SMU-L: Quand demander l'ALS?

M L Mon, 17 Feb 2003 07:24:28 -0800

Bonjour Mme Forgues, voici un petit outil bien pratique pour les mots ou petites phrases que vous auriez de la misère à saisir. Je sais que ce n'est pas toujours les bonnes traductions, mais c'est un bon départ.

http://babelfish.altavista.com/

Bonne journée

Marcel Lapensée, paramédic
Corporation D'Urgences-santé, Laval

From: forgues line <[EMAIL PROTECTED]>
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Subject: SMU-L: Quand demander l'ALS?
Date: Sun, 16 Feb 2003 21:08:17 -0500
en francais svp
From: Stephan Gascon <[EMAIL PROTECTED]>
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To: [EMAIL PROTECTED]
Subject: SMU-L: Quand demander l'ALS?
Date: Sun, 16 Feb 2003 01:49:20 -0500 (EST)

Article intéressant, sur une situation qui sera très bientôt une réalité à Montéal, et éventuellement dans le reste du Québec.

Salutations

Stéphan Gascon

The following is the abstract for the study mentioned:

Prehosp Emerg Care 2001 Oct-Dec;5(4):360-5Related Articles, Links

Can basic life support personnel safely determine that advanced life support
is not needed?

Cone DC, Wydro GC.

Department of Surgery, Yale University School of Medicine, New Haven,
Connecticut, USA. [EMAIL PROTECTED]

OBJECTIVE: To determine whether firefighter/emergency medical
technicians-basic (FF/EMT-Bs) staffing basic life support (BLS) ambulances
in a two-tiered emergency medical services (EMS) system can safely determine
when advanced life support (ALS) is not needed. METHODS: This was a
prospective, observational study conducted in two academic emergency
departments (EDs) receiving patients from a large urban fire-based EMS
system. Runs were studied to which ALS and BLS ambulances were
simultaneously dispatched, with the patient transported by the BLS unit.
Prospectively established criteria for potential need for ALS were used to
determine whether the FF/EMT-B's decision to cancel the ALS unit was safe,
and simple outcomes (admission rate, length of stay, mortality) were
examined. In the system studied, BLS crews may cancel responding ALS units
at their discretion; there are no protocols or medical criteria for
cancellation. RESULTS: A convenience sample of 69 cases was collected. In 52
cases (75%), the BLS providers indicated that they cancelled the responding
ALS unit because they did not feel ALS was needed. Of these, 40 (77%) met
study criteria for ALS: 39 had potentially serious chief complaints, nine
had abnormal vital signs, and ten had physical exam findings that warranted
ALS. Forty-five (87%) received an intervention immediately upon ED arrival
that could have been provided in the field by an ALS unit, and 16 (31%) were
admitted, with a median length of stay of 3.3 days (range 1.1-73.4 days).
One patient died. CONCLUSION: Firefighter/EMT-Bs, working without protocols
or medical criteria, cannot always safely determine which patients may
require ALS intervention.

My subscription to Prehospital Emergency Care has not been activated yet, so
if someone has a copy of the fulltext of this article and can send it to me,
it would be much appreciated.
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From: gerald maloney
To: EMS-L List Server
Sent: Friday, February 14, 2003 12:32 AM
Subject: [ems-l] Re: ALS Intercept Timing

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Interesting question. The trend, in many areas, seems to be moving towards
an all ALS system. When you say current teaching, do you mean in EMT-B
class? There has been one study that I am aware of that addresses the issue
of, Can BLS predict who needs ALS? The results of that study, at least,
seem to suggest that BLS will undertriage in at least a third of cases (I'd
have to look it up again to get the exact #).

NOCC_______________________________
ColbaNet - http://www.colba.net

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SMU-L: Quand demander l'ALS?

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