Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Hydrazine (HZ) and Hydrazine Derivative (HZ-D) exposures pose health risks to people in industrial and aerospace settings. Several recent systematic reviews and case series have highlighted common clinical presentations and management strategies. Given the low frequency at which HZ and HZ-D exposures occur, a strong evidence base on which to develop an evidence-based guideline does not exist at this time. Therefore, the aim of this project is to establish a consensus guideline for prehospital care of patients with exposures to HZ and HZ-Ds. ⋯ The consensus guideline for clinical care of patients with exposure to HZ/HZ-Ds is as follows: Prior to decontamination, use appropriate personal protective equipment, and when necessary, support ventilation using a bag-valve-mask and administer midazolam intramuscularly for seizures. After decontamination, provide supplemental oxygen; consider selective advanced airway management when indicated; administer inhaled beta-agonists for wheezing; and, for seizures unresponsive to multiple doses of benzodiazepines that occur during pre-planned, high-hazard activities, such as spacecraft recovery, consider intravenous or intraosseous pyridoxine.
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In response to the escalating overdose crisis there is an urgent need for innovative strategies to reduce overdose death. Emergency Medical Services (EMS) is uniquely poised to reduce mortality and other harms associated with opioid use through prevention, harm reduction, and treatment, yet there is a paucity of nationally recognized best practices or quality measures to guide prehospital quality improvement (QI) efforts related to opioid use disorder (OUD). ⋯ Grounded in evidence-based practices and informed by collaborative expertise, this framework represents a pivotal step toward enhancing the effectiveness and responsiveness of EMS in combating the multifaceted challenges posed by OUD.
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Many United States (U.S.) communities face challenges with Emergency Medical Services (EMS) workforce turnover. The demands created by the pandemic have worsened the stressors EMS clinicians face, possibly changing the drivers of workforce turnover. Our study aims to understand the factors associated with Emergency Medical Technicians (EMTs) and paramedics' likelihood of leaving EMS. ⋯ Although increased stress and pandemic-related factors are most common reasons reported for being likely to leave EMS, job dissatisfaction was the most impactful factor. A better understanding of factors that drive job satisfaction needs evaluation to develop strategies to enhance retention.
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The objective of this study was to evaluate the feasibility of point-of-care testing (POCT) devices for N-terminal pro-B-type natriuretic peptide (NT-proBNP) measurement in prehospital settings, with the aim of improving the speed and accuracy of stroke diagnosis, thereby facilitating quicker and more effective patient care. ⋯ This study highlights the potential of NT-proBNP POCT devices in ambulances to expedite stroke diagnosis and management within 10 min. Smartphone integration further enhances efficiency, adding advancement in prehospital stroke management.
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In 2021, the opioid overdose crisis led to 1,441 fatalities in Chicago, the highest number ever recorded. Interdisciplinary post-overdose follow-up teams provide care at a critical window to mitigate opioid-related risk and associated fatalities. Our objective was to describe a pilot follow-up program in Chicago including eligible overdose incidents, provision of response team services, and program barriers and successes. ⋯ The CARE ORT model proved successful in engaging predominantly older, non-Hispanic Black men in post-overdose outreach who were stably housed. While the number of individuals reached compared to the total eligible individuals was low, the program successfully navigated multiple barriers of limited EMS referral information, limited accuracy of data management, and urban realities of public overdose locations to reach a marginalized patient population with a high risk of mortality.