Prehospital management of XXXX --a population-based intervention study.

@entity1 @entity6 @entity341 @entity74 @entity4136 @entity204 @entity413
BACKGROUND: @entity6 -related @entity341 are frequent and potentially life-threatening. A study was performed to obtain reliable data about the prevalence of @entity6 and to improve the quality of prehospital care of @entity1 with @entity6 . METHODS: A prospective population-based study in a German emergency medical service district in the period from 1997 to 2000 was conducted. After initial @entity6 training for the entire emergency team, a standardized protocol was introduced for prehospital emergency therapy of severe hypoglycaemia (SH) and severe @entity74 . A rapid blood @entity413 test was performed on all emergency @entity1 with the exception of resuscitations and @entity204 . Indicators of treatment quality before and after these interventions were compared. RESULTS: A rapid blood @entity413 test was performed in 6631 (85%) of the 7804 @entity341 that occurred during the period investigated. The prevalence of acute @entity6 complications was 3.1%, and 213 cases of SH and 29 severe @entity74 were recorded. Education of the emergency team led to a significant improvement in the quality of treatment. Larger volumes of iv 40% @entity413 solution (50 +/- 20 ml (1997-2000) vs. 25 +/- 17 ml (1993-96); P < 0.0001) were administered to @entity1 with SH. Insulin-treated @entity1 who were well educated about their @entity6 were more often treated only at the emergency scene, after SH (25% vs. 8%; P = 0.007), and without complications. In 50 @entity1 who experienced @entity4136 -induced SH, the mandatory additional @entity413 infusions and hospitalization for further observation reduced mortality from 4.9% to 0% (P = 0.2). CONCLUSION: Training of the emergency team is an effective and efficient intervention to improve quality of treatment and prognosis outcome for @entity1 with @entity6 . Treatment of SH at the emergency scene only was demonstrated to be safe in type 1 @entity6 @entity1 who had previously received structured @entity1 education.
