Intravenous @entity859 as first-line prehospital management of XXXX by EMS personnel without direct physician control.

@entity1 @entity859 @entity591 @entity955 @entity1167 @entity4710 @entity943 @entity7129
This study was conducted to evaluate the safety and efficacy of intravenous @entity859 therapy for prehospital treatment of @entity591 with a presumptive field diagnosis of @entity4710 ( @entity4710 ) by paramedics without direct physician control. A ten-month prospective case series was designed in an urban EMS system that has paramedics operating under standing orders before physician radio contact. All @entity1 with @entity4710 field diagnosis were included. Diagnosis of @entity4710 was made by regular, @entity591 with a heart rate greater than 160 beats/min by field ECG. Interpretation was performed solely by paramedics; ECG transmission was not available. In hemodynamically stable @entity1 , vagal maneuvers were followed by intravenous placement and administration of @entity859 was recommended by the manufacturer. If three @entity859 boluses failed to convert the @entity943 , @entity1 were monitored and transported, with electrical cardioversion available. Data collection included demographic, history, medications, vital signs, and EGG tracings. Of 14 included @entity1 , 31 were correctly diagnosed with @entity4710 (75.6%), with mean ventricular rate of 205 beats/min (SD 7 beats/min); one had @entity7129 ; nine had @entity955 ( @entity955 ) (22%). Of the 31 cases correctly diagnosed as @entity4710 , 28 converted to sinus rhythm after @entity859 (90.3%). Of those converted, 16 required a single dose (57.1%), nine required one additional dose (32.1%), and three required two additional doses (10.8%). None reverted to @entity4710 after @entity859 conversion during the study period (conversion to arrival at emergency department). No significant difference in length of @entity1167 pause or in outcome was detected between the true @entity4710 cases and the @entity955 cases receiving @entity859 .(ABSTRACT TRUNCATED AT 250 WORDS)
