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Query: UMLS:C1522282 (EMT)
 2,868 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Blind defibrillation, defibrillation of an unconscious, pulseless adult without electrocardiographic verification of arrhythmia, allows early definitive treatment of cardiac arrest victims. Basic EMT-As have the ability to perform blind defibrillation in a prehospital setting, and place an esophageal obturator airway. When basic EMT-As are performing blind defibrillation, there should be a standard operating procedure involving diagnosis, defibrillation, CPR and re-evaluation.
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PMID:Blind defibrillation outside the hospital. 94 Feb 41

Published reports of out-of-hospital cardiac arrest give widely varying results. The variation in survival rates within each type of system is due, in part, to variation in definitions. To determine other reasons for differences in survival rates, we reviewed published studies conducted from 1967 to 1988 on 39 emergency medical services programs from 29 different locations. These programs could be grouped into five types of prehospital systems based on the personnel who deliver CPR, defibrillation, medications, and endotracheal intubation; the five systems were three types of single-response systems (basic emergency medical technician [EMT], EMT-defibrillation [EMT-D], and paramedic) and two double-response systems (EMT/paramedic and EMT-D/paramedic). Reported discharge rates ranged from 2% to 25% for all cardiac rhythms and from 3% to 33% for ventricular fibrillation. The lowest survival rates occurred in single-response systems and the highest rates in double-response systems, although there was considerable variation within each type of system. Hypothetical survival curves suggest that the ability to resuscitate is a function of time, type, and sequence of therapy. Survival appears to be highest in double-response systems because CPR is started early. We speculate that early CPR permits definitive procedures, including defibrillation, medications, and intubation, to be more effective.
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PMID:Cardiac arrest and resuscitation: a tale of 29 cities. 230 97

The outcome from cardiopulmonary arrest in children in the prehospital and hospital setting is generally poor. The event that compromises the cardiac status is often respiratory embarrassment, and the presenting rhythms are often bradyarrhythmias and asystole. Emergency medical services (EMS) systems have primarily an adult focus and may not be organized to manage optimally the critically ill and injured child. Data from a survey of training programs demonstrate that paramedic and EMT education in pediatric emergencies may be inadequate. Forty-one percent of the programs surveyed had less than 10 hr of pediatric training. Data suggest that EMS providers may not be equipped to manage children effectively. The Los Angeles EMS System for children is described. There are two levels of receiving facilities: Emergency Departments Approved for Pediatrics and Pediatric Critical Care Centers. The system is voluntary and has 85% of the hospitals in compliance with the guidelines. Early recognition of the prearrest state, improved training, and equipping of prehospital care personnel, development of EMS services for children, dissemination of an advanced pediatric life support course, as well as research in pediatric CPR may improve the outcome of resuscitation in the pediatric population.
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PMID:A needs assessment of advanced life support and emergency medical services in the pediatric patient: state of the art. 377 27

The Heartstart Scotland project for out-of-hospital defibrillation covers the whole of Scotland, a population of approximately 5,102,400 (14.9% > 65 years, 48.3% male). All 395 ambulances in Scotland have been equipped with an automated external defibrillator and crews are trained in basic cardiopulmonary resuscitation and defibrillator use (EMT-D). Between 1 May 1990 and 30 April 1991 a total of 1700 cardiac arrests was reported by the ambulance service. Of the 1676 arrests which we could trace, 63% were witnessed. A total of 1383 (83%) of all patients were declared dead on arrival at hospital or in the emergency department, 119 (7%) died in hospital and 174 (10%) were discharged alive. Of the 174 survivors, 87% were conscious and normal at discharge, 9% had moderate residual disability and 2% severe disability. Survival of patients discharged alive from hospital was 85% at 1 year. Defibrillation was undertaken in 71% of the reported cardiac arrests. Survival of bystander witnessed arrests was increased from 7 to 15% with bystander CPR (P < 0.005). If the cardiac arrest was witnessed by the ambulance crew and required defibrillation, survival to discharge was 39%. Of bystander witnessed arrests reached while still in VF (n = 643), 11% were discharged alive. Patients who were defibrillated within 4 min of arrest had a 43% survival rate to hospital discharge.
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PMID:Performance of an established system of first responder out-of-hospital defibrillation. The results of the second year of the Heartstart Scotland Project in the 'Utstein Style'. 821 Jul 35

Many studies have shown improved survival of cardiac arrest patients by the use of early defibrillation (EMT-D) in the field. This prospective study was the first in Pennsylvania and was undertaken to determine if an EMT-D program would be successful in our suburban/rural setting. One hundred two EMTs were trained to use a semi-automatic defibrillator and data were collected over 16 months. There were 96 cardiac arrests, with only 33 patients (34%) presenting with initially treatable dysrhythmias--ventricular fibrillation (VF) or tachycardia (VT). Twenty-three patients (24%) were admitted to the hospital; survival to hospital discharge occurred in only 5 patients (5.2%). Survival to hospital admission was higher among VF/VT presenting rhythms (36%) than for those with other rhythms (17%, P = 0.07), but survival to discharge among VF/VT rhythms (9%) was not statistically different from other rhythms (3%, P = 0.45). Among VF/VT patients, survival to discharge was correlated with shorter call to first defibrillation intervals. Mean call to response interval was longer than in other reported studies (7.2 +/- 4.3 minutes). In addition, there was a high drop-out rate of EMT participants, no central/uniform early access system (that is, 911), and a lower rate of CPR than reported in other studies. It is concluded that introduction of an EMT-D program without careful analysis of systems response factors will not lead to the improved cardiac arrest survival percentages that have previously been reported.
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PMID:Early defibrillation program: problems encountered in a rural/suburban EMS system. 850 13

The potential role of transforming growth factor-beta in in vivo resistance was examined by administration of transforming growth factor-beta-neutralizing antibodies to animals bearing the EMT-6/Parent tumor or the antitumor alkylating resistance tumors, EMT-6/CTX or EMT-6/CDDP. Treatment of tumor bearing animals with anti-TGF-beta antibodies by intraperitoneal injection daily on days 0-8 post-tumor cell implantation increased the sensitivity of the EMT-6/Parent tumor to cyclophosphamide (CTX) and cisplatin (CDDP) and markedly increased the sensitivity of the EMT-6/CTX tumor to CTX and the EMT6/CDDP tumor to CDDP, as determined by tumor cell survival assay. Bone marrow granulocyte-macrophage colony-forming units (CFU-GM) survival was determined from these same animals. The increase in the sensitivity in the tumors upon treatment with the anti-TGF-beta antibodies was also observed in increased sensitivity of the bone marrow CFU-GM to CTX and CDDP. Treatment of non-tumor-bearing animals with the anti-TGF-beta regimen did not alter blood ATP or serum glucose level but did decrease serum lactate levels. This treatment also decreased hepatic glutathione, glutathione S-transferase, glutathione reductase, and glutathione peroxidase in non-tumor bearing animals by 40-60% but increased hepatic cytochrome P450 reductase in these normal animals. Animals bearing the EMT-6/CTX and EMT-6/CDDP tumors had higher serum lactate levels than normal or EMT-6/Parent tumor-bearing animals; these were decreased by the anti-TGF-beta regimen. Treatment of animals bearing any of the three tumors with the anti-TGF-beta regimen decreased by 30-50% the activity of hepatic glutathione S-transferase and glutathione peroxidase, and increased by 35-80% the activity of hepatic cytochrome P450 reductase. In conclusion, treatment with transforming growth factor-beta-neutralizing antibodies restored drug sensitivity in the alkylating agent-resistant tumors, altering both the tumor and host metabolic states.
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PMID:Transforming growth factor-beta in in vivo resistance. 861 16

During the initial assessment of the injured athlete, the Sports Physical Therapist (PT) must first be concerned with life-threatening emergencies such as absence of breathing and pulse. The sports PT must also be aware of the possibility of "sudden cardiac death" that could occur in others, including coaches, officials, and fans. If the PT assumes the role of "most medical" person at the contest or event, the responsibility for life saving action falls squarely on their shoulders. Therefore, skills and ongoing certification in cardio- pulmonary resuscitation techniques and the use of an automated external defibrillator are a basic necessity. These skills are required as part of the specialty practice of sports PT (BLS Healthcare Provider course or CPR for the Professional Rescuer in addition to completion of the First Responder Course OR credentials as an EMT or ATC), and are mandatory for being qualified to sit for the exam to become a sports certified specialist (SCS) by the American Board of Physical Therapy Specialties (ABPTS).(3).
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PMID:The use of cardiopulmonary resuscitation and the automated external defibrillator in the practice of sports physical therapy. 2190 2

Long non-coding RNAs (lncRNAs) have been proposed as suppressors or promoters in many tumor processes. LncRNA LINC01123 (LINC01123) was a newly identified lncRNA which was firstly functionally analyzed in lung cancer. However, its expression and function in other tumor types were rarely reported. In this study, we firstly confirmed that LINC01123 was highly expressed in both endometrial cancer (EC) tissues and cell lines using bioinformatics analysis and RT-CPR. Then, we preliminarily analyzed the mechanisms involved in overexpression of LINC01123 in EC, finding that STAT1 could bind directly to the LINC01123 promoter region and activate its transcription. Clinical research with 106 patients indicated that high expression of LINC01123 was associated with advanced clinical progression and poor clinical outcome of EC patients. Functionally, knockdown of LINC01123 suppressed the proliferation, migration and invasion of EC cells, and promoted apoptosis. Mechanistically, we observed that LINC01123 may act as an endogenous sponge by competing for miR-516b, thereby regulating KIF4A. Overall, our study revealed a novel LINC01123/miR-516b/KIF4A pathway regulatory axis in EC pathogenesis. LINC01123 may be a novel prognostic biomarker and therapeutic target in EC.Abbreviations: EC: Endometrial cancer; LncRNA: Long non-coding RNA; EMT: epithelial-mesenchymal transition; miRNA: microRNA; qRT-PCR: Quantitative real-time polymerase chain reaction; SPSS: Statistical Package for Social Sciences; Chip: chromatin-immunoprecipitation, TCGA: The Cancer Genome Atlas; CCK-8: Cell Counting Kit-8; KIF4A: Chromosome-associated kinesin KIF4A.
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PMID:STAT1-induced upregulation of lncRNA LINC01123 predicts poor prognosis and promotes the progression of endometrial cancer through miR-516b/KIF4A. 3240 59