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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

Clinical Performance Measures that Matter —Are You Ready?
Conclusion The future will belong to those who can prove value. The use of a clinical performance dashboard and comparisons to national data will help to ensure that when the payers come knocking on our doors looking for "proof" that what we do enhances patient care and improves patient outcome, we’ll have an answer! This is the first in a yearlong series of articles developed by the Academy of International Mobile Healthcare Integration (AIMHI).The AIMHI article series is developed in partnership with JEMS to help educate EMS agencies on the hallmarks and attributes of high-performance/high-value EMS system de...
Source: JEMS Special Topics - December 11, 2018 Category: Emergency Medicine Authors: Wayne C. Harbour, NRP Tags: Exclusive Articles Operations Administration and Leadership Source Type: news

Short answer question: a distracting ECG
Part 1 A 76-year-old man with a past medical history of chronic obstructive pulmonary disease is brought to the emergency department (ED) with suspected sepsis. He is a smoker of 15 cigarettes per day who has an exercise tolerance of approximately 30 m. He saw his general practitioner who treated him with antibiotics and steroids. He has rung for an ambulance complaining of increasing shortness of breath and back pain. His initial vital signs were: BP 100/87 mm Hg, HR 120 bpm, RR 24 breaths per minute, oxygen saturations 100% on room air and normal temperature. He appeared sweaty and clammy, but his hea...
Source: Emergency Medicine Journal - December 23, 2015 Category: Emergency Medicine Authors: Lyddon, K., Thevendra, M., Jang Tags: Tachyarrhythmias, Cardiomyopathy, Drugs: infectious diseases, Pneumonia (infectious disease), TB and other respiratory infections, Echocardiography, Pain (neurology), Stroke, Hypertension, Acute coronary syndromes, Percutaneous intervention, Pain (palliat Source Type: research

Looking Past Dementia Reveals Hidden Life Threats
Conclusion Acute delirium is commonly underdiagnosed, and can be masked by chronic alterations in cognition and mentation. Delirium has many causes, and can be assessed using the acronym DELIRIUM. The most common presentations suggesting delirium over dementia are short-term memory loss, rapid fluctuation in condition, acute alteration, and a condition present that may be responsible for delirium. Management includes searching for causes of acute alteration in mental status, negating environmental factors of delirium, and—only when necessary—reducing the patient’s threat to themselves or providers by using butyrophen...
Source: JEMS Special Topics - August 13, 2018 Category: Emergency Medicine Authors: Joseph K. Mesches, NRP, FP-C Tags: Exclusive Articles Patient Care Source Type: news

Transporting Patients to Appropriate Receiving Destinations
Conclusion EMS is in a position to be the initiator of specialty center destination. In large cities with multiple hospitals, EMS should transport patients to the closest, most appropriate facility based on patient condition, even if this requires passing a closer facility. Where there are hospitals with multiple specialty services, EMS may be asked to activate a specific team, such as the stroke or cardiac team. In rural communities, EMS can communicate with the local hospital and by letting the hospital know of patient condition, help start the interfacility transport process from the field....
Source: JEMS Special Topics - July 19, 2018 Category: Emergency Medicine Authors: Dennis Edgerly, MEd, EMT-P Tags: Exclusive Articles Columns Operations Source Type: news

Using Benchmark Data as a Launching Point for Quality Improvement in EMS
EMS agencies strive to provide the best possible care and contribute to positive patient outcomes. To ensure a high level of care, many agencies implement quality improvement programs; choosing a place to start for a quality improvement initiative, however, can seem overwhelming, with so many important conditions like cardiac arrest, sepsis, stroke, overdoses, etc. With limited time and resources, it’s necessary to concentrate efforts on measures that matter and are likely to make an impact. A great place to start with quality improvement efforts is where the gold standard is known and the frequency of events isn’t rar...
Source: JEMS Operations - February 20, 2019 Category: Emergency Medicine Authors: Remle Crowe, PhD, NREMT Tags: Exclusive Articles Operations Top Story Source Type: news

Patient Care Falters as COVID-19 Devastates L.A. County (CA) Hospitals
Soumya Karlamangla, Rong-Gong Lin II, Luke Money Los Angeles Times (MCT) Los Angeles County’s healthcare system was buckling Wednesday under the unprecedented surge of COVID-19 patients, with bodies piling up at morgues and medical professionals resorting to increasingly desperate measures as they brace for conditions to worsen in the coming weeks. With hospitals overwhelmed by patients and no outlet valve available, doctors, nurses and paramedics are being forced to make wrenching choices about who gets care and at what level. “No one would believe this is in the United States,” ...
Source: JEMS Patient Care - December 31, 2020 Category: Emergency Medicine Authors: JEMS Staff Tags: Coronavirus News News Feed California EMS Hospital Paramedic Source Type: news