Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
-
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.
-
The authors have successfully implemented automated external defibrillation (AED) training in police departments that function as first responders. The initial elements are to think the project through, and to develop clear policies and procedures for the police as they relate to dispatching so there is timeliness of notification, because response time is such a critical element. ⋯ A system to evaluate training, compliance with protocol, and efficacy must be developed and closely monitored. While this is a tremendous amount of work and a large time investment, the result can be a dramatic increase in patient survival.
-
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.
-
To examine the practice of clinically "clearing" the cervical spine (c-spine) of trauma patients brought to the ED by EMS with cervical immobilization in place, and to examine developing trends in prehospital c-spine clearance. ⋯ There is tremendous variation in the ED practice of clinically clearing cervical spines. This, and a lack of support from many ED directors, may hinder attempts at development of research and standardized protocols for pre-hospital c-spine clearance.