RESUMO
The purpose of this study was to evaluate the cost effectiveness of screening emergency medical technicians (EMTs) and paramedical personnel prior to administering hepatitis B vaccine. Hepatitis B screening and Heptavax vaccine were offered to 259 basic EMTs and paramedics. Of the 259 individuals, 62 refused screening, and six who had already received hepatitis B vaccine were excluded from the study. The screening was not continued after the results of the first 174 tests returned negative. All 191 participants were vaccinated. No hepatitis B surface antigen carriers and only three individuals positive for hepatitis B surface antibody were found among those screened. This study corroborates the Centers for Disease Control guidelines of cost effectiveness in screening prehospital health care workers.
Assuntos
Pessoal Técnico de Saúde , Auxiliares de Emergência , Anticorpos Anti-Hepatite B/análise , Antígenos de Superfície da Hepatite B/análise , Hepatite B/epidemiologia , Programas de Rastreamento/economia , Doenças Profissionais/epidemiologia , Vacinas contra Hepatite Viral , Análise Custo-Benefício , Hepatite B/prevenção & controle , Vacinas contra Hepatite B , Humanos , Minnesota , Doenças Profissionais/prevenção & controle , Cooperação do PacienteAssuntos
Esôfago , Intubação , Ressuscitação , Morte Encefálica , Serviços Médicos de Emergência , Feminino , Insuficiência Cardíaca/etiologia , Humanos , Intubação/efeitos adversos , Intubação/instrumentação , Intubação Intratraqueal/efeitos adversos , Masculino , Pneumonia Aspirativa/etiologia , Ressuscitação/efeitos adversos , Estudos RetrospectivosRESUMO
We evaluated the efficacy of the esophageal airway (EA) by prospectively randomizing 175 prehospital cardiopulmonary arrest patients to receive either an esophageal gastric tube airway (EGTA) or an endotracheal tube (ET). If attempts with the initial airway failed, the alternate airway was attempted. The cost of training paramedics in EA use was considerably less than the ET ($80 vs $1,000). Survival to the emergency room, to hospitalization and to discharge in ET and EGTA groups were 64.4 percent, 25.6 percent, 11.1 percent, and 54.1 percent, 27.1 percent, 12.9 percent, respectively--differences not statistically significant. The incidence of neurologic residual (ET 50 percent, EGTA 36.4 percent) and congestive heart failure (ET 40 percent, EGTA 45.5 percent) in surviving ET and EGTA patients did not differ (NS). An additional 125 consecutive patients with only the opportunity to receive an EA were also evaluated and did not differ in mortality, neurologic residual, or congestive heart failure from ET patients. We conclude that the EA is a satisfactory alternative to the ET for short-term prehospital use in cardiopulmonary arrest patients.
