 1989;29:1104–1112.Google Scholar
13. Myers, RA, Britten, JS: Are arterial blood gases of value in treatment decisions for carbon monoxide poisoning? Grit Care Med 1989;17:139–142.Google Scholar
14. Paris, PM, Stewart, RD, Deggler, F: Prehospital use oi dcxamethasone in pulseless idioventricular rhythm. Ann Emerg Med 1984;13:1008–1010.CrossRefGoogle Scholar
15. McCabe, JL, Adhar, GG, Menegazzi, JJ, et al: Intravenous adenosine in the prehospital treatment of paroxysmal supraventricular tachycardia. Ann Emerg Med 1992;21:358–361.CrossRefGoogle ScholarPubMed