Cardiac Arrest Survivor Searches and Finds Paramedic Who Was “Comforting Soul” on Her Journey
First responders often have to look hard for the right address, the right house and even the right person to deliver what is often life-saving care. But it’s not often that a survivor of the care provided by a paramedic goes on a protracted search for a first responder – and finds him five years later. Yet that’s exactly what happened in the case of Battle Ground, Wash. paramedic David Crabtree and the young woman whose survival he contributed to on Feb. 12, 2013. When Heidi Stewart, now 23 and an American Heart Association Go Red For Women volunteer, was a senior at Evergreen High School in Vancouver, Wa...
Source: JEMS Patient Care - May 25, 2018 Category: Emergency Medicine Authors: American Heart Association Tags: Cardiac & Resuscitation Patient Care Source Type: news

IAFC Recommends Use of Mobile Technology to Activate Citizens and First Responders to Improve Sudden Cardiac Arrest Survival Rates
CHANTILLY, Va. —The International Association of Fire Chiefs (IAFC) supports the use of mobile technology for citizen response in conjunction with community cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) programs. In a Position Statement adopted May 9, the IAFC Board of Directors cited the PulsePoint mobile phone application (app) as a unique solution to increase survival from sudden cardiac arrest by bridging the gap between a cardiac arrest event and arrival of medical assistance. According to the Position Statement, “Applications such as PulsePoint offer a unique way to involv...
Source: JEMS Patient Care - May 22, 2018 Category: Emergency Medicine Authors: International Association of Fire Chiefs Tags: Cardiac & Resuscitation Operations Source Type: news

Congo Announces 6 New Confirmed Cases of Ebola Virus
KINSHASA, Congo (AP) — Congo's health ministry announced six new confirmed Ebola cases and two new suspected cases Tuesday as vaccinations entered a second day in an effort to contain the deadly virus in a city of more than 1 million. Dozens of health workers in the northwestern provincial capital, Mbandaka, have received vaccinations amid expectations that some will be deployed to the rural epicenter of the epidemic. Front-line workers are especially at risk of contracting the virus, which spreads in contact with the bodily fluids of infected people, including the dead. "In the next five days 100 people must be...
Source: JEMS Patient Care - May 22, 2018 Category: Emergency Medicine Authors: Saleh Mwanamilongo and Carley Petesch, Associated Press Tags: Patient Care News Source Type: news

American Medical Response Teams Up with International Association of Fire Chiefs and American College of Emergency Physicians to Train Bystanders How to Save Lives
GREENWOOD VILLAGE, Colo. – More than 350,000 Americans experience sudden cardiac arrest annually. When a bystander performs CPR until EMS arrives, the odds of the victim surviving can triple. To raise awareness and increase bystander CPR, American Medical Response (AMR), the nation’s largest provider of medical transportation, announced it is collaborating for the second year with the International Association of Fire Chiefs (IAFC) and the American College of Emergency Physicians (ACEP). During National EMS Week, May 20-26, the organizations will train communities on how to assist those experiencing signif...
Source: JEMS Patient Care - May 18, 2018 Category: Emergency Medicine Authors: American Medical Response Tags: Trauma Cardiac & Resuscitation News Administration and Leadership Source Type: news

FDA Approves First Non-opioid Drug to Ease Withdrawal Symptoms
TRENTON, N.J. (AP) — Federal regulators have approved the first nonopioid treatment to ease withdrawal symptoms from quitting addictive opioids. The U.S. Food and Drug Administration expedited approval of Lucemyra (luc-eh-MEER'-eh) to help combat the U.S. opioid epidemic. The tablet was approved Wednesday to treat adults for up to two weeks for common withdrawal symptoms like vomiting, diarrhea, muscle pain and agitation. It is not an addiction treatment but can be part of a longer-term plan. People going through detox are usually given opioid medicine like methadone, which eases the cravings without an intense high....
Source: JEMS Patient Care - May 16, 2018 Category: Emergency Medicine Authors: Linda A. Johnson, Associated Press Tags: Patient Care News Source Type: news

Congo Approves use of Experimental Ebola Vaccine, WHO Says
KINSHASA, Congo (AP) — Congo has agreed to allow the World Health Organization to use an experimental Ebola vaccine to combat an outbreak announced last week, the WHO director-general said Monday. The aim is for health officials to start using the vaccine, once it's shipped, by the end of the week, or next week if there are difficulties, said WHO Director-General Tedros Adhanom Ghebreyesus. "We have agreement, registration, plus import permit — everything formally agreed already. And as you know that vaccine is safe and efficacious and has been already tested. So I think we can all be prepared," he sa...
Source: JEMS Patient Care - May 14, 2018 Category: Emergency Medicine Authors: Saleh Mwanamilongo and Jamey Keaten, Associated Press Tags: Patient Care News Source Type: news

Congo Health Ministry Confirms 2 Ebola Cases in New Outbreak
KINSHASA, Congo (AP) — Congo's government on Tuesday declared a new outbreak of Ebola in the country's rural northwest, after two cases of the deadly virus were confirmed in Bikoro. Congo's Health Ministry said that of the five samples sent to the National Institute of Biological Research in Kinshasa, two came back positive for the Zaire strain of Ebola in the country's Equateur Province. The samples were gathered after the Equateur Province Health Ministry notified Kinshasa on May 3 of some 21 cases of a hemorrhagic fever in the Ikoko Impenge area, including 17 deaths, according to the World Health Organization and ...
Source: JEMS Patient Care - May 9, 2018 Category: Emergency Medicine Authors: Saleh Mwanamilongo and Carley Petesch, Associated Press Tags: Patient Care News Source Type: news

Duped Patients Crowdfund for Fraudulent Medical Care, Study Says
CHICAGO (AP) — They're the tech-age version of donor jars at the diner: crowdfunding websites that aim to link ailing people with strangers willing to help pay for medical treatment. But new research suggests duped patients sometimes crowdfund to pay for bogus stem cell treatments. A study published Tuesday in the Journal of the American Medical Association focused on for-profit clinics that use direct-to-consumer advertising for costly unproven stem-cell treatments for conditions including chronic lung disease, Parkinson's disease, multiple sclerosis and arthritis. Treatments are often marketed as cures or with a pr...
Source: JEMS Patient Care - May 8, 2018 Category: Emergency Medicine Authors: Lindsey Tanner, Associated Press Tags: Patient Care News Source Type: news

Stroke Triage: EMS needs a diagnostic tool that goes beyond a simple history & physical exam
As a young EMT and paramedic, I had relatively little education about acute myocardial infarctions. In the age of the 3-lead ECG, education was largely focused on arrhythmia detection and how to differentiate heart blocks, tachycardia and bradycardia. Detection of heart attack was largely based upon history and physical exam findings. Three decades later, the thought of relying on a physical exam to diagnose a ST- elevation myocardial infarction (STEMI) is hard to imagine. Although we’ve made remarkable progress in the prehospital detection of STEMI, we’ve made significantly less progress in the diagnosis of ac...
Source: JEMS Patient Care - May 2, 2018 Category: Emergency Medicine Authors: Mark E.A. Escott, MD, MPH, FACEP, NRP Tags: Patient Care Columns Source Type: news

Burn Care: Provider Expertise and Quick Decisions are a Patient ’s Best Chance for Survival
This article will provide an in-depth update of the prehospital care for burn patients. (Source: JEMS Patient Care)
Source: JEMS Patient Care - May 2, 2018 Category: Emergency Medicine Authors: Robert P. Girardeau, BS, NREMT-P, FP-C Tags: Patient Care Source Type: news

The Role of Core Interventions in Improving Health Outcomes and Reducing Acute Care Utilization
During home visits with patients, the CORE team aims to increase self-management, reduce acute care utilization and improve clinical outcomes. Photos courtesy Alicia Dinkeldein   The Community Outreach Resource Efficiency (CORE) program was created in 2012 as a division of Indianapolis (Ind.) Emergency Medical Services (IEMS) in partnership with Eskenazi Health. Since then, CORE has grown, and now has a team of two community paramedics, six community health workers, an EMT and a social worker. By leveraging this diverse and effective combination of expertise, the team can work with individuals who experience a combi...
Source: JEMS Patient Care - May 2, 2018 Category: Emergency Medicine Authors: Unnati Patel, MPH, CPH Tags: Patient Care Operations Mobile Integrated Healthcare Source Type: news

Assessment & Treatment of Five Diabetic Emergencies
Patients experiencing a diabetic emergency should be placed on a cardiac monitor due to the potential for severe electrolyte disturbances. Photos courtesy Nashville Fire Department EMS calls for patients with diabetes are common for many reasons, including their increased risk for cardiac disease, cerebrovascular disease, pneumonia, infection and their many diabetic complications. Knowing and recognizing common emergencies encountered in diabetics is important due to both their frequency and that they are often life-threatening. In this article, we focus on five diabetic emergencies: 1) diabetic ketoacidosis (DKA); 2) h...
Source: JEMS Patient Care - May 2, 2018 Category: Emergency Medicine Authors: H. Evan Dingle, MD Tags: Patient Care Source Type: news

Polk County (Fla.) Fire Rescue Protocol Includes Consideration for Wake-Up Strokes
Patients who awaken with stroke symptoms that weren’t present prior to falling asleep is a phenomenon known as wake-up stroke. Photo courtesy Raf Vittone   EMS was dispatched at 6:43 a.m. for a 47-year-old man who was experiencing right-sided paralysis. On arrival, the medics noticed that he couldn’t seem to understand them and thus wasn’t able to follow commands. The patient’s wife stated that her husband was perfectly normal when they went to bed at about 11 p.m. the previous night. Upon arrival at a primary stroke center, the time last known normal was acknowledged as 11 p.m., which meant ...
Source: JEMS Patient Care - May 2, 2018 Category: Emergency Medicine Authors: Paul R. Banerjee, DO Tags: Patient Care Cardiac & Resuscitation Source Type: news

Acute Stroke: From Prehospital Care to In-Hospital Management
Early recognition of stroke by clinical presentation and prehospital stroke assessment tools facilitate rapid prehospital and ED diagnosis. CanStockPhoto/focalpoint   Stroke is a leading cause of morbidity and mortality in the United States and requires prompt recognition by prehospital providers to ensure rapid transport. Stroke can present in a variety of different ways, some more readily apparent than others. Delays in diagnosis and treatment can have devastating effects on the outcomes for these patients. In this article, we describe a patient who initially presented with altered mental status and was subsequent...
Source: JEMS Patient Care - May 2, 2018 Category: Emergency Medicine Authors: Henry G. Colmer IV, MD Tags: Patient Care Cardiac & Resuscitation Source Type: news

Stopping the Bleed is Just the Beginning
This study was a retrospective review of available data from mass shooting events occurring between 1984 and 2013. The researchers attempted to get data from 25 public mass shootings, and they were able to obtain it from 12 events involving 139 patients. The researchers reviewed all of the cases to determine the anatomical locations of wounds. They were able to review 115 of the cases to determine the anatomical location of the wound that caused death, and reviewed 125 of the cases for the potential for survivability with appropriate prehospital and in-hospital trauma care. Results: The researchers calculated an average of...
Source: JEMS Patient Care - May 1, 2018 Category: Emergency Medicine Authors: Sean J. Britton, MPA, NRP Tags: Trauma Columns Source Type: news

Maintain a Fresh Approach to Routine Medical Calls
Always the same, but never the same When emergencies are your everyday concern, perspective sometimes gets skewed. After a while, it’s easy to imagine that every heartbeat is just waiting to wobble. Yet somehow, the hearts in your service area take the licking of daily life and keep on ticking. And when they don’t, you get the call. Dispiriting Similarity The challenge of a good cardiac call is something to look forward to in the mix of the requests for help from those of us at 9-1-1. Those squiggly lines on the cardiac monitor have meaning to our educated eyes. It’s interesting to parse the information, ...
Source: JEMS Patient Care - May 1, 2018 Category: Emergency Medicine Authors: Kate Dernocoeur, NREMT Tags: Patient Care Cardiac & Resuscitation Columns Source Type: news

Blood Pressure Management Goals in Stroke Care
Blood pressure management goals in stroke care You arrive at a small rural emergency healthcare facility to transport a 72-year-old female who presents to the ED with the worst headache of her life. She’s to be transported to a tertiary center with neurosurgical services. Upon further questioning you determine her headache was sudden onset with maximum intensity. When reviewing her history and medications, you note that she’s currently on Coumadin (warfarin) with an international normalized ratio (INR) of 3.5, with the following vital signs noted on the monitor upon entering the room: blood pressure of 209/75 m...
Source: JEMS Patient Care - May 1, 2018 Category: Emergency Medicine Authors: Ken Davis, BA, EMT-P, FP-C Tags: Patient Care Cardiac & Resuscitation Source Type: news

Prehospital Assessment for Stroke Isn ’t Perfect
Prehospital assessment tools for neurological deficits aren’t perfect An approximately 30-year-old male answers the door to let you and your partner into the house you’ve been called to. Hank introduces himself and thanks you for coming, quickly adding that he’s concerned about his mother who’s “acting weird.” Hank tells you he stopped by his mom’s house for lunch and found her using paper plates to heat food on the stove. He stopped her before the plate ignited. His mother seemed confused and so he called 9-1-1. Patient Assessment Margaret, Hank’s 53-year-old mot...
Source: JEMS Patient Care - May 1, 2018 Category: Emergency Medicine Authors: Dennis Edgerly, EMT-P Tags: Patient Care Cardiac & Resuscitation Columns Source Type: news

Teen Delivers a Baby Days After Learning About Childbirth in School
EDEN, Utah (AP) — A northern Utah high school student delivered her aunt's baby Saturday, days after learning about childbirth in her child development class. Morlie Hayes, 16, was at home in Eden over the weekend while her mom was out running errands and a surprise visitor showed up: her pregnant aunt Laura Creager, who was going into early labor. "My mom's outside. She's going to have her baby!" Creager's 7-year-old daughter said through tears, the teenager told the Deseret News. The baby wasn't due until May 19. Creager thought she had another hour before she would make it to the hospital, but her baby w...
Source: JEMS Patient Care - May 1, 2018 Category: Emergency Medicine Authors: Associated Press Tags: Patient Care News Source Type: news

A Team of Two: EMS And Epidemiology
“What’s an epidemiologist?” is usually the first question I get asked when people inquire about my career. If someone happens to know what an epidemiologist is, they usually ask if I work with viruses like Ebola or the flu. They might even reference a few movies like Outbreak, Contagion, or World War Z. I must admit, I wouldn’t mind single-handedly saving the world from a rare and horrific disease, but in the real world, epidemiology is a little less glamorous. Epidemiology is “the study of the distribution and determinants of health-related states or events in specified populations, and ...
Source: JEMS Patient Care - April 26, 2018 Category: Emergency Medicine Authors: Morgan K. Anderson, MPH Tags: Documentation & Patient Care Reporting Source Type: news

Portable Test Helps Identify Refugees at Risk of Outbreaks
WASHINGTON (AP) — Call it a lab in a box: Researchers created a device about the size of a toaster that can test a drop of blood to tell, in about half an hour, who's immune to certain infections and who's not. The goal is to find groups of people at risk of outbreaks, especially in impoverished and remote parts of the world, in time to save lives. Wednesday, Canadian researchers reported their novel tool worked pretty well at identifying people vulnerable to measles and rubella in a refugee camp in Kenya. "We're very excited about the potential for this technology," said epidemiologist Aimee Summers of the...
Source: JEMS Patient Care - April 26, 2018 Category: Emergency Medicine Authors: Lauren Neergaard, Associated Press Tags: Patient Care News Source Type: news

Physio-Control Launches Newest Version of LUCAS Chest Compression System in United States
REDMOND, Wash.--(BUSINESS WIRE)--(Product Bulletin) Today Physio-Control, now part of Stryker, announced its newest version of the LUCAS 3 Chest Compression System, version 3.1. The latest version provides powerful new capabilities for tailored device functionality, wireless reporting and device status notifications sent over email. The latest LUCAS 3.1 version allows professional users to tailor setup options for compression rate/depth, pauses, alerts, timer, and ventilation features to meet local emergency care protocols. LUCAS 3.1 now includes Wi-Fi® connectivity with a LIFENET® Syst...
Source: JEMS Patient Care - April 25, 2018 Category: Emergency Medicine Authors: Physio-Control Tags: Cardiac & Resuscitation Patient Care Industry News Source Type: news

Hennepin County (Minn.) EMS Sees Highest Number of Overdoses in the State
MINNEAPOLIS (WCCO) — The people on the front lines of the opioid epidemic see the crisis daily. It’s become typical for a crew in Hennepin County to respond to an opioid-related overdose on every shift. In Minnesota, that’s where the highest number of overdoses occur. (Source: JEMS Patient Care)
Source: JEMS Patient Care - April 23, 2018 Category: Emergency Medicine Authors: Jennifer Mayerle, WCCO Tags: News Videos Patient Care Source Type: news

Patient Thanks Ada County (Idaho) Paramedics Who Saved His Life
BOISE, Idaho – On a chilly November night, Ada County Paramedics responded to a 9-1-1 call after a vehicle struck Robert Savage on his motorcycle, propelling him 35 feet down a hill and into a fence. Ada County Paramedics arrived on scene to find Savage with a broken leg, having a grand mal seizure. After a lengthy physical and emotional healing process, Savage is finally at a place where he can tell his story—and he wants to thank the paramedics who saved his life that night. “I am very excited to meet them,” Savage said. “There are a lot of gaps in my mind that I hope they can fill for me.&r...
Source: JEMS Patient Care - April 19, 2018 Category: Emergency Medicine Authors: Ada County Paramedics Tags: Patient Care Industry News Source Type: news

New Data Suggests Americans Filling Fewer Opioid Prescriptions
TRENTON, N.J. (AP) — New data show that the number of prescriptions for opioid painkillers filled in the U.S. fell dramatically last year. They showed their biggest drop in 25 years. The decline comes amid increasing legal restrictions and public awareness of the dangers of addiction. A health data firm released a report Thursday showing a 9 percent average drop nationwide in the number of prescriptions for opioids filled by retail and mail-order pharmacies. All 50 states and the District of Columbia had declines of more than 5 percent. The U.S. is estimated to consume roughly 30 percent of all opioids used worldwid...
Source: JEMS Patient Care - April 19, 2018 Category: Emergency Medicine Authors: Linda A. Johnson, Associated Press Tags: Patient Care News Source Type: news

Powell County (Ky.) EMS Crew Delivers Baby in Back of Ambulance
POWELL COUNTY, Ky. (WKYT) - It's not a place you expect to give birth, but one woman in Powell County ended up giving birth to a baby girl in the back of an ambulance Sunday. Two Powell County paramedics and one emergency medical technician successfully delivered the baby girl while they were rushing the parents to the hospital. "She already had her clothes partially pulled off," said EMT Terri Patrick, "I told her, 'ma'am I'm going to have to take a look.' She said 'this baby is coming.'" The baby was coming out feet first, which sometimes requires a c-section. "One little purple foot stickin...
Source: JEMS Patient Care - April 18, 2018 Category: Emergency Medicine Authors: Chelsea Jones Tags: News Videos Patient Care Source Type: news

Organs from Drug Overdoses May Help Transplant Shortage
WASHINGTON (AP) — Fatal drug overdoses are increasing organ donations, and researchers reported Monday that people who receive those transplants generally fare as well as patients given organs from more traditional donors. The findings could encourage more use of organs from overdose victims. Researchers from Johns Hopkins University found those transplants have jumped nearly 24-fold since 2000. That was before overdoses were making headlines or most transplant centers considered accepting such organs. In 2016, there were 3,533 transplants using overdose-related donated organs, up from just 149 such transplants in 20...
Source: JEMS Patient Care - April 17, 2018 Category: Emergency Medicine Authors: Lauran Neergard, Associated Press Tags: Patient Care News Source Type: news

One Paramedic's Perspective on Civilian Naloxone Distribution
The U.S. surgeon general, Dr. Jerome Adams, recently issued the first national public health advisory in 13 years. He wants more civilians to start carrying naloxone “to help combat the nation’s opioid crisis and save lives.” Since 2010, the number of Americans who die from opioid overdoses annually has more than doubled, and in 2016 there were more than 42,000 deaths. The need for a multifaceted strategy to combat this deadly epidemic is clear. Among many EMS providers, there’s a great deal of angst directed at civilian naloxone distribution programs, as well as at opioid overdoses in general. If y...
Source: JEMS Patient Care - April 16, 2018 Category: Emergency Medicine Authors: Simon Taxel, NREMT-P Tags: Patient Care Administration and Leadership Source Type: news

On His Day Off, Roanoke County (Va.) Paramedic Saves An Infant's Life
Roanoke, Va. (WSLS) - Being a hero has no boundaries. We tell you the story of this year's Red Cross Emergency Responder Hero. He's a Roanoke County paramedic and firefighter, and even on a day off, he saved a life. Andrew Goodpasture has worked on an ambulance in Roanoke County for eight years, helping save numerous lives. But an incident that happened during an out-of-town hunting trip in January 2017 was unlike any other. "So I was in the middle of nowhere, out of town. I do a lot of hunting,” Goodpasture said. “Me and a couple of buddies went on a goose hunt.” It was supposed to be a fun day...
Source: JEMS Patient Care - April 14, 2018 Category: Emergency Medicine Authors: Lindsey Ward, WSLS Tags: News Videos Patient Care Administration and Leadership Source Type: news

New Way of Defining Alzheimer's Aims to Find Disease Sooner
Government and other scientists are proposing a new way to define Alzheimer's disease — basing it on biological signs, such as brain changes, rather than memory loss and other symptoms of dementia that are used today. The move is aimed at improving research, by using more objective criteria like brain scans to pick patients for studies and enroll them sooner in the course of their illness, when treatments may have more chance to help. But it's too soon to use these scans and other tests in routine care, because they haven't been validated for that yet, experts stress. For now, doctors will still rely on the tools the...
Source: JEMS Patient Care - April 9, 2018 Category: Emergency Medicine Authors: Marilynn Marchione, Associated Press Tags: Patient Care News Source Type: news

In Iowa, Teachers Learn How to 'Stop The Bleed'
PLEASANT HILL, Iowa (AP) — As she learned the basics of applying direct pressure, packing a wound with gauze and tying a tourniquet, sixth-grade math and social studies teacher Kari Stafford shook her head at the thought that this may now be an essential skill for her profession. Stafford didn't like it, but with school shootings now a regular occurrence, she and her colleagues have reluctantly accepted that the attacks won't stop and that teachers must know how to keep the victims from bleeding to death. "Learning to help and not just stand there is important," said Stafford, who joined about a dozen other...
Source: JEMS Patient Care - April 9, 2018 Category: Emergency Medicine Authors: Scott McFetridge, Associated Press Tags: Training Trauma News Source Type: news

New Drug Mixtures Cause Surge in Ohio Overdose Deaths
CINCINNATI (AP) — New surges in use of methamphetamine and cocaine mixed with a powerful synthetic opioid are contributing to rising drug overdose death tolls in already hard-hit Ohio. As county coroners have begun releasing their 2017 tallies, a trend has emerged of more deaths involving meth or cocaine mixed with fentanyl, the painkiller blamed for increasing U.S. fatalities in recent years as authorities focused on reducing heroin overdoses. U.S. authorities say illicit fentanyl made in China has flooded in while there is increased availability of meth and a rebound in cocaine. All have been contributing to the na...
Source: JEMS Patient Care - April 2, 2018 Category: Emergency Medicine Authors: Dan Sewell, Associated Press Tags: Patient Care News Source Type: news

The BLAST Approach: Rethinking the Way We Approach MCI Triage
  I’ve studied and taught mass casualty incident (MCI) care and response for 40 years and have found that students often get confused when tasked with memorizing rarely used triage processes or algorithms. They easily grasp and master the difference between BLS and ALS, because they use these concepts daily. However, they often stumble when at the scene of a mass casualtyor active shooter incident, where they’re tasked with rapidly determining the category of seriously or mortally wounded patients. When I train students, I explain how to perform triage as a simple modification of the daily BLS/ALS decision...
Source: JEMS Patient Care - April 1, 2018 Category: Emergency Medicine Authors: A.J. Heightman, MPA, EMT P Tags: Major Incidents Trauma Columns Mass Casualty Incidents Patient Care Source Type: news

A Modern Approach to Basic Airway Management
A modern approach to the essentials of ventilation & oxygenation Administering oxygen via nasal cannula while treating a patient with CPAP increases the fraction of inspired oxygen and doesn’t typically interfere with the mask seal. Photos courtesy Andrew Merelman You arrive on scene and find a 68-year-old man is lying on the couch with difficulty breathing. He’s obese and obtunded, with severe respiratory distress. His wife tells you he has a history of congestive heart failure. He appears pale and diaphoretic, with snoring, slow, shallow breaths and his initial oxygen saturation is 72%. What are the m...
Source: JEMS Patient Care - April 1, 2018 Category: Emergency Medicine Authors: Andrew Merelman, BS, NRP, FP-C Tags: Airway & Respiratory Patient Care Source Type: news

Evidence-Based Prehospital Lung Protective Ventilation Protocol Reduces Lung Injury
Protective mechanical ventilation strategies in the prehospital setting Montgomery County Hospital District EMS developed an evidence-based paramedic-initiated lung protective ventilation bundle to reduce ventilator-induced lung injury. Photo courtesy Montgomery County Hospital District Lowering tidal volumes in an effort to reduce lung injury following initiation of mechanical ventilation is far from a new idea, the original ARDSNet data are nearly 20 years old. Recent ED-based studies have shown decreased mortality when lower tidal volumes are used early in ventilated patient management.1 Montgomery County Hospital D...
Source: JEMS Patient Care - April 1, 2018 Category: Emergency Medicine Authors: Casey B. Patrick, MD, FACEP Tags: Airway & Respiratory Patient Care Source Type: news

Optimize Patient Outcomes with Good Post-Intubation Management Methods
Methods to optimize patient outcomes When making a choice for both analgesics and sedatives, one should be guided by the patient’s clinical condition and anticipated clinical course. Photos courtesy Ryan Hodnick As EMS providers, we’re commonly called upon to transport the critically ill or injured intubated patient. It’s easy to focus on the intubation procedure, but pre- and post-intubation management are just as important. What we do before the actual act of intubation, resuscitation, pre-oxygenation really matters. The initial management of these patients can have a significant impact on both thei...
Source: JEMS Patient Care - April 1, 2018 Category: Emergency Medicine Authors: Ben Stone, FP-C Tags: Airway & Respiratory Patient Care Source Type: news

In the Bag or Out of Control? BVM Revisited
In the bag or out of control? A recent article highlighting new changes to the comprehensive 2015 European Research Council (ERC) Guidelines for Resuscitation states that there’s “little new in how we should manage the airway in 2017.”1,2 The article references two studies that demonstrate increased use of, and better success rates with, videolaryngoscopy for endotracheal intubation (ETI), as well as another study showing that inexperienced providers can successfully perform cricothyroidotomies on fresh cadavers using pocket knives and ballpoint pens. Although the increasing use of video technology may le...
Source: JEMS Patient Care - April 1, 2018 Category: Emergency Medicine Authors: Neal Richmond, MD, FACEP Tags: Airway & Respiratory Patient Care Columns Source Type: news

Tale of the Tape: How Accurate is the Broselow Tape for Weight Estimation and Drug Dosing?
In this study, the authors wanted to address questions regarding the Broselow tape’s accuracy in estimating pediatric weight, as well as examine its impact on drug calculations. They examined 1,318 studies and found 118 that met eligibility criteria for statistical review. Eighty-four studies addressed weight estimation, of which 58 met criteria for review based on the strength of the quantitative data. The studies spanned from the 1988 article that introduced the Broselow tape to the latest articles in 2017. Their findings included the following: >> The Broselow tape was significantly more accurate than provid...
Source: JEMS Patient Care - April 1, 2018 Category: Emergency Medicine Authors: Keith Wesley, MD, FACEP, FAEMS Tags: Patient Care Columns Source Type: news

Bystander Epinephrine in Community Anaphylaxis
Discussion This case represents the value of Good Samaritan willingness to share designated epinephrine auto-injectors. Early access to epinephrine saves lives, and there’s no absolute contraindication to epinephrine in the treatment of anaphylaxis.1 Moreover, rates of anaphylaxis have increased and most cases occur in communities rather than healthcare settings. (Source: JEMS Patient Care)
Source: JEMS Patient Care - April 1, 2018 Category: Emergency Medicine Authors: Marcus Shaker, MD, MS Tags: Patient Care Source Type: news

The Psychology of Prehospital Pediatric Emergencies
This article will present an overview of psychological factors that affect children, parents and EMS providers. The focus will be on children less than or equal to 10 years old, because cognition and understanding start to approach those of adults after age 10. The term “younger children” will be used to refer to children less than or equal to 6 years old. No other differentiation along developmental stages will be presented in this article because this would usually require some form of developmental or psychological testing and may be unreliable in an emergency since regression to an earlier stage might o...
Source: JEMS Patient Care - April 1, 2018 Category: Emergency Medicine Authors: Harald Karutz, PhD, EMT-P Tags: Patient Care Source Type: news

Maryland Agency Tracks Tourniquet Use to Measure Success in Managing Uncontrolled Bleeding
When a man in Prince George’s County, Maryland severely injured his foot while sawing down a tree in his yard, the first on-scene Prince George’s County Police Officer accessed a Tactical Emergency Casualty Care (TECC) Kit in his vehicle, applied a tourniquet to the wound, and controlled the excessive bleeding to save the man’s life. That casualty care kit was supplied by the Prince George’s County Fire/Emergency Medical Services Department through an Urban Area Security Intelligence Program (UASI) grant to equip public safety officials with tools to prepare for and act against terrorism. Throughout...
Source: JEMS Patient Care - March 30, 2018 Category: Emergency Medicine Authors: JEMS Staff Tags: Patient Care Administration and Leadership Source Type: news

Onslow County (N.C.) EMS Initiates Naloxone Distribution Program
ONSLOW COUNTY, N.C. (WNCT) - A drug that reverses potentially fatal overdoses such as heroin, fentanyl, prescription painkillers, and its derivatives is now more accessible to overdose patients and their support systems in Onslow County, under new efforts by Onslow County. In June 2016, North Carolina became the third state in the country to establish a standing order that allows naloxone to be given to people without a doctor’s prescription (Senate Bill 734). In 2017, Onslow County Emergency Medical Services (EMS) responded to 20,438 calls for service and EMS providers administrated Narcan 355 times. As of Marc...
Source: JEMS Patient Care - March 29, 2018 Category: Emergency Medicine Authors: Elizabeth Tew, WNCT Tags: News Videos Patient Care Source Type: news

National Stop the Bleed Day is March 31, 2018
By now you know the statistics: The number-one preventable cause of death from trauma is severe bleeding, and 20 percent of people who died could have survived with bleeding control. March 31st is "Stop the Bleed Day," and a good time to stress the importance of preventing deaths by slowing and stopping uncontrolled bleeding caused by traumatic injuries. Bystanders play a key role in interventions requiring a timely response, such as bleeding control and use of AEDs.   Stop the Bleed Day gives us a good reminder of how important public education is in helping to save lives. This national event p...
Source: JEMS Patient Care - March 28, 2018 Category: Emergency Medicine Authors: EMS.gov Tags: Patient Care News Source Type: news

In Wake of Fla. Nursing Home Deaths, Gov. Scott Signs Bills Mandating Backup Power
TALLAHASSEE, Fla. (AP) — Gov. Rick Scott signed legislation Monday requiring backup power sources in Florida nursing homes and assisted living facilities, months after the deaths of several residents from a sweltering nursing home that lost power in a hurricane. The legislation require the facilities to have a generator capable of keeping nursing homes and assisted living facilities at 81 degrees Fahrenheit (27 degrees Celsius) or lower for at least four days. All of Florida's 685 nursing homes and 3,089 assisted living facilities must be in compliance by the June 1 start of hurricane season. State agencies can grant...
Source: JEMS Patient Care - March 26, 2018 Category: Emergency Medicine Authors: Joe Reedy, Associated Press Tags: Major Incidents Patient Care News Source Type: news

Automated CPR Machine Helps Save Life After Michigan Car Crash
  (Source: JEMS Patient Care)
Source: JEMS Patient Care - March 16, 2018 Category: Emergency Medicine Authors: WXMI Fox 17 Tags: News Videos Cardiac & Resuscitation Source Type: news

Three Reasons Not to Use Normal Saline or Crystalloids in Trauma
You're responding to a gunshot wound. When you arrive, you find a young man has been shot in the chest, and has significant hemorrhage. As you load him into the ambulance, your partner tells you he is spiking a 1-liter bag of 0.9% sodium chloride, also known as normal saline (NS).  You're curious, because the patient is hemorrhaging blood, not salt water, and ask why you’re not prepping blood products instead. Your partner responds, “Because it’s something we can give him now, and it helps with circulation.” But, does it actually help? This review provides historical information and research wi...
Source: JEMS Patient Care - March 14, 2018 Category: Emergency Medicine Authors: Brandon M. Carius, MPAS, PA-C Tags: Trauma Patient Care Source Type: news

Christiana Care and New Castle County Announce Innovative Partnership to Combat the Opioid Overdose Epidemic
Newark, Delaware – Today Christiana Care Health System and New Castle County announced the creation of an innovative pilot program to help individuals receive addiction treatment and support after they are released from the emergency department (ED) following treatment from an opioid overdose. Launching in fall 2018, the program – called the Community Substance Overdose Support (SOS) Program – will create a response team of specially trained engagement specialists who, with the patients’ consent, will visit with patients at home following an overdose. The team will provide education and access to r...
Source: JEMS Patient Care - March 14, 2018 Category: Emergency Medicine Authors: New Castle County Tags: Patient Care Industry News Source Type: news

Opioid Overdoses in in EDs Increase by 30 Percent
NEW YORK (AP) — Emergency rooms saw a big jump in overdoses from opioids last year — the latest evidence the nation's drug crisis is getting worse. A government report released Tuesday shows overdoses from opioids increased 30 percent late last summer, compared to the same three-month period in 2016. The biggest jumps were in the Midwest and in cities, but increases occurred nationwide. "This is a very difficult and fast-moving epidemic and there are no easy solutions," said Dr. Anne Schuchat, acting director of the Centers for Disease Control and Prevention. Overdose increases in some states and citi...
Source: JEMS Patient Care - March 7, 2018 Category: Emergency Medicine Authors: Mike Stobbe, Associated Press Tags: Patient Care News Source Type: news

Opioid Poisonings, Overdoses Send More US Kids to Hospitals
CHICAGO (AP) — Opioid poisonings and overdoses are sending increasing numbers of U.S. children and teens to the hospital, according to a study showing a substantial rise in young patients needing critical care. The study included accidental poisonings along with overdoses from intentional use. Prescription painkillers were most commonly involved, but heroin, methadone and other opioid drugs also were used. Hospitalizations were most common among kids aged 12-17 and those aged 1 to 5. The youngest kids typically found parents' medications or illicit drugs and used them out of curiosity, said Dr. Jason Kane, the lead a...
Source: JEMS Patient Care - March 6, 2018 Category: Emergency Medicine Authors: Lindsey Tanner, Associated Press Tags: Patient Care News Source Type: news

Worst of Bad US Flu Season is Over as Illnesses Decline
NEW YORK (AP) — The worst of the nation's nasty flu season is finally over. U.S. health officials said Friday that the flu season apparently peaked in early February and has been falling since then. The number of people going to the doctor with symptoms of the flu has continued to decline. Deaths from the flu or pneumonia are going down, too. The Centers for Disease Control and Prevention said 32 states reported heavy patient flu traffic last week, down from 43 a month ago. This flu season started early and the intensity level was among the highest seen in a decade. The flu vaccine didn't work very well this season a...
Source: JEMS Patient Care - March 2, 2018 Category: Emergency Medicine Authors: Mike Stobbe, Associated Press Tags: Patient Care News Source Type: news