Safety is Third, Not First, and We All Know It Should Be
Conclusion
In educational opportunities, train like you plan to fight. Since there may not be an actual patient, the “benefit” in the risk-benefit analysis may be lesser. However, taking no risks in training ensures you’ll be less prepared to take risks—even R+ risks—in actual operations. For example, you don’t stop patient care because it’s raining, so don’t stop your training simply because it’s raining.
Also, during your education, fight the idea that we can ever say “the scene is safe.” Accept that our work is done in an imperfect environment where safety cannot be ensured. Then, recognize that yo...
Source: JEMS Special Topics - November 13, 2018 Category: Emergency Medicine Authors: Christopher Davis, MD, NRP, FAWM Tags: Exclusive Articles Operations Source Type: news
Firefighting and On-Duty Cardiac Deaths
Conclusion
Using autopsy data from on-duty fatalities that occurred over a 15-year period, the underlying cardiac pathological conditions associated with sudden cardiac death were investigated among firefighters. Our data suggest a need for updated and improved medical screening for firefighters. Particularly, screening for CHD and cardiac enlargement should be incorporated into a firefighter’s routine screening.
Given the important role of EMS in ensuring both civilian and firefighter safety, EMS personnel should be alert to the potential to encounter either sudden cardiac arrest or a myocardial infarction in firefighte...
Source: JEMS Special Topics - November 12, 2018 Category: Emergency Medicine Authors: Denise L. Smith, PhD, FACSM Tags: Training Exclusive Articles Source Type: news
St John Ambulance Bicycle Team Turns 20 Years Old
They say necessity is the mother of invention. In 1998, two years prior to the Sydney 2000 Olympics, necessity reared its head in the form of the realisation that one of the world’s biggest events would soon challenge the very way St John Ambulance Australia (NSW) supports events.
With its large crowds, big venues, security and access challenges, the Olympics like no other event would test traditional approaches to major event coverage. St John Ambulance Australia (NSW) would need to think of new more innovative ways of responding to incidents, often across significant distances whilst navigating dense crowds and securi...
Source: JEMS Special Topics - November 9, 2018 Category: Emergency Medicine Authors: Didier Moutia Tags: Exclusive Articles International Operations Source Type: news
Thousand Oaks, Calif., Bar Shooting Underscores Several Points for EMS to Consider
The shooting at Borderline Bar & Grill, a country music bar in Thousand Oaks, Calif., the second-largest city in Ventura County, highlights several key areas EMS/Fire/Rescue/police agencies should consider during similar incidents.
1. Formal mass casualty incident triage may be delayed.
According to the FBI, most shootings are over in five minutes. First-arriving EMS crews must be ready to take on, triage, treat and transport patients immediately upon arrival. Therefore, crews coming in minutes later may be the ones required to set up formal triage, patient collection and treatment areas.
This image made from aerial ...
Source: JEMS Special Topics - November 8, 2018 Category: Emergency Medicine Authors: A.J. Heightman, MPA, EMT-P Tags: Training Exclusive Articles Terrorism & Active Shooter Source Type: news
The Critical Role EMS Plays in Fighting the Flu
Influenza has been impacting public health on a global scale since the beginning of recorded history. Influenza, also known as the “flu,” has numerous organizations committed to public health research, developing vaccines, and educating on best practices to prepare for the upcoming flu season. By gaining an understanding of the flu through history, virology, and how it impacts our society, we can have a better appreciation for the commitment that’s involved with combating the flu.
What Is Influenza (and What’s Not)?
The eyes of an epidemiologist can twitch for a variety of reasons, one of them being when someone sa...
Source: JEMS Special Topics - November 8, 2018 Category: Emergency Medicine Authors: Morgan K. Anderson, MPH Tags: Exclusive Articles Operations Source Type: news
Brownsville, Texas, Kickstarts New Program to Help Reduce Non-Emergency 9-1-1 Calls
BROWNSVILLE (KRGV) – A growing number of non-emergent 9-1-1 calls have one Rio Grande Valley city looking to reduce those calls.
Brownsville Fire Chief Jarrett Sheldon says a new program will be able to identify the people who frequently call for non-emergency situations.
“We’ll get a patient – an elderly patient who falls a lot. The goal of this program is, basically, go in their home, find out why are they falling, you know, why are we responding three times a week, four times a week to these homes,” he explains.
Read more at KRGV. (Source: JEMS Special Topics)
Source: JEMS Special Topics - November 7, 2018 Category: Emergency Medicine Authors: Cecilia Gutierrez (KRGV) Tags: News News Videos Mobile Integrated Healthcare Source Type: news
Raising the Intubation Bar is Noble, But Not Practical
We thank Mr. Wood and Mr. Podsialdo for their insightful comments regarding the Pragmatic Airway Resuscitation Trial (PART) results.
With regards to their comment of prior studies finding better outcomes with intubation than supraglottic airways, one must bear in mind that these prior studies were biased by their retrospective designs; the airway was selected by paramedic choice and may have been influenced by a range of factors such as the patient’s condition, anatomy, the physical environment or the practitioner’s level of comfort. Meta-analysis or systematic reviews of these retrospective studies also unf...
Source: JEMS Special Topics - November 6, 2018 Category: Emergency Medicine Authors: Shannon W. Stephens, EMT-P Tags: Airway & Respiratory Exclusive Articles Source Type: news
It ’s About Paramedic Intubation Skill Maintenance, Not ETI vs. SGA
Conclusion
The PART study’s aim was to demonstrate that SGA is superior to SETI. Whether this is true or not remains to be seen. That doesn’t mean this study doesn’t have value. It clearly demonstrated that an important, time-honored and gold standard skill in resuscitation isn’t being practiced effectively by paramedics. The solution should not be to abandon the procedure. The solution is that we need to fix the problem. We need to enhance education, provide more opportunity for skills maintenance and develop systems that ensure that paramedics are regularly practicing these advanced skills. It is time for the EMS...
Source: JEMS Special Topics - November 6, 2018 Category: Emergency Medicine Authors: Stephen P. Wood, MS, ACNP-BC Tags: Airway & Respiratory Exclusive Articles Source Type: news
Pediatric Extremity Hemorrhage and Tourniquet Use
Conclusion
Current evidence suggests that direct pressure, commercial tourniquets and improvised tourniquets can adequately control pediatric extremity hemorrhage.
Being prepared for an emergency requires dedicated and recurrent training. Practice bleeding control by applying direct pressure, a commercial tourniquet, and a cravat on a simulated (yet human, i.e., standardized) small patient.
Take a moment to share the information you gained from this article, and from your own practice, with colleagues. Your knowledge, and the knowledge that you impart to others, will save lives.
Back to the Call
You take a deep breath and ...
Source: JEMS Special Topics - November 1, 2018 Category: Emergency Medicine Authors: Erica Simon, DO, MHA Tags: Trauma Exclusive Articles Source Type: news
Executive Institute (XI) Convenes in Hershey, Pennsylvania
EMS leaders convened in “Chocolatetown USA”—also known as the town of Hershey, Pennsylvania—on Monday, Oct. 22, 2018, for the Page, Wolfberg and Wirth (PWW) Media XI Leadership Conference at the Hershey Lodge.
The Executive Institute (XI) is a one-day interactive workshop with sessions tailored for EMS industry executives, chiefs, top-level managers, owners and leaders interested in high-level views and discussions about reimbursement, compliance, privacy, leadership and human resource management.
Well-known industry leader, Mike Taigman, kicked off the morning with an eye-opening keynote. Taigman offered atte...
Source: JEMS Special Topics - October 27, 2018 Category: Emergency Medicine Authors: A.J. Heightman, MPA, EMT P Tags: Exclusive Articles Administration and Leadership Source Type: news
abc360 Conference Offers Treasure Trove of New Information
The Page, Wolfberg and Wirth (PWW) abc360 Conference kicked off on Tuesday, Oct. 23, at the Hershey Lodge in Hershey, Pennsylvania, offering a robust audience a treasure trove of new information on several key EMS administrative areas.
Up first were the reimbursement, compliance and privacy updates from PWW partners Doug Wolfberg, Steve Wirth and Ryan Stark, which was packed with the latest about what’s going on with the Centers for Medicare and Medicaid Services cost data collection requirements, Medicare appeals, and some interesting air ambulance news.
“We aim to not only inform attendees about the latest in reimbur...
Source: JEMS Special Topics - October 26, 2018 Category: Emergency Medicine Authors: A.J. Heightman, MPA, EMT P Tags: Exclusive Articles Administration and Leadership Source Type: news
Pennsylvania Passes Epic Ambulance Non-Transport Payment
 
Video from WNEP-TV.
Barrar's bill to reimburse ambulance companies heads to governor
WEST CHESTER, Pa.–Legislation drafted by state Rep. Steve Barrar, R-160, that would require ambulance companies to be reimbursed for providing medical treatment, even if the patient is not transported to a hospital, was successfully voted on concurrence by the House.
Read more at Daily Local News
Mobile Integrated Healthcare Editor Matt Zavadsky's Take:
A very logical step being taken by the Pennsylvania legislature!
And, one that is currently in place for payers such as Anthem and the Medicaid prog...
Source: JEMS Special Topics - October 26, 2018 Category: Emergency Medicine Authors: Matt Zavadsky, MS-HSA, EMT Tags: News Mobile Integrated Healthcare Source Type: news
Pennsylvania Agency Reveals ‘Fallen Hero’ Ambulance
Commonwealth Health EMS headquartered in Scranton, Pennsylvania, revealed an ambulance with a special meaning on Tuesday, October 23. The “Fallen Hero” ambulance pays tribute to members of the emergency services and military community from Northeastern Pennsylvania who have paid the ultimate sacrifice in the line of duty.
The families and friends of many of the fallen heroes immortalized on this tribute ambulance were on hand for the unveiling ceremony. The event was also attended by representatives from Scranton Fire Department, Scranton Police Department, the Pennsylvania State Police, the Pennsylvania Army National ...
Source: JEMS Special Topics - October 25, 2018 Category: Emergency Medicine Authors: Julian P. Watras, NRP, CIT Tags: Exclusive Articles Ambulances & Vehicle Ops Source Type: news
Ditch the Machine to Improve Accuracy in Blood Pressure Measurement and Diagnostics
Conclusion
For the patient in this case, the decision to forego the convenience of a machine in favor of the skills of a knowledgeable paramedic was lifesaving. Much like the comparison often drawn between the old-fashioned barbell and more sophisticated exercise machines, newer, more complex, and more expensive might make a process more comfortable, but doesn’t always equate to superior results.
As we surrender more and more of our hands-on skills to the ease of automated technology, we risk more than the loss of the aptitudes that form the foundation of sound patient assessment—we place our patients in jeopardy of mi...
Source: JEMS Special Topics - October 24, 2018 Category: Emergency Medicine Authors: Mark Rock, NRP Tags: Exclusive Articles Cardiac & Resuscitation Source Type: news
Taking a Manual Blood Pressure: Techniques & Pitfalls
Follow the steps below in order to get the best results from use of the aneroid sphygmomanometer when measuring a patient’s blood pressure, taking care to avoid some common errors.
1. Properly expose the patient.
The blood pressure should be measured during the secondary examination, which begins with exposing the patient. This will ensure that the cuff is placed on the skin. The blood pressure cuff should never be placed over clothing, as doing so will increase pressure on the cuff and produce an inaccurate reading.
2. Properly position the patient.
The patient should be seated comfortably, with the legs uncrossed. The ...
Source: JEMS Special Topics - October 24, 2018 Category: Emergency Medicine Authors: Mark Rock, NRP Tags: Exclusive Articles Cardiac & Resuscitation Source Type: news
