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

Status of the Philips Monitor/Defibrillator Hold (Consent Decree) by the FDA
Philips recently reached agreement on a consent decree with the U.S. Department of Justice, representing the Food and Drug Administration (FDA), related to compliance with current good manufacturing practice requirements arising from past inspections focusing primarily on Philips’ Emergency Care and Resuscitation (ECR) facilities in Andover, MA and Bothell, WA, in and before 2015. The decree also provides for increased scrutiny, for a period of time, of the compliance of the other patient care businesses at Philips facilities with the Quality System Regulation.  Under the decree, Philips is required to suspend t...
Source: JEMS Patient Care - January 18, 2018 Category: Emergency Medicine Authors: A.J. Heightman, MPA, EMT P Tags: Cardiac & Resuscitation Equipment Gear 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