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Doctors Struggle to Treat Youngest Victims of Opioid Epidemic
CHICAGO (AP) — Two babies, born 15 months apart to the same young woman overcoming opioid addiction. Two very different treatments. Sarah Sherbert's first child was whisked away to a hospital special-care nursery for two weeks of treatment for withdrawal from doctor-prescribed methadone that her mother continued to use during her pregnancy. Nurses hesitated to let Sherbert hold the girl and hovered nervously when she visited to breast-feed. Born just 15 months later and 30 miles away at a different South Carolina hospital, Sherbert's second child was started on medicine even before he showed any withdrawal symptoms a...
Source: JEMS Patient Care - February 14, 2018 Category: Emergency Medicine Authors: Lindsey Tanner, Associated Press Tags: Patient Care News Source Type: news

Paramedics for Children is Making a Difference in Honduras
Making a difference in Honduras In 1997, Rodger Harrison started Paramedics for Children, a nonprofit that provides medical care to people in northern Honduras and throughout Central America. Photo courtesy Rodger Harrison One afternoon in 1997, a gregarious American paramedic was practicing his Spanish language skills in a bar in Copán Ruinas, Honduras, when an urgent plea for help filtered through the door. "There's a kid hurt," recalled Rodger Harrison. "They thought I was a doctor. There was not a doctor in town who would treat the poor people, so I got involved." He asked about an...
Source: JEMS Patient Care - February 13, 2018 Category: Emergency Medicine Authors: Kate Dernocoeur, NREMT Tags: Patient Care Administration and Leadership Source Type: news

Should Ketamine Be Contraindicated for Patients with Traumatic Brain Injury?
Is ketamine safe for head-injured patients? You're called to rendezvous with an ALS unit at an altitude of 8,300 feet in the mountains. On board is an altered male in his 50s or 60s who was witnessed crashing his motorcycle at highway speeds on a windy mountain road. On arrival, you find your patient altered and extremely combative. No vital signs or blood sugar are obtained secondary to the patient's combative state. He's noncompliant with a non-rebreather mask and pulls it off. The patient wasn't wearing a helmet and is only wearing jeans with a T-shirt. He's noted to have multiple abrasions to his right flank, forehead ...
Source: JEMS Patient Care - February 12, 2018 Category: Emergency Medicine Authors: Bradley Kitts, NRP, FP-C Tags: Trauma Patient Care Source Type: news

Flu Season, Still Worsening, Now as Bad as 2009 Swine Flu
NEW YORK (AP) — The flu has further tightened its grip on the U.S. This season is now as bad as the swine flu epidemic nine years ago. A government report out Friday shows 1 of every 13 visits to the doctor last week was for fever, cough and other symptoms of the flu. That ties the highest level seen in the U.S. during the 2009 swine flu pandemic. And it surpasses every winter flu season since 2003, when the government changed the way it measures flu. This season started early and has been driven by a nasty type of flu that tends to put more people in the hospital and cause more deaths. But its long-lasting intensity...
Source: JEMS Patient Care - February 9, 2018 Category: Emergency Medicine Authors: Mike Stobbe, Associated Press Tags: Patient Care News Source Type: news

In Small Counties, Dispatcher-Led CPR Instruction Leaves Call Centers Short-Staffed
MADISON, Wis. (WMTV) -- A bill that would require 9-1-1 dispatchers in Wisconsin to receive training on how to walk callers through CPR administration could put a strain on short-staffed call centers. Several counties across the state like Dane, Columbia and Rock already require their dispatchers to receive CPR training. Director of Dane County 911, John Dejung, says in 2017, dispatchers saved eleven lives by giving CPR information over the phone. "We know, from our own experience, that it truly can be life saving," Dejung said. He spoke in favor of the proposal at a Senate public hearing on Tuesday. Sm...
Source: JEMS Patient Care - February 8, 2018 Category: Emergency Medicine Authors: NBC15/WMTV Tags: News Videos Cardiac & Resuscitation Communications Dispatch Source Type: news

Regulators Say Herbal Supplement Kratom Contains Opioids
WASHINGTON (AP) — U.S. health authorities say an herbal supplement promoted as an alternative pain remedy contains the same chemicals found in opioids, the addictive family of drugs at the center of a national addiction crisis. The Food and Drug Administration analysis, published Tuesday, makes it more likely that the supplement, kratom, could be banned by the federal government. The FDA also said it has identified 44 reports of death involving kratom since 2011, up from 36 reported in November. Sold in various capsules and powders, kratom has gained popularity in the U.S. as a treatment for pain, anxiety and drug de...
Source: JEMS Patient Care - February 8, 2018 Category: Emergency Medicine Authors: Matthew Perrone, Associated Press Tags: Patient Care News Source Type: news

Patients to Address Court in Doctor's Opioid Kickback Scheme
PROVIDENCE, R.I. (AP) — Victims of a scheme in which a doctor prescribed them a highly addictive opioid spray in exchange for kickbacks are expected to tell a federal judge how their lives were affected, including stories of overdoses, monthslong withdrawals, weight loss and broken bones from falling while on the powerful drug. Jerrold Rosenberg told one patient, "Stop crying, you're acting like a child," when she complained of severe side effects, which included losing 40 pounds and repeated vomiting for years, according to an excerpt of grand jury testimony filed by prosecutors in the case. Thursday's hea...
Source: JEMS Patient Care - February 5, 2018 Category: Emergency Medicine Authors: Michelle R. Smith, Associated Press Tags: Patient Care News Source Type: news

New Report Details Misuse of Antipsychotics in Nursing Homes
NEW YORK (AP) — U.S. nursing homes have significantly reduced the use of powerful antipsychotic drugs among their elderly residents, responding to pressure from many directions. Yet advocacy groups insist that overmedication remains a major problem, and want the pressure to intensify. According to the latest data from the federal Centers for Medicare & Medicaid Services, known as CMS, the percentage of long-term nursing home residents being given antipsychotic drugs dropped from about 24 percent in late 2011 to under 16 percent last year. Decreases were reported in all 50 states, with the biggest in Tennessee, Ca...
Source: JEMS Patient Care - February 5, 2018 Category: Emergency Medicine Authors: David Crary, Associated Press Tags: Patient Care News Source Type: news

Blind Insertion or Blindly Inserted: Advanced Airways Revisited
Blind insertion or blindly inserted? One thing we do in EMS that many of us most pride ourselves on is advanced airway management—though gaining that pride may have required a few moments of pants-wetting terror along the way. For patients in respiratory failure rapidly progressing to respiratory or cardiac arrest, there are few scenarios that run us right up against the front lines of life and death, and with so much potential to affect the outcome. These cases bring into focus the cognitive (knowledge), psychomotor (manual), and affective (emotional/psychological) elements of our job like nothing else we do. Yet ev...
Source: JEMS Patient Care - February 1, 2018 Category: Emergency Medicine Authors: Neal Richmond, MD Tags: Patient Care Columns Source Type: news

Is the Novel Lateral Trauma Position More Effective than the Log-Roll Maneuver for Spinal Trauma?
Is it the new position for trauma? The Research Hyldmo PK, Horodyski M, Conrad BP, et al. Does the novel lateral trauma position cause more motion in an unstable cervical spine injury than the logroll maneuver? Am J Emerg Med. 2017;35:1630–1635. The Science The authors sought to examine the degree of cervical spine motion that occurs during the traditional log-roll maneuver compared to a technique called the "lateral trauma position." A neurosurgeon created an unstable cervical spine injury in five fresh cadavers by cutting all the ligaments between the fifth and sixth cervical vertebra. An electromagnetic ...
Source: JEMS Patient Care - February 1, 2018 Category: Emergency Medicine Authors: Keith Wesley, MD, FACEP, FAEMS Tags: Trauma Columns Source Type: news

Improving Patient Safety with Simulation: Behavioral Health Emergencies, Appropriate Stretcher Use, Reducing Medication Errors and Pediatric Patients
In the December column, three of the 10 topics identified as patient and provider safety issues by the Center for Patient Safety's EMS Forward initiative1 were discussed and simple objectives with associated simulation activities were provided to help you understand how simulation can support patient safety. This month we continue the discussion by addressing four additional topics and explore how simulation can support addressing each, thus working to improve patient and provider safety and outcomes. Behavioral Health Although behavioral health emergencies serve as a small percentage of overall EMS patient interactions,...
Source: JEMS Patient Care - February 1, 2018 Category: Emergency Medicine Authors: Jennifer McCarthy, MAS, NRP, MICP, CHSE Tags: Trauma Patient Care Source Type: news

Zurich ’s Air Medical Program Flies Seven ECMO Missions in Ten Days
In a ten day period in January, Rega aircraft in Zurich, Switzerland transported and cared for a total of seven patients, including a two-year-old child, with the most severe cardiovascular and pulmonary disease. This was made possible by a small, portable heart-lung extracorporeal membrane oxygenation (ECMO) machine, which is compatible with both the ambulance jets, and the two types of helicopters used by Rega. Since 2009, Rega has been the only air rescue organization in Switzerland to have its own ECMO equipment. The devices have been instrumental in the care and transport of 25 intensive care patients annually. That&r...
Source: JEMS Patient Care - February 1, 2018 Category: Emergency Medicine Authors: A.J. Heightman, MPA, EMT P Tags: Cardiac & Resuscitation Patient Care Operations Source Type: news

Point-of-Care Ultrasound in the Prehospital Setting
A deep dive into the use of point-of-care sonography in the field You're working on an ALS unit dispatched to an unconscious patient who is now in cardiac arrest. First responders work in concert to administer high-performance CPR. As you enter the home and lay eyes on your patient, a colleague gives you a brief report and concludes that the automated external defibrillator (AED) advised not to deliver a shock. You and your partner quickly ensure that effective CPR is underway. You gain vascular access and push epinephrine and, without compression interruption, establish an advanced airway. Your end-tidal carbon dioxide is...
Source: JEMS Patient Care - February 1, 2018 Category: Emergency Medicine Authors: Faizan H. Arshad, MD Tags: Patient Care Source Type: news

Whole Blood in EMS May Save Lives
The case for the use of whole blood in prehospital civilian medicine The administration of whole blood is the simplest way to deliver the functionality of lost blood back to the patient. Photos courtesy Andrew Fisher You're called to the home of a 38-year-old woman who has been fainting. When you arrive, her husband tells you that she's been experiencing heavy vaginal bleeding for about two weeks. She recently underwent a caesarean-section delivery of her second child. On exam, she appears pale and sweaty, with notable pallor of the lips and gums. Her eyes remain closed as she stumbles over her words and barely follow...
Source: JEMS Patient Care - February 1, 2018 Category: Emergency Medicine Authors: Max Dodge, BS, NRP, EMT-P Tags: Trauma Patient Care Source Type: news

Pittsburgh EMS Implements Program to Leave Naloxone with Overdose Patients
Pittsburgh, Pa. (WPXI) - A new voluntary program in Pittsburgh allows EMTs to leave the overdose reversal drug naloxone, marketed as Narcan, behind with the patient, family members or friends at the scene.  (Source: JEMS Patient Care)
Source: JEMS Patient Care - January 31, 2018 Category: Emergency Medicine Authors: 11 News (WPXI) Tags: News Videos Patient Care Source Type: news

5 Ideas Win $10K Each in Ohio Opioid Science Challenge
COLUMBUS, Ohio (AP) — Virtual reality, neural feedback and digital therapy were among five ideas to help solve the U.S. opioid crisis that won a global technology challenge in Ohio on Tuesday. Winners were selected from hundreds of ideas submitted by researchers, caregivers, service providers and individuals from Ohio, other states and nine countries. Each will receive $10,000 to take their idea to the next phase. The $8 million Ohio Opioid Technology Challenge is modeled after the Head Health competition launched by the NFL, Under Armour and GE to address traumatic brain injuries sustained playing football. It's par...
Source: JEMS Patient Care - January 30, 2018 Category: Emergency Medicine Authors: Julie Carr Smith, Associated Press Tags: Patient Care News Source Type: news

Lessons from a Legend: Dr. Joseph Ornato's Impact on Resuscitation Research
Triple-board-certified, Dr. Joseph Ornato was one of the authors of the seminal ‘chain of survival’ paper 26 years ago. Published in 1991 in Circulation, "Improving survival from sudden cardiac arrest: the "chain of survival" concept. A statement for health professionals from the Advanced Cardiac Life Support Subcommittee and the Emergency Cardiac Care Committee, American Heart Association,"1 was authored by Drs. Richard Cummins, Joseph Ornato, William Thies and Paul Pepe. The term 'chain of survival' provides a useful metaphor for the elements of the Emergency Cardiac Ca...
Source: JEMS Patient Care - January 26, 2018 Category: Emergency Medicine Authors: A.J. Heightman, MPA, EMT P Tags: Cardiac & Resuscitation Patient Care Source Type: news

Flu Widespread Across US for Third Straight Week
NEW YORK (AP) — Sick with the flu? You've got a lot of company. The flu blanketed the U.S. again last week for the third straight week. Only Hawaii has been spared. Last week, 1 in 15 doctor visits were for symptoms of the flu. That's the highest level since the swine flu pandemic in 2009. The government doesn't track every flu case but comes up with estimates; one measure is how many people seek medical care for fever, cough, aches and other flu symptoms. Flu is widespread in every state except Hawaii, and 39 states reported high flu traffic for doctors last week, up from 32. At this rate, by the end of the season s...
Source: JEMS Patient Care - January 26, 2018 Category: Emergency Medicine Authors: Mike Stobbe, Associated Press Tags: Patient Care News Source Type: news

Study Confirms Flu Increases Risk of Heart Attack in Elderly
NEW YORK (AP) — As if the flu wasn't bad enough already: Researchers have confirmed that flu sharply increases the risk of heart attack for older people. Doctors have long known that flu can trigger heart problems. It's one of the reasons flu shots are recommended for nearly everyone. A new Canadian study found that risk was six times higher in the first week after flu is diagnosed, compared to the year before and after the bug hits. Unlike previous studies, the researchers used lab tests to make sure people suspected of having the flu really did. "It's a much more rigorous study that allows us to make a much mo...
Source: JEMS Patient Care - January 25, 2018 Category: Emergency Medicine Authors: Mike Stobbe, Associated Press Tags: Patient Care News Source Type: news

Oregon Man Saved by Quick CPR and Use of AED by Coworker After Cardiac Arrest
Andy* was preparing for a meeting after lunch on July 7, 2016, when his colleagues noticed he looked like he was falling asleep. “I remember someone asked if I was okay, and then they said I just slumped down in my chair,” he said. Andy, who lives in Beaverton, Oregon and was 45 at the time, was having a cardiac arrest. His colleagues quickly called for help, and within moments, a coworker named Natalie Chitwood arrived and began performing Hands-Only CPR, while another colleague grabbed the automated external defibrillator or AED. Chitwood had deployed two shocks from the AED before a local sheriff’s dep...
Source: JEMS Patient Care - January 24, 2018 Category: Emergency Medicine Authors: Jeff A. Woodin, NRP, FAHA Tags: Cardiac & Resuscitation Patient Care News Source Type: news

5 in US, 2 in Italy Charged with Running Opioid "Mills"
KNOXVILLE, Tenn. (AP) — Two people in Italy and five U.S. residents have been charged in a fraud and drug trafficking conspiracy to distribute opioids in Florida and Tennessee, leading to hundreds of deaths, federal prosecutors said Friday. The indictments were unsealed by federal officials Friday in Knoxville but handed down earlier. They allege the defendants were involved in a widespread scheme to operate "pill mills" in the U.S. Prosecutors say defendants ran the Urgent Care & Surgery Center Enterprise, which distributed enough oxycodone, oxymorphone and morphine to generate clinic revenue of at lea...
Source: JEMS Patient Care - January 19, 2018 Category: Emergency Medicine Authors: Associated Press Tags: Patient Care News Source Type: news

Walmart Offers Way to Turn Leftover Opioids into Useless Gel
Walmart is helping customers get rid of leftover opioids by giving them packets that turn the addictive painkillers into a useless gel. The retail giant said Wednesday that it will provide the packets free with opioid prescriptions filled at its 4,700 U.S. pharmacies. The small packets, made by DisposeRx, contain a powder that is poured into prescription bottles. When mixed with warm water, the powder turns the pills into a biodegradable gel that can be thrown in the trash. The move by Walmart is the latest precaution being taken to cut down on opioid abuse. Around 4 million Americans are addicted to prescription painkille...
Source: JEMS Patient Care - January 17, 2018 Category: Emergency Medicine Authors: Tom Murphy, Associated Press Tags: Patient Care News Source Type: news

Susquehanna Valley (Pa.) EMS Trains Community Members to 'Stop the Bleed'
  HELLAM TOWNSHIP, YORK COUNTY, Pa. -- When someone’s in an accident, first responders say uncontrolled bleeding is the number one cause of preventable death. That’s why Susquehanna Valley Emergency Medical Services is freely training people, using dummies and fake blood, to 'Stop the Bleed'.  Saving a life is as simple as having someone around who knows how to stop an uncontrolled bleed. “The wounds getting to be a scary place. There’s no doubt about that," said Chief Mike Fitzgibbons, Susquehanna Valley Emergency Medical Services. Chief Fitzgibbons says accidents...
Source: JEMS Patient Care - January 13, 2018 Category: Emergency Medicine Authors: Grace Griffaton, Fox43 Tags: Training News Videos Patient Care Source Type: news

CPR Training, Quick Thinking Help Newlywed Save Husband's Life
INDIANAPOLIS (WISH) — A CPR class taken by an Indianapolis woman six years ago helped saved the life of her new husband when he went into sudden cardiac arrest, according to Indianapolis Fire Department emergency responders. Chyna Taylor married her longtime sweetheart Robert on Sept. 30. Just 11 weeks later, their love story almost ended. (Source: JEMS Patient Care)
Source: JEMS Patient Care - January 12, 2018 Category: Emergency Medicine Authors: Brenna Donnelly, WISH Tags: News Videos Cardiac & Resuscitation Source Type: news

ZOLL First Company to Receive Premarket Approval From The FDA on its Full Portfolio of Defibrillators
ZOLL Medical Corporation, a manufacturer of medical devices and related software solutions, today announced that it is the first company to achieve premarket approval (PMA) by the U.S. Food and Drug Administration (FDA) to continue to market and distribute its full line of defibrillators in the U.S. The list of defibrillators which received PMA approval include the R Series and X Series monitor/defibrillators and the AED Pro and AED Plus automated external defibrillators. All of these devices are equipped with ZOLL’s proprietary rectilinear biphasic waveform to deliver maximum current to high...
Source: JEMS Patient Care - January 11, 2018 Category: Emergency Medicine Authors: ZOLL Tags: Cardiac & Resuscitation Industry News Source Type: news

ESO Solutions Predicts Key Hospital Trends to Watch in 2018
Austin, Texas – ESO Solutions, the leading data and software company serving emergency medical services, fire departments, and hospitals, today shared the trends it predicts will have the biggest impact on hospitals in 2018: A greater emphasis on evidence-based approaches to acute conditions; healthcare financing changes affecting the way hospitals admit and readmit patients; reshuffling of hospital ownership; and a shift in how patient volume is managed. “Few areas of healthcare have seen more significant change over the past several years than hospitals,” said Allen Johnson, Vice President of ESO HDE an...
Source: JEMS Patient Care - January 5, 2018 Category: Emergency Medicine Authors: ESO Solutions Tags: Patient Care Industry News Source Type: news

Is TXA a Lifesaving Drug That ’s Too Cheap to Bother Using?
Is TXA a lifesaving drug that’s too cheap to bother using? Male found sitting upright in the back of the bar holding his hand to his neck and friends holding bandages to his abdomen … immediately secured to stretcher and ambulance due to multiple significant wounds and unruly / unsafe environment … [Patient] stated that he and another male had an argument and he was stabbed multiple times by a knife … This is how the run sheet from an early morning bar fight describes the first patient to receive a lifesaving medication from Massachusetts paramedics under a new trauma protocol. The drug is tranex...
Source: JEMS Patient Care - January 2, 2018 Category: Emergency Medicine Authors: Matt Bivens, MD Tags: Trauma Patient Care Source Type: news

An Interdisciplinary Literature Review of Prehospital Use of Tranexamic Acid (TXA) in Major Bleeding
An interdisciplinary literature review Discovered in the 1950s, tranexamic acid (TXA) is an antifibrinolytic medication that, over the last decade, has drawn considerable attention from researchers, clinicians and mainstream media.1 TXA is a synthetic chemical that’s a competitive antagonist to the lysine binding site of plasminogen.2 When a fibrin clot forms in the body in response to bleeding, it’s naturally degraded over time. In major trauma and hemorrhage, it’s thought that the body’s fibrin degradation process is accelerated due to high levels of fibrinolytic factors in circulation.3 This cont...
Source: JEMS Patient Care - January 2, 2018 Category: Emergency Medicine Authors: Michael J. Carr, MD Tags: Trauma Patient Care Source Type: news

Beyond Naloxone: Providing Comprehensive Prehospital Care to Overdose Patients in the Midst of a Public Health Crisis
Providing comprehensive prehospital care to overdose patients Medic 3 arrives on scene to find a 36-year-old male patient supine on the living room floor. The patient is in respiratory arrest and fire department first responders are providing rescue breaths with a bag-valve mask (BVM). The patient has a bounding carotid pulse. A nasopharyngeal airway is placed in the patient’s left nares and the patient is ventilated easily with adequate bilateral lung sounds. The floor is bare wood and the patient is only wearing light undergarments. The ambient temperature in the room is approximately 55 degrees F. The patient&rsqu...
Source: JEMS Patient Care - January 2, 2018 Category: Emergency Medicine Authors: Simon Taxel, NREMT-P Tags: Patient Care Source Type: news

Is qSOFA the ‘Holy Grail’ of Sepsis Research?
  The Research Dorsett M, Kroll M, Smith C, et al. qSOFA has poor sensitivity for prehospital identification of severe sepsis and septic shock. Prehosp Emerg Care. 2017;21(4):489–497. The Science The authors reviewed the medical records, including the EMS report, of 152 patients arriving by EMS at a large urban ED and who were diagnosed with an infection (n = 71), sepsis (n = 38) or severe sepsis (n = 43). The records were examined for signs and symptoms that are components of a sepsis scoring scheme called quick sequential organ failure assessment (qSOFA), which could’ve been performed by the EMS provider...
Source: JEMS Patient Care - January 1, 2018 Category: Emergency Medicine Authors: Keith Wesley, MD, FACEP, FAEMS Tags: Patient Care Columns Source Type: news

Prehospital Field Amputation Leads to Improved Patient Outcome
Industrial accident leads to extrication by amputation Your aeromedical team responds to a 29-year-old female whose right hand has been entrapped between the inside of a hopper wall and industrial auger for five hours. She’s found in a semi-erect position on top of a platform. Although she’s in pain, she expresses that she’s losing sensation to her hand. Upon physical examination, you find that her right hand is entrapped proximal to the metacarpophalangeal joints, excluding the patient’s thumb. Multiple attempts at freeing the hand are made to no avail. Upon arrival of a second aeromedical team wit...
Source: JEMS Patient Care - January 1, 2018 Category: Emergency Medicine Authors: Calvin Yang, DO Tags: Trauma Patient Care Source Type: news

Treating Patients in Austere, Remote Settings
Considerations when treating patients in austere, remote settings You glance over at your partner who’s driving to the call and ask if he knows where he’s going. He tells you he knows the area but not the location of the specific address. He thinks you’re still about 20 minutes away. You look back at the map and locate the trailhead where the caller is supposed to meet you. A 24-year-old male riding an ATV meets you at a trail marker. You key the microphone to let dispatch know you’ve made contact and you hear, “Last unit repeat, unreadable.” You repeat your transmission and dispatch res...
Source: JEMS Patient Care - January 1, 2018 Category: Emergency Medicine Authors: Dennis Edgerly, EMT-P Tags: Patient Care Columns Source Type: news

8 Americans, 2 Swedes, 1 Canadian Dead in Mexican Bus Crash
CANCUN, Mexico (AP) — Driver negligence and speed caused a bus crash in southern Mexico that killed eight Americans, two Swedes, one Canadian and a Mexican tour guide as they traveled from cruise ships to visit nearby Mayan ruins, officials said Wednesday. Quintana Roo state prosecutors said a preliminary manslaughter investigation indicated the driver lost control of the bus and when he tried to get back on the narrow highway, the bus flipped, struck a tree and landed in vegetation along the roadside. "Due to a lack of care the driver lost control of the bus' steering to the right, leaving the asphalt," st...
Source: JEMS Patient Care - December 21, 2017 Category: Emergency Medicine Authors: Gabriel Alcocer, Associated Press Tags: Trauma News Source Type: news

Illinois High School Student Brendan Gould Wins Sudden Cardiac Arrest Foundation's People Saving People Award
Illinois high school student Brendan Gould has been named winner of the Sudden Cardiac Arrest Foundation’s People Saving People Award for saving his father’s life with CPR. The announcement and award presentation took place at the Citizen CPR Foundation’s Emergency Cardiovascular Care Update conference on December 8 in New Orleans, LA. On February 6, 2016, Brendan, then 16, had been speaking with his father, Tom Gould, at their home in Barrington, when Tom suddenly collapsed, became unresponsive and stopped breathing. Brendan immediately called 911 and fortunately, CenCom 911 disp...
Source: JEMS Patient Care - December 14, 2017 Category: Emergency Medicine Authors: Sudden Cardiac Arrest Foundation Tags: Cardiac & Resuscitation Administration and Leadership Industry News Source Type: news

Quick CPR, AED Give Oregon Survivor a New Appreciation for Resuscitation Training
Helen Winberg was leaving the local mall after finishing her morning routine of walking on April 4, 2013, when she collapsed due to sudden cardiac arrest. Mall security personnel witnessed the incident on security cameras. They rushed to begin CPR and then used a public-access automated external defibrillator, or AED, to deliver a shock before emergency medical responders could arrive. Winberg, then 79, was transported to the hospital, where doctors placed three stents due to blockages and removed fluid from around her heart. She was placed into a medically-induced coma to rest for a few days and was released from the hosp...
Source: JEMS Patient Care - December 8, 2017 Category: Emergency Medicine Authors: Jeff A. Woodin, NRP, FAHA Tags: Patient Care Cardiac & Resuscitation Source Type: news

Cardiac Arrest Victim Thanks D.C. First Responders Who Saved His Life
WASHINGTON (Fox5DC)- There was a joyful reunion between a man who runs the company that makes French's Mustard and the D.C. firefighters who saved his life earlier this year. Inside Engine Company 3 on New Jersey Avenue in Northwest D.C., Elliot Penner, his son Brayden and his wife Karen meet the firefighters, EMTs and paramedics who saved the 57-year-old New Jersey man's life on April 15. The previously heart-healthy Penner went into full cardiac arrest shortly after he and Brayden arrived at Union Station for a Washington Capitals hockey game. Read more... (Source: JEMS Patient Care)
Source: JEMS Patient Care - December 5, 2017 Category: Emergency Medicine Authors: Bob Barnard, Fox5DC Tags: News Videos Patient Care Cardiac & Resuscitation Source Type: news

S.C. State Basketball Player Collapses in Cardiac Arrest, Wake County EMS on Scene
Paramedics Greg Rodevick and Rich Eldridge got themselves and their equipment in place at Raleigh’s PNC Arena on Saturday December 2, with a simple plan of having a Chick-Fil-A sandwich and standing by courtside for EMS coverage at the N.C. State Wolfpack men’s basketball game as they hosted the South Carolina State Bulldogs.  Things changed quickly.  Not long into the game, they were called over for an N.C. State player with an apparent knee injury.  As they approached, determining if they would need to bring their stretcher over, they were interrupted by commotion over on the South Carolina Sta...
Source: JEMS Patient Care - December 4, 2017 Category: Emergency Medicine Authors: Jeffrey Hammerstein, Wake County EMS Tags: Patient Care Cardiac & Resuscitation News Source Type: news

Seven Tools Result in Dramatic Improvements in Cardiac Arrest Outcomes in Rialto, Calif.
This article describes the RFD's journey toward increased SCA survival-a journey that, in 2016, resulted in a 71% (Utstein) survival rate from sudden cardiac arrest (SCA) in Rialto. This is due in large part to what the RFD unlearned about cardiac arrest; Rialto's outcome-based data now shows that all of these assumptions are false: CPR should be done on a hard, flat surface; Always defibrillate ventricular fibrillation (v fib); Intubation attempts should be limited to 30 seconds; ALS actions are what saves lives; Prioritize epinephrine to improve cerebral perfusion and survival; Asystolic patients have essentially n...
Source: JEMS Patient Care - December 1, 2017 Category: Emergency Medicine Authors: Joe Powell, EMT-P Tags: Patient Care Cardiac & Resuscitation Source Type: news

Are Lift Assists an Early Indicator of More Serious Problems?
Are lift assists an early indicator of bigger problems? The Research Leggatt L, Van Aarsen K, Columbus M, et al. Morbidity and mortality associated with pre-hospital "Lift-Assist." Prehosp Emerg Care. 2017;21(5):556-562. The Science This paper comes from our esteemed colleagues in London, Ontario, Canada, who explored the outcome of patients that received a lift assist by EMS. They defined lift assist as, "When an individual is assisted up to a more mobile position from the ground by paramedics, but not treated or brought to hospital for further medical attention." During the 2013 calen...
Source: JEMS Patient Care - December 1, 2017 Category: Emergency Medicine Authors: Keith Wesley, MD, FACEP, FAEMS Tags: Patient Care Columns Source Type: news

Pro Bono: Capturing Dying Declarations on Video
Should we get them on video? Dying declarations are usually made by a conscious patient who believes that death is imminent and communicates information about the circumstances surrounding their critical injury and subsequent death. In some cases, these statements may be the last best hope for capturing-and convicting-an alleged perpetrator. Normally, statements made by individuals who aren't available for cross-examination are considered inadmissible hearsay in a court of law. However, there are exceptions to this rule, and a person's dying declaration is one of them. These statements are considered much mo...
Source: JEMS Patient Care - December 1, 2017 Category: Emergency Medicine Authors: Steve Wirth, Esq., EMT-P Tags: Columns Patient Care Administration and Leadership Source Type: news

The Resuscitation Recipe
The importance of a 'resuscitation recipe' Ho, ho, ho! After completing a practice run to prepare for my annual trek across the world on Christmas Eve-something I do to ensure I don't miss any homes and to get the reindeer in shape for the long journey-I sat down to debrief with my reindeer and elves. The trial run turned out to be a good opportunity to test out the new oscillating red LED nose that Rudolph had implanted in the off- season, and the micro-drones we'll be deploying to speed up the delivery of gifts this year. At the postflight meeting, I asked my hardworking reindeer to load up lots of presents that I want t...
Source: JEMS Patient Care - December 1, 2017 Category: Emergency Medicine Authors: A.J. Heightman, MPA, EMT P Tags: Patient Care Cardiac & Resuscitation Columns Source Type: news

FDA Approves Monthly Injection for Opioid Addiction Treatment
WASHINGTON (AP) — U.S. health officials on Thursday approved the first injectable form of the leading medication to treat patients recovering from addiction to heroin, prescription painkillers and other opioids. The Food and Drug Administration approved once-a-month Sublocade for adults with opioid use disorder who are already stabilized on addiction medication. The monthly injection has the potential to reduce dangerous relapses that occur when patients stop taking the currently available daily medication. But that benefit has not yet been shown in studies and the new drug comes with a hefty price: $1,580 per monthl...
Source: JEMS Patient Care - December 1, 2017 Category: Emergency Medicine Authors: Matthew Perrone, Associated Press Tags: Patient Care News Source Type: news

Sensitivity and Specificity as Guides to Clinical Decision Making
From headache to helping hand Many of us get headaches and go cross-eyed when we see statistical concepts like sensitivity and specificity in print. Usually, these appear in articles about a diagnostic test's ability to tell you when a condition or disease state is present (i.e., sensitivity) or, conversely, to tell you when that condition or disease state isn't there (i.e., specificity). An initial 12-lead ECG, for example, has a sensitivity of about 68% for diagnosing an acute ST-elevation myocardial infarction (STEMI). That means that a little more than two-thirds of patients who eventually rule-in for MIs are...
Source: JEMS Patient Care - December 1, 2017 Category: Emergency Medicine Authors: Neal Richmond, MD Tags: Patient Care Columns Source Type: news

An Overview of Acute Kidney Injury and Considerations for Treatment
An overview of renal failure & considerations for treatment Among critically ill and injured patients, maintaining homeostasis and preserving adequate organ function is always the primary objective of our care. However, the sequela of our most frequently encountered disease processes can greatly impact this goal. When derangements in homeostasis progress to organ dysfunction, patients can quickly become critically ill, with steadily increasing mortality rates. One of the first systems to derail because of critical illness are the kidneys. When renal dysfunction occurs as a result of an acute illness, an expe...
Source: JEMS Patient Care - December 1, 2017 Category: Emergency Medicine Authors: Robert P. Girardeau, BS, NREMT-P, FP-C Tags: Patient Care Source Type: news

CPR-Proficient High School Graduates Are the Next Generation of Lifesaving Bystanders
Doubling down on a crucial piece of the cardiac arrest resuscitation puzzle As much as EMS systems focus on delivering rapid, high-quality resuscitation, cardiac arrest survival continues to be a long shot in most communities. More than 350,000 people a year experience cardiac arrest outside of a hospital and despite enormous advances in resuscitation science, on average only 12% survive.1 A major factor responsible for the overall poor survival rate is the fact that most cardiac arrest victims still don't receive bystander CPR. This key bystander intervention, if performed immediately, can double or even triple a...
Source: JEMS Patient Care - December 1, 2017 Category: Emergency Medicine Authors: Bentley J. Bobrow, MD Tags: Cardiac & Resuscitation Source Type: news

The Role of EtCO2 in Termination of Resuscitation
EtCO2 may not always determine when to terminate resuscitation Out-of-hospital cardiac arrest (OHCA) is a common occurrence; it's estimated that approximately 300,000 people per year are treated for OHCA in the United States, with a survival rate of 9.6%.1 EMS systems used to transport all cardiac arrest patients to hospitals, regardless of return of spontaneous circulation (ROSC). However, evidence now suggests that appropriate management of OHCA includes the termination of resuscitation (TOR) in certain settings, given that the overall outcome for many patients is grim. A 2016 study conducted in Paris, Fran...
Source: JEMS Patient Care - December 1, 2017 Category: Emergency Medicine Authors: Alysha Joseph, BS Tags: Patient Care Cardiac & Resuscitation Source Type: news

High-Perfusion CPR Technology Dramatically Improves Cardiac Arrest Survival
New technology dramatically improves cardiac arrest survival in Collierville, Tenn. Serving in the medical oversight role for nearly 30 EMS services in and around Memphis, Tenn., I have the challenging task of tailoring equipment and protocols to each site's population, budget and needs. Collierville is a Memphis suburb, with a population of around 45,000. Its residents are relatively affluent and well-educated, and community education efforts have improved the frequency and quality of bystander CPR. It's a perfect example of a small town that's done very well in improving survival from cardiac arrest, which i...
Source: JEMS Patient Care - December 1, 2017 Category: Emergency Medicine Authors: Joe Holley, MD, FACEP Tags: Patient Care Cardiac & Resuscitation Source Type: news

How Physicians Perform Prehospital ECMO on the Streets of Paris
The objective of ECPR is to perfuse the brain while the cause of the cardiac arrest is sought and treated at a specialty hospital (e.g., by coronary angiography, CT scan, etc.). Indeed, the primary objective is to obtain return of spontaneous circulation (ROSC), however, long-term survival depends on the neurological prognosis of the patient. Once ECPR has been initiated, acceptable blood flow is restored to the whole body, and especially to the brain and coronary arteries in order to limit ischemic consequences. Many studies, both clinical and experimental, have shown that the blood flow delivered by ECPR is much highe...
Source: JEMS Patient Care - December 1, 2017 Category: Emergency Medicine Authors: Alice Hutin, MD, MSc Tags: Patient Care Cardiac & Resuscitation Source Type: news

A Medical Director's Personal Experience with ECMO Reveals Several Lessons Learned
My personal experience with ED ECMO What does it take to save the life of someone who's in shock and suffering from an acute massive pulmonary embolism? The answer is a comprehensive system of medical care that starts in the field with well-trained providers and is seamlessly backed up by hospitals that can provide highly sophisticated treatments that can now be started in the ED. As a cardiologist and the operational medical director for the city of Richmond, Va., and the surrounding Henrico County, I've had the privilege of helping to develop a comprehensive, regional system of care. In this article, I'm going t...
Source: JEMS Patient Care - December 1, 2017 Category: Emergency Medicine Authors: Joseph P. Ornato, MD, FACP, FACC, FACEP Tags: Patient Care Cardiac & Resuscitation Source Type: news

The Controversy and Science Behind Double Sequential Shocks for Refractory V Fib
Do or die? Double defibrillation, harnessing two defibrillators to administer simultaneous or double sequential shocks (sometimes called the "one-two punch"), has seen increased use among various EMS agencies. Though well-intentioned and considered by some as an innovative approach to treating shock-resistant ventricular fibrillation (v fib), biphasic double defibrillation is also controversial, off-label and poorly studied. What Do We Actually Know? Double defibrillation is based on the belief that a very high energy shock (achieved by coupling two defibrillators) is needed when v fib is unresponsive to a serie...
Source: JEMS Patient Care - December 1, 2017 Category: Emergency Medicine Authors: Peter J. Kudenchuk, MD, FACP, FACC, FAHA, FHRS Tags: Patient Care Cardiac & Resuscitation Source Type: news