Full Video of EMS Call Prior to Death of South Carolina Man with Schizophrenia
ORANGEBURG, SC (WRDW/WAGT) - It started with a few 911 calls on Sept. 9, 2018.  911 Caller: There is a man naked running down the interstate on 95. 911 Caller: I don't know if you are going to believe me or not, but I just had a naked guy come walk up on me on the side of the road, and I took off and I think he jumped on my catwalk.  JEMS: Questions Surround Case of South Carolina Patient’s Death It was 26-year-old Paul Tarashuk. When Orangeburg County Sheriff's Office deputies arrived to try and grab Tarashuk, they believed he was on drugs. He was not. He was having a schizophrenic episode. Tarashuk's diso...
Source: JEMS Patient Care - March 21, 2019 Category: Emergency Medicine Tags: News Videos Patient Care Administration and Leadership Source Type: news

Questions Surround Case of South Carolina Patient ’s Death
ORANGEBURG, SC (WRDW/WAGT) - Questions continue to surround the case of a man who was killed while walking down Interstate 95 in Orangeburg County last year. Those questions surround an EMT and a paramedic who treated Paul Tarashuk before he was released from their care and into the care of an Orangeburg County deputy. That deputy dropped Tarashuk off 18 miles away at a closed gas station. The paramedic is allowed to keep working after South Carolina ruled she and the other EMT abandoned Tarashuk instead of taking him to a nearby hospital. It started with a few 911 calls on Sept. 9, 2018. 911 Caller: There is a man naked r...
Source: JEMS Patient Care - March 20, 2019 Category: Emergency Medicine Tags: News Patient Care Administration and Leadership Source Type: news

Prehospital Fluid Management in Hemorrhagic Shock
Hemorrhagic shock is a clinical state in which severe blood loss causes insufficient cellular oxygen delivery, leading to organ failure and, ultimately, death.1 Annually, over 60,000 deaths in the United States and some 1.9 million worldwide are due to hemorrhagic shock, with some 1.5 million of these cases associated with trauma.2,10 IV fluid resuscitation has become a staple of prehospital management of hemorrhagic shock. However, subsequent studies from both laboratory control models and post-transport patient outcomes have questioned this practice, suggesting that permissive hypotension (i.e., systolic blood pressure [...
Source: JEMS Patient Care - March 19, 2019 Category: Emergency Medicine Authors: Raymond L. Fowler, MD, FACEP, FAEMS Tags: Trauma Cardiac & Resuscitation Top Story Exclusive Articles Patient Care Source Type: news

NAEMT and Sepsis Alliance Announce Results of National Sepsis Survey
In a recent national survey of more than 1,300 EMS providers, the National Association of Emergency Medical Technicians (NAEMT) in association with the Sepsis Alliance found that although nearly all respondents (98%) consider sepsis a medical emergency, only about half (51%) feel very confident in their ability to recognize symptoms of sepsis—the body’s life-threatening response to an infection. Each year, about 1.7 million people in the United States are diagnosed with sepsis, with 270,000 dying, making sepsis a priority public health issue. This is reflected in the 83% of respondents who say that they’v...
Source: JEMS Patient Care - March 15, 2019 Category: Emergency Medicine Authors: JEMS Staff Tags: Patient Care News Source Type: news

Drones Expected to Deliver Defibrillators in 2020
RENO, Nev. (KOLO) - Drone company Flirty has received approval from the Federal Aviation Administration to conduct drone delivery flights beyond visual line of sight (BVLOS), allowing for drones to deliver defibrillators to heart attack victims so treatment can begin before paramedics arrive. The new approval enables Flirtey to conduct drone delivery operations with a pilot controlling the flights from a remote location. Beginning in 2020, when 911 is called about a heart attack victim, a dispatcher will send an ambulance while talking through how to use a defibrillator delivered by a drone faster than paramedics can get t...
Source: JEMS Patient Care - March 14, 2019 Category: Emergency Medicine Tags: News Cardiac & Resuscitation Patient Care Operations Source Type: news

A Push for Push Dose Epinephrine
You transport a 79-year-old woman to the hospital for fever and urinary incontinence. Her family mentions a history of frequent urinary tract infections. Her initial vital signs are a heart rate of 115 bpm, an oxygen saturation of 97% on room air, and a blood pressure of 105/75 mmHg. You establish a peripheral IV line and begin a bolus of normal saline. About 15 minutes away from the hospital, you note the patient becomes increasingly drowsy. Her heart rate has increased to 125 bpm and her blood pressure is now 85/47 mmHg. What are your next steps? Prehospital Shock Starting in 2018, push dose epinephrine replaced dopamine...
Source: JEMS Patient Care - March 14, 2019 Category: Emergency Medicine Authors: Sammy Hodroge, MD Tags: Training Cardiac & Resuscitation Top Story Exclusive Articles Patient Care Source Type: news

Video Shows Ohio Pizza Employees Save Co-Worker ’s Life
  NEW PHILADELPHIA, Ohio — Three employees of an Ohio Little Caesars are being hailed as heroes, credited with helping save a co-worker's life. Gilbert Gaynesbloom, 63, fell unconscious in full cardiac arrest at the restaurant, and the actions of his quick-thinking co-workers were all caught on camera. While 34-year-old Keralyn Songer rushed to call paramedics, 35-year-old Nicole Strong, who learned CPR in high school, cleared Gaynesbloom's airway and got him on his back. Brody Ferris, 24, immediately started CPR. Ferris had just learned the lifesaving technique for a summer lifeguard job. Read more at WGN. (Sou...
Source: JEMS Patient Care - March 12, 2019 Category: Emergency Medicine Authors: WGN Tags: Cardiac & Resuscitation News News Videos Source Type: news

Unvaccinated Boy Becomes Oregon's 1st Tetanus Case in Years
  PORTLAND, Ore. (KOIN) -- A 6-year-old Oregon boy contracted tetanus in 2017 -- the state's first pediatric case in over 30 years. The information was outlined in a new CDC report released on Friday. According to the report, the boy had never received any vaccines. (Source: JEMS Patient Care)
Source: JEMS Patient Care - March 12, 2019 Category: Emergency Medicine Authors: KOIN 6 News Tags: News News Videos Patient Care Source Type: news

Paramedic with Rare Heart Condition Suffers Complications after Open Heart Surgery
  HAGERSTOWN, Md. (WDVM) - Brandon Bolyard is a paramedic and firefighter here in Washington County. He was born with a very rare heart defect which has changed his life drastically in the past few weeks. (Source: JEMS Patient Care)
Source: JEMS Patient Care - March 12, 2019 Category: Emergency Medicine Authors: Valerie Bell (WDVM) Tags: News News Videos Patient Care Source Type: news

Critical Considerations for Fixed-Wing Air Medical Transports
The need to move ill or injured patients from one location to another by air isn’t a new concept. Injured soldiers were among the first patients in history to be transported by air to a medical facility, beginning with the use of hot air balloons in 1784.1 Since fixed-wing aircraft were developed in 1903, the use of these engineering marvels for patient transport has seen incredible advances. Although an invaluable resource, in addition to the medical care required on the ground, there are important physiologic changes that occur at higher altitudes and must be considered by the transport personnel. Some of the physi...
Source: JEMS Patient Care - March 6, 2019 Category: Emergency Medicine Authors: Alexander Torres, DO, MBA Tags: Top Story Exclusive Articles Patient Care Operations Source Type: news

Seven Injured, Two Killed after Car Strikes Crowd in New Orleans
NEW ORLEANS (AP) — A driver suspected of killing two people and injuring seven others, most of them on bikes, as large crowds gathered in New Orleans for Mardi Gras told police after the deadly crash, "I have a drinking problem," according to a police report. New Orleans police said Tashonty Toney, 32, was charged with two counts of vehicular homicide and other charges after crashing his car Saturday evening on a busy thoroughfare near the route of one of New Orleans' largest Mardi Gras parades. Police spokesman Andy Cunningham said in a statement Sunday morning that authorities are waiting for the results ...
Source: JEMS Patient Care - March 4, 2019 Category: Emergency Medicine Tags: Trauma News Patient Care Source Type: news

Beverly Hills Fire Department Adds Nurse Practitioner Unit
In an effort to cut down ED overcrowding in its city's hospitals, the Beverly Hills Fire Department has added a Nurse Practitioner Response Unit (NPRU) to its prehospital care team. The one-year program, paid for by the city of Beverly Hills, is an effort to cut down on ED overcrowding.   "If you take a look at any of the local hospitals you'll know their emergency rooms are filled with truly non-critical patients, but nonetheless people who need care," Beverly Hills Mayor Julian Gold told KABC in an interview earlier this week. Nurse practitioners are not new to Los Angeles-area fire department...
Source: JEMS Patient Care - March 1, 2019 Category: Emergency Medicine Authors: JEMS Staff Tags: News News Videos Patient Care Administration and Leadership Top Story Mobile Integrated Healthcare Source Type: news

EMS Medical Directors Chart the Future of EMS at Annual Gathering of Eagles
The Metropolitan Medical Directors Coalition (AKA “Eagles”) 21st Annual Retreat (AKA “Eagle Creek”) was held Wednesday and Thursday, February 27 and 28, at the Dallas Sheraton Hotel under the leadership of Paul Pepe, MD. The closed, invitation-only retreat is attended by 70 medical directors from the most-populated metropolitan EMS systems as well as 18 EMS fellows—33% of the nation’s current EMS fellows. This group oversees EMS for a combined population of over 114 million people in the United States and abroad, with representatives from Canada; Germany; New Zealand; Italy; Amsterdam, T...
Source: JEMS Patient Care - February 28, 2019 Category: Emergency Medicine Authors: A.J. Heightman, MPA, EMT P Tags: Top Story News Exclusive Articles Patient Care Administration and Leadership Operations Source Type: news

SAM Medical Launches New Bleeding Control Kits for Novice and Experienced Users
News Higlights: - SAM Medical brings the most essential supplies together to empower everyone to become first responders - New SAM Medical Bleeding Control Kits feature the award-winning SAM XT Extremity Tourniquet, an easy-to-use “click, twist and secure” tourniquet anyone can use - The SAM XT Extremity Tourniquet is an approved emergency medical device through the Department of Defense’s Stop the Bleed licensing program - SAM Medical opens new e-commerce site, making its entire product line available to the public for the first time ever WILSONVILLE, Ore. -- SAM Medical, an industry leader in the pre-ho...
Source: JEMS Patient Care - February 28, 2019 Category: Emergency Medicine Authors: SAM Medical (press release) Tags: Trauma Press Releases Source Type: news

Hospital Inpatient Resuscitation Systems of Care
Up to one-third or more of inpatient cardiac arrest deaths may be avoidable, either through arrest prevention efforts or via improved resuscitative measures. Unfortunately, hospitals have struggled to implement effective programs that reduce the incidence of cardiac arrest, and inpatient arrest survival rates have been relatively stagnant for decades. Based on a recent Society of Hospital Medicine survey, most hospitals use biennial life support training as their sole source for maintaining resuscitation competency among their providers. This is too infrequent and doesn’t address the unique hospital-based resources a...
Source: JEMS Patient Care - February 27, 2019 Category: Emergency Medicine Authors: Daniel P. Davis, MD Tags: Cardiac & Resuscitation Top Story Exclusive Articles Patient Care Heart of America Source Type: news

Hypercoagulation After Cardiac Arrest
Optimal intra- and post-arrest care for out-of-hospital cardiac arrest (OHCA) requires careful management of the complex interaction between clot formation (i.e., coagulation) and its natural resolution (i.e., fibrinolysis).1 In greater than 70% of cases, OHCA is caused by a clot blocking either a coronary artery, pulmonary artery, acute coronary syndrome (ACS), or pulmonary thromboembolism (PTE).2 When OHCA occurs, lack of pulsatile blood flow facilitates rapid clot formation in larger blood vessels and structures demonstrated by abnormally high levels of clotting byproducts, such as d-dimer.3 CPR mechanically disrupts fu...
Source: JEMS Patient Care - February 27, 2019 Category: Emergency Medicine Authors: Michael C. Kurz, MD, MS-HES, FACEP Tags: Cardiac & Resuscitation Top Story Exclusive Articles Patient Care Heart of America Source Type: news

Alameda County EMS Improves Cardiac Arrest Survival
This article addresses those changes and the resulting improvement in cardiac arrest resuscitation. The endorsed system of care for OHCA by ALCO EMS has been modeled after that of the decade-old and nationally recognized Take Heart America.1 All of the changes and system design are based upon recommended evidence-driven treatment strategies, techniques and devices that are consistent with the 2005, 2010 and 2015 American Heart Association (AHA) Guidelines.2–4 These have included measures to improve the rate of bystander CPR through CPR-7, a community outreach education program using seventh graders and those they tra...
Source: JEMS Patient Care - February 27, 2019 Category: Emergency Medicine Authors: Michael J. Jacobs, EMT-P Tags: Cardiac & Resuscitation Top Story Exclusive Articles Patient Care Heart of America Source Type: news

Whatcom County Faces Challenges Despite Improvements Resulting from a Bundle of Care Approach to OHCA
Whatcom County, Washington, is the furthermost northwest county in the continental United States. The county covers over 2,200 square miles and has a population of approximately 250,000 people, of which 150,000 are within the city of Bellingham. Whatcom County is the state’s 12th largest county, part of which is only accessible by land through Canada. Whatcom County’s ALS program began in 1974. Over the years, the manner in which care has been delivered has steadily improved. In 1996, all BLS response units were equipped with an AED and a strong community effort to provide CPR training was initiated. Then, in ...
Source: JEMS Patient Care - February 27, 2019 Category: Emergency Medicine Authors: Marvin Wayne, MD, FACEP, FAAEM, FAHA Tags: Cardiac & Resuscitation Top Story Exclusive Articles Patient Care Heart of America Source Type: news

Palm Beach County Sees Results After Instituting a Bundle of Care Approach to Resuscitation
Palm Beach County, Florida, is home to 1.4 million residents and is host to many more visitors each year as a major tourist destination. It’s a sprawling, multicultural and diverse socioeconomic demographic with extremes of age. In 2015, based upon disappointing resuscitation rates, the bundle of care approach was instituted by the county’s new EMS medical directors. Within three months, resuscitation rates improved dramatically, and in the ensuing years, have remained at over double their prior level. How did this occur, and what are the implications for enhancing cardiac arrest survival across other jurisdict...
Source: JEMS Patient Care - February 27, 2019 Category: Emergency Medicine Authors: Kenneth A. Scheppke, MD Tags: Cardiac & Resuscitation Top Story Exclusive Articles Patient Care Heart of America Source Type: news

Rialto Fire Department Changes the Paradigm of Cardiac Arrest
The Rialto, Calif., Fire Department (RFD) changed the way we view cardiac arrest. Our goal was to transform from the way we’ve “always done it,” which was resulting in 77% of our cardiac arrest patients never regaining a pulse, to a progressive bundle of care approach that utilizes the synergy of multiple small improvements for significant improvements in return of spontaneous circulation (ROSC)—eventually tripling of our survival to hospital discharge. The RFD bundle of care, which we call our “resuscitation toolbox,” was implemented on the vision that survival from cardiac arrest shoul...
Source: JEMS Patient Care - February 27, 2019 Category: Emergency Medicine Authors: Sean Grayson, MS, EMT-P Tags: Cardiac & Resuscitation Top Story Exclusive Articles Patient Care Heart of America Source Type: news

Adroit Surgical Is Pleased to Announce as of Today the Following Distributor Partners Are Offering Adroit Surgical ’s New Vie Scope Product to the EMS Market
OKLAHOMA CITY, OK – Adroit Surgical is pleased to announce the following Distributor Partners now offer the full line of Adroit Surgical products to the North American EMS Market. Distributors are listed in alphabetical order: Dixie EMS E. Pickering Guardian EMS Supply J&B Medical Live Action Safety Medline Industries The EMS Stoeighre The Fire Store Kris Bordnick, Director of EMS Sales issued the following statement regarding the announcement – “We are looking forward to partnering with these premier EMS Distributors to offer Adroit Surgical’s product line to EMS Professionals throughout Nort...
Source: JEMS Patient Care - February 27, 2019 Category: Emergency Medicine Authors: Adroit Surgical (press release) Tags: Airway & Respiratory Press Releases Source Type: news

Three Pillars for Pediatric Resuscitation Success
Data from the American Heart Association and the Pediatric Advanced Life Support (PALS) guidelines consistently report neurologically intact survival from pediatric cardiac arrest to be 3% for infants and 10% for children. This pediatric survival data has remained unchanged for decades without a clear vision or path to improved survival statistics. Change is needed, and we recommend focusing on the following three pillars in order to achieve success in pediatric cardiac arrest: 1) bystander CPR; 2) telecommunicator CPR (TCPR); and 3) on-scene EMS resuscitation. Using a different lens to evaluate these links in the chain of...
Source: JEMS Patient Care - February 27, 2019 Category: Emergency Medicine Authors: Peter Antevy, MD, MPH Tags: Cardiac & Resuscitation Top Story Exclusive Articles Patient Care Heart of America Source Type: news

Transesophageal Echocardiography During Cardiac Arrest
Transthoracic echocardiography (TTE) has been endorsed by international guidelines as a potentially useful diagnostic modality for the evaluation of patients in cardiac arrest.1,2 Echocardiography can identify organized cardiac activity vs. standstill, predict the likelihood of survival,3–5 and may be used to establish the cause of the arrest and guide treatment, such as in the case of pericardial tamponade or massive pulmonary embolus. However, the process of TTE image acquisition has been observed to cause prolonged pauses in the delivery of vital chest compressions and reduce hands-on time.6,7 A structured protoco...
Source: JEMS Patient Care - February 27, 2019 Category: Emergency Medicine Authors: Scott T. Youngquist, MD, MS, FAHA, FACEP, FAEMS Tags: Cardiac & Resuscitation Top Story Exclusive Articles Patient Care Heart of America Source Type: news

Active Intrathoracic Pressure Regulation During Resuscitation
Active intrathoracic pressure regulation (aIPR) is a novel therapy approved for the treatment of low blood flow states, such as cardiac arrest. This therapy is delivered with a device called the CirQPOD that’s inserted into a standard respiratory circuit between the patient and a means to provide positive pressure ventilation (e.g., bag-valve balloon or mechanical ventilator). Between each positive pressure ventilation, aIPR decrease intrathoracic pressure to subatmospheric levels, which subsequently enhances blood return to the heart and increases stoke volume, cardiac output, arterial blood pressures and coronary p...
Source: JEMS Patient Care - February 27, 2019 Category: Emergency Medicine Authors: Nicolas Segal, MD, PhD Tags: Cardiac & Resuscitation Top Story Exclusive Articles Patient Care Heart of America Source Type: news

Neuroprotective Effects of Targeted Temperature Management
Hypothermia has a number of potential neuroprotective effects; however, they can be broken down into two main properties: metabolic and neuronal protection. When mammals hibernate, they experience acidosis both from lactate and carbon dioxide, resulting in hypoxia and hypoglycemia. These conditions are not unlike those that occur post-cardiac arrest: Hypothermia decreases metabolic rate by about 6% per 1 degree C reduction in brain temperature. If blood flow and demand are coupled, it’s possible to see a 50% decline in cerebral metabolic after cooling the brain to 32 degrees C. The protective effects occur via reduct...
Source: JEMS Patient Care - February 27, 2019 Category: Emergency Medicine Authors: Brian J. O ’Neil, MD, FACEP, FAHA Tags: Cardiac & Resuscitation Top Story Exclusive Articles Patient Care Heart of America Source Type: news

Extracorporeal Pulmonary Resuscitation (ECPR) of Out-of-Hospital Cardiac Arrest
For decades, extracorporeal life support (commonly referred to as extracorporeal membrane oxygenation, or ECMO) was used in the operating room (OR) and ICU to treat refractory shock, typically after surgery. More recently, ECMO has been used to treat refractory cardiac arrest; in this indication, it takes the name “ECPR.” Today, ECPR is used in many places. Although there are published case reports, series and after/before studies, there have been no randomized controlled trials to illustrate its effectiveness in the resuscitation of out-of-hospital cardiac arrest (OHCA) patients. However, ECPR is now recommend...
Source: JEMS Patient Care - February 27, 2019 Category: Emergency Medicine Authors: Lionel Lamhaut, MD, PhD Tags: Cardiac & Resuscitation Top Story Exclusive Articles Patient Care Heart of America Source Type: news

Minnesota Resuscitation Consortium Advanced Perfusion & Reperfusion Cardiac Life Support Strategy for Out-of-Hospital Refractory V Fib
Approximately 400,000 people in the United States suffer out-of-hospital cardiac arrest (OHCA) each year. One-third present to EMS with a shockable rhythm (v fib/v tach). Of these patients with an initial shockable rhythm, 50% are refractory to treatment resulting in prolonged duration of resuscitation and poor outcomes.1,2 The Minnesota Resuscitation Consortium (MRC) initiated the Advanced Perfusion and Reperfusion Cardiac Life Support Strategy for Out-of-Hospital Refractory Ventricular Fibrillation (v fib) in December 2015, in an effort to improve survival outcomes for patients suffering refractory v fib arrest. Extracor...
Source: JEMS Patient Care - February 27, 2019 Category: Emergency Medicine Authors: Jason Bartos, MD, PhD Tags: Cardiac & Resuscitation Top Story Exclusive Articles Patient Care Heart of America Source Type: news

REBOA and SAAP: Aortic Interventions for Resuscitation
REBOA Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) involves the use of an aortic balloon catheter to limit blood loss caudal to the inflated balloon in patients with severe, uncontrolled truncal and junctional hemorrhage. Initially described during the Korean War, aortic balloon occlusion for hemorrhage control in trauma was reported sporadically over the ensuing decades without general adoption into clinical practice. This has changed in the past decade in response to injury patterns observed in the combat theaters of the Middle East. Preclinical studies in U.S. military research labs characterized th...
Source: JEMS Patient Care - February 27, 2019 Category: Emergency Medicine Authors: James E. Manning, MD Tags: Cardiac & Resuscitation Top Story Exclusive Articles Patient Care Heart of America Source Type: news

Cerebral Monitoring May Aid Assessment of Brain Function During Cardiac Arrest
The overall aims of neuromonitoring are to identify worsening neurological function and secondary cerebral insults that may benefit from specific treatment(s) and improve pathophysiological understanding of cerebral disease in critical illness, to provide clear physiological data to guide and individualize therapy, as well as assist with neuroprognostication. It’s not a novel concept to directly monitor the organ of interest to direct and assess therapies. The human brain constitutes 2% of the total body weight, yet the energy-consuming processes that enable the brain to function adequately account for about 25% of t...
Source: JEMS Patient Care - February 27, 2019 Category: Emergency Medicine Authors: Kees Polderman, MD, PhD Tags: Cardiac & Resuscitation Top Story Exclusive Articles Patient Care Heart of America Source Type: news

Epinephrine in Cardiac Arrest
Epinephrine has been a key component of ALS since the first CPR guidelines were published in the early 1960s, and its use has continued with little change in dose or timings over the past 60 years. As well as its positive inotropic and chronotropic properties mediated through beta-agonist properties, the demonstration that epinephrine’s alpha-agonist effects increased aortic diastolic pressure to increase both coronary blood flow (associated with an increased chance of return of spontaneous circulation [ROSC]) and cerebral blood flow was also thought to be of benefit.1,2 However, there have been concerns about potent...
Source: JEMS Patient Care - February 27, 2019 Category: Emergency Medicine Authors: Charles Deakin, MA, MD, MB BChir, FRCA, FRCP, FFICM, FERC Tags: Cardiac & Resuscitation Top Story Exclusive Articles Patient Care Heart of America Source Type: news

St. Petersburg (FL) Fire Rescue EMS Team Takes First Place at JEMS Games 2019
By Steven Lawrence The St. Petersburg (FL) Fire Rescue EMS team took first place against 20 teams in the 2019 JEMS Games at EMS Today 2019 in National Harbor, Maryland. The JEMS Games is a challenging and educational clinical competition for emergency medical personnel, highlighting cutting-edge simulation technology. The competition challenges teams to appropriately assess and provide efficient patient care during realistic high-pressure scenarios. More than 4,600 EMS professionals from around the world attended EMS Today's conference to learn about the most innovative products and services available to the EMS indus...
Source: JEMS Patient Care - February 22, 2019 Category: Emergency Medicine Tags: Patient Care EMS Today Source Type: news

Hiker Recalls Being Stuck in Quicksand in Utah Park
SALT LAKE CITY (AP) — A man who was stranded for hours in frigid weather with his leg sunk up to the knee in quicksand at a creek in Utah's Zion National Park said Tuesday that he feared he would lose his leg and might die because the quicksand's water was so cold. Ryan Osmun, 34, of Mesa, Arizona, told NBC's "Today" show that he hallucinated at one point while waiting several hours alone after his girlfriend Jessika McNeill left him last Saturday to get help. "I thought for sure I would lose my leg," Osmun said. "And then toward the end I thought I wasn't going to make it." Quicksand ca...
Source: JEMS Patient Care - February 20, 2019 Category: Emergency Medicine Tags: Rescue & Vehicle Extrication News Patient Care Operations Source Type: news

California Airport Worker Killed when Jet Bridge Tire Explodes
SANTA ANA, Calif. (AP) — A worker at Southern California's John Wayne Airport was killed when a large tire from a jet bridge used to connect terminals to aircraft doors exploded during maintenance, officials said Wednesday. Two contract employees were in a workshop disassembling the tire when the explosion happened late Tuesday, said airport spokeswoman Deanne Thompson. The blast set off a fire alarm that summoned airfield rescue crews. "One of the men sustained fatal injuries due to the force of the explosion," Thompson said. He died at the scene. The other worker did not seek treatment. The state's workpl...
Source: JEMS Patient Care - February 20, 2019 Category: Emergency Medicine Tags: Trauma Patient Care News Source Type: news

Man Dies in Portable Toilet Fire at Baltimore Ravens Stadium
BALTIMORE (AP) — Firefighters say a man died in a fire in a portable toilet near the Baltimore Ravens' stadium. News outlets quote Baltimore police as saying the Sunday fire in the parking lot of M&T Bank Stadium didn't appear to be criminal. Baltimore Fire spokeswoman Blair Skinner says a security guard saw a man engulfed in flames running from the burning toilet. By the time medics arrived, the man was dead and two other portable toilets were also ablaze. The man hasn't been identified. It's unclear how long he had been in the toilet. The cause of the fire is still under investigation. The stadium wasn't hostin...
Source: JEMS Patient Care - February 20, 2019 Category: Emergency Medicine Tags: Patient Care News Source Type: news

EMS Today 2019: Heightman: 'We Are Complete Responders!'
A.J. Heightman, JEMS Editor in Chief and EMS Today Conference Chair, addressed the audience at the EMS Today Opening Ceremony & General Session in National Harbor, Maryland on Wednesday, February 20, 2019: More: Photos from Day 1 of EMS Today “I wear this uniform proudly and in honor of my father, who commanded the Scranton Fire Department Ambulance Division for 36 years. “As a young firefighter, my Dad was required to report to work in his Class A uniform; stand at attention for inspection; and then, when released, change into jeans and a navy-blue T-shirt to return to the apparatus floor and crawl on cree...
Source: JEMS Patient Care - February 20, 2019 Category: Emergency Medicine Tags: Patient Care EMS Today Source Type: news

EMS Today 2019: EMS 10 Innovators Recognized
At Wednesday’s Opening Ceremonies of EMS Today, JEMS Editor in Chief and EMS Today Conference Chair A.J. Heightman recognized this year’s EMS 10 Innovator of the Year Award winners. Selected by an expert review committee, this year’s winners each distinguished themselves in the field of EMS by developing and implementing innovative projects or concepts that will benefit the EMS community worldwide. In addition, each of the EMS 10 award winners will be profiled in detail on jems.com after EMS Today. The Innovators in EMS are the following: Morgan Anderson, MPH Epidemiologist, ImageTrend Leading the CrewCar...
Source: JEMS Patient Care - February 20, 2019 Category: Emergency Medicine Tags: Patient Care EMS Today Source Type: news

EMS Today 2019: James O. Page, John P. Pryor Awards Presented
During the EMS Today Opening Ceremonies & General Session on Wednesday, February 20, JEMS Editor in Chief A.J. Heightman, Executive Editor Mike McEvoy, and CEO of Hartwell Medical Gary R Williams presented the EMS Today annual awards. The awards were sponsored this year by Hartwell Medical. ALSO: Photos from Day 1 of EMS Today The first award was the 2019 James O. Page Leadership Award. It encourages EMS personnel and EMS agencies to deliver quality service, gain the respect of their colleagues in the field of EMS, and fight to do what’s in the best interest of patient care. The award recognizes an indi...
Source: JEMS Patient Care - February 20, 2019 Category: Emergency Medicine Tags: Patient Care EMS Today Source Type: news

Three Children Among Four Dead in Michigan Shooting
SOLON TOWNSHIP, Mich. (AP) — Authorities say three children and a woman were found dead of apparent gunshot wounds at a home in western Michigan. Kent County Sheriff Michelle LaJoye-Young says authorities responded Monday to a property near Cedar Springs, a community about 30 miles (48 kilometers) north of Grand Rapids. She says someone discovered the bodies and called 911. LaJoye-Young said the three children were elementary school-aged and younger but declined to provide further information about the victims' relationships to one another. She said authorities were still confirming the victims' identities. LaJoye-Yo...
Source: JEMS Patient Care - February 19, 2019 Category: Emergency Medicine Tags: Trauma News Patient Care Source Type: news

EMS Today 2019: Let the Learning Begin
There are a variety of educational opportunities to take advantage of at EMS Today. Clarion Fire & Rescue Group Executive Editor Diane Rothschild polled EMS Today instructors to find out why their class topic is important; what their message is to their students; and what they consider to be hot, emerging topics in the EMS arena. Here are excerpts from their responses. SEE MORE PHOTOS FROM EMS TODAY 2019>> Mike Taigman is teaching “Ask a Quality Expert” and “From a Vision to Reality: EMS Agenda 2050.” He has been teaching quality improvement in EMS since 1988 and has taught at between...
Source: JEMS Patient Care - February 19, 2019 Category: Emergency Medicine Tags: Patient Care EMS Today Source Type: news

Trauma Scenarios in Virginia
Fairfax County Fire and Rescue - The paramedic students are a little over the half-way point of their training. To prepare for testing next week, they conducted realistic trauma scenarios at the Fairfax County Police Department academy on February 14, 2019. Instructors video each session and hold a debrief after each to provide the student feedback.    (Source: JEMS Patient Care)
Source: JEMS Patient Care - February 19, 2019 Category: Emergency Medicine Tags: News Videos Patient Care Source Type: news

Five Bystanders Wounded in New Orleans Police Shootout
NEW ORLEANS (AP) — Five people waiting at a downtown New Orleans bus stop were wounded by gunfire during a police shootout with an armed robbery suspect, authorities said, in a city weekend marred with multiple shootings. The shootout that injured the five bystanders happened Sunday night, and officials said the robbery suspect was killed during an exchange of gunfire between the suspect and officers with the New Orleans Police Department and the Louisiana State Police that stretched over two city blocks. The New Orleans Police Department said officers investigating two armed robberies that happened last week confron...
Source: JEMS Patient Care - February 18, 2019 Category: Emergency Medicine Tags: Trauma Patient Care News Source Type: news

CO2 Measurements Can Guide OHCA Resuscitative Efforts
Carbon dioxide (CO2) in the body is a product of metabolism. It’s produced in cells dependent on oxygen supply. During cardiac arrest, oxygen delivery to cells falls, and CO2 production decreases. CO2 levels may be monitored at the airway through CO2 excretion, and they may be monitored in the cells through peripheral measurement. Peripheral measurement of CO2 has typically been carried out through arterial or venous analysis. Transcutaneous CO2 measurement is now a popular and useful method of providing the monitoring of CO2 levels in critically ill patients, especially pediatric patients. Variations between the lev...
Source: JEMS Patient Care - February 15, 2019 Category: Emergency Medicine Authors: Raymond L. Fowler, MD, FACEP, FAEMS Tags: Airway & Respiratory Cardiac Resuscitation Exclusive Articles Patient Care Heart of America Top Story Source Type: news

Active Compression-Decompression CPR Plus an Impedance Threshold Device
Although conventional closed-chest manual CPR has been the standard of care for over 60 years,1 its limitations have resulted in new CPR techniques.2–6 Conventional, standard CPR provides only about 20–30% of normal blood flow to the heart and brain, which in many cases is insufficient to enable a return of spontaneous circulation (ROSC).7–10 In addition, it’s difficult to perform correctly and consistently.11–14 Over the past 25 years, a new method of CPR called “active compression-decompression (ACD) CPR plus an impedance threshold device (ITD)” has been developed as a superior a...
Source: JEMS Patient Care - February 15, 2019 Category: Emergency Medicine Authors: Tom P. Aufderheide, MD, MS, FACEP, FACC, FAHA Tags: Cardiac & Resuscitation Top Story Exclusive Articles Patient Care Heart of America Source Type: news

High-Quality CPR Requires Measurement and Feedback
Survival from out-of-hospital cardiac arrest (OHCA) continues to be dismal in many EMS systems around the world.1 Is this actually true, or is it merely an often-used opening line to thousands of papers published annually on OHCA survival? Evidence from many communities suggests otherwise. In fact, in many jurisdictions, survival from OHCA has improved dramatically, impacting many lives.2–5 So, what’s the difference between some jurisdictions and others when it comes to OHCA survival? Are there common themes that others can learn from in improving their own survival rates? One of the common themes we see in are...
Source: JEMS Patient Care - February 15, 2019 Category: Emergency Medicine Authors: Sheldon Cheskes, MD, CCFP (EM), FCFP Tags: Training Cardiac & Resuscitation Exclusive Articles Patient Care Heart of America Top Story Source Type: news

Supraglottic Airways: Use in Cardiac Arrest Remains Controversial
We examined whether different SGAs behave the same way when used clinically. Our work builds on prior studies in pigs suggesting that not all SGAs function the same and that some may cause internal strangulation. Our current work also builds on recent studies that were performed using the human cadaver model to study the physiology of CPR. This human cadaver model is particularly useful in that we can measure airway pressures as well as intracranial pressures. The airway and intracranial pressures and changes in those pressures are similar to what we’ve observed in animal models and cardiac arrest in humans. More spe...
Source: JEMS Patient Care - February 15, 2019 Category: Emergency Medicine Authors: Joe Holley, MD, FACEP, FAEMS Tags: Airway & Respiratory Cardiac Resuscitation Exclusive Articles Patient Care Heart of America Top Story Source Type: news

Mechanical CPR: A Critical Element in Any Cardiac Arrest Bundle of Care
Mechanical CPR devices (mCPR) provide automated chest compressions during cardiac arrest. High-performance CPR improves survival, and mechanical CPR has multiple advantages over manual CPR: consistent compressions, “cognitive offloading,” effective CPR during patient transport and crew safety, as well as the ability to provide PCI/ECMO during CPR, the need for less rescuers and decreased CPR pauses. Published data showing the errors in the performance of CPR are common, and research has shown that proper CPR rate and depth improve survival.1 At present, there are no mCPR devices that actively decompress the che...
Source: JEMS Patient Care - February 15, 2019 Category: Emergency Medicine Authors: Charles Lick, MD Tags: Cardiac & Resuscitation Top Story Exclusive Articles Patient Care Heart of America Source Type: news

Head-Up CPR May Improve Neurologically Intact Survival Rates
Head-up CPR is a novel concept in resuscitation that has the potential to improve neurologically intact survival after cardiac arrest. Inspired by the clinical question of whether patients in cardiac arrest should be transported either head-up or feet-up in a small elevator, an initial animal study was performed in 2014. In this swine model of cardiac arrest, pigs underwent five-minute periods of automated CPR with an impedance threshold device (ITD-16) in the traditional supine position, then with a 30-degree whole-body head-up tilt, and then a 30-degree whole-body head-down tilt. The cerebral blood flow and cerebral perf...
Source: JEMS Patient Care - February 15, 2019 Category: Emergency Medicine Authors: Johanna C. Moore, MD, MS Tags: Cardiac & Resuscitation Top Story Exclusive Articles Patient Care Heart of America Source Type: news

Quantum EMS Solutions Appoints Patrick Wilson as Vice President of Sales North America
LAKE SUCCESS, NY– Quantum EMS announces the appointment of Patrick Wilson as Vice President of Sales North America. Patrick Wilson is an accomplished business professional with in-depth experience and proven success in leadership and operations management.  His collaborative and outcome focused management style has allowed him to successfully negotiate over 70 contracts during his prior tenure as President of Medval, Inc.    Mr. Wilson brings an entrepreneurial spirit to Quantum EMS Solutions, having previously identified unique market opportunities and developed a business model for sales success in s...
Source: JEMS Patient Care - February 14, 2019 Category: Emergency Medicine Authors: Quantum EMS Solutions (press release) Tags: Patient Care Press Releases Source Type: news

Community Response to Cardiac Arrest in the Netherlands
In 1767, the Foundation of the Rescue of Drowned Persons was established in the Netherlands because of the high number of people who drowned in Amsterdam’s many canals. The foundation promoted rescue techniques, informing Amsterdam’s citizens that drowned persons could actually be saved by first-aid interventions. They also gave medals to rescuers. The foundation exists and is still active today, and it illustrates the proactive Dutch attitude toward community participation to save lives. Like drowning, the first few minutes of an out-of-hospital cardiac arrest (OHCA) are essential. This is especially true when...
Source: JEMS Patient Care - February 12, 2019 Category: Emergency Medicine Authors: Hans van Schuppen, MD Tags: Cardiac & Resuscitation Exclusive Articles Heart of America Top Story International Communications Dispatch Source Type: news

Dispatch-Assisted CPR
Early recognition of cardiac arrest, early effective CPR and early defibrillation are the most effective treatments yielding favorable neurological outcome from out-of-hospital cardiac arrest (OHCA). If CPR is started prior to the arrival of EMS, the patient’s chances for survival dramatically increase. The data supporting this axiom is extensive but is exemplified by a recent large review. CPR provided by bystanders prior to EMS arrival was studied in a retrospective Swedish cohort of over 31,000 patients spanning a period from 1990–2011, and researchers found that 30-day survival improved from 4% to 10.9%.1 B...
Source: JEMS Patient Care - February 12, 2019 Category: Emergency Medicine Authors: Michael Levy, MD, FACEP, FAEMS, FACP Tags: Cardiac & Resuscitation Exclusive Articles Patient Care Operations Heart of America Top Story Communications Dispatch Source Type: news