Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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The United States Pharmacopoeia (USP) recommends that medication storage temperatures should be maintained between 15 degrees C and 30 degrees C (59 degrees F to 86 degrees F). Concerns have been raised that storage temperatures in EMS may deviate from this optimal range, predisposing drugs to degradation. This study was conducted to determine whether temperatures inside the drug box carried by paramedics aboard a helicopter remained within the range. ⋯ Medications stored aboard an EMS helicopter are exposed to extremes of temperature, even inside a drug bag. Measures are needed to attenuate storage temperature fluctuations aboard aeromedical helicopters.
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Comparative Study
Response interval comparison between urban fire departments and ambulance services.
To measure the response intervals of fire departments compared with ambulance services in three urban centers to determine whether defibrillators should be added to fire vehicles. ⋯ The shorter response interval of fire departments suggests placing defibrillators on fire response vehicles in an effort to decrease the time to defibrillation for cardiac arrest victims in this EMS system.
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Although death education is a standard component in most medical schools and nursing programs, few include instruction on dealing with sudden death. Typically, death education courses overlook instruction in areas germane to emergency medicine, e.g., making death notifications, interacting with survivors during the immediate grief period, and reducing professional stress innate to working with newly bereaved persons. ⋯ Topics include death perspectives and awareness, death typology, cultural and religious considerations, communicating with bereaved persons, making death notifications, and dealing with initial grief reactions. Units of instruction are outlined, including educational goals, descriptions of units, teaching strategies, and supplemental readings.
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One of the highest priorities for prehospital emergency personnel is airway management. Several rescuer positions for intubation on the ground have been published. ⋯ Using four case reports, situations in which inverse intubation may be an important tool for successful airway management are discussed. Other uses of the method are listed.
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To determine whether paramedics can safely use a spinal clearance algorithm to reduce unnecessary spinal immobilization (SI) in the out-of-hospital setting. ⋯ An out-of-hospital spinal clearance algorithm administered by paramedics can reduce SI by one-third. Any application of a spinal clearance algorithm should be accompanied by rigorous medical supervision.