Conclusions Primary care doctors on-call and the primary health care system with rGPs on daytime took part in clinical judgement and treatment in half of all red response cases, and for one third of these a clinical judgement was made before an EMCC was contacted. The inhabitants in the catchment area were offered different Dinaciclib datasheet levels of professional medical judgement and treatment. The EMCCs are not consistent with regards to alerting doctors on-call in red responses. There are differences

between the EMCCs areas in terms of frequency of alerted primary care doctors on-call, but the type of response was more similar among the doctors. Competing interests The authors declare that they have no competing interests. Authors’ Inhibitors,research,lifescience,medical contributions EZ and SH planned and established the project, including the procedures for data collection. EZ performed the analyses and drafted the manuscript. Both authors took part in the rewriting and approved the final manuscript. Pre-publication history The pre-publication history for this Inhibitors,research,lifescience,medical paper can be accessed here: http://www.biomedcentral.com/1471-227X/10/5/prepub Acknowledgements This study could not have been

carried out without help from the three EMCCs and support from Lars Solhaug, Dag Frode Kjernlie, Sissel Grønlien and Jan Nystuen from the area of Innlandet. Unni Eskeland and Olav Inhibitors,research,lifescience,medical Østebø from the area of Stavanger and Leif Landa, Kari Hauge Nilsen and Trond Kibsgaard in the area of Haugesund. We want to thank Pål Renland

for valuable help in data Inhibitors,research,lifescience,medical coding, Tone Morken for help in statistical challenges, Thomas Knarvik and Lars Myrmel for good discussions about dispatch centres, and all the doctors on-call and personnel at casualty clinics and air ambulance crews who submitted copies of medical records
Cyclic vomiting syndrome (CVS) is a chronic idiopathic functional gastrointestinal disorder that is characterized by recurrent, Inhibitors,research,lifescience,medical stereotypical, disabling, discrete episodes of intense nausea and vomiting that last a few hours to days, interspersed with varying symptom-free intervals. This disorder is primarily recognized in children, with increasing recognition in adults. The pathophysiology of CVS is unknown, but several theories have been advanced including a dysfunctional brain-gut interaction involving corticotrophin-releasing factor [1], dysregulation of the autonomic nervous system and mitochondrial dysfunction [2-9]. The diagnosis of 17-DMAG (Alvespimycin) HCl CVS in adults is based on Rome III criteria: 1) Stereotypical episodes of vomiting regarding onset (acute) and duration (less than 1 week); 2) Three or more discrete episodes in the prior year; and 3)Absence of nausea and vomiting between episodes and absence of metabolic, gastrointestinal, central nervous system structural or biochemical disorders. A personal or family history of migraines is supportive of the diagnosis [10].