Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
-
Abstract Objectives. To compare paramedics' ability to minimize cervical spine motion during patient transfer onto a vacuum mattress with two stabilization techniques (head squeeze vs. trap squeeze) and two transfer methods (log roll with one assistant (LR2) vs. 3 assistants (LR4)). Methods. ⋯ Conclusion. Paramedics performing a log roll with three assistants created less motion compared to a log roll with only one assistant, and using the trap squeeze stabilization technique resulted in less motion than the head squeeze technique but the clinical relevance of the magnitude remains unclear. However, large individual differences suggest future paramedic training should incorporate both best evidence practice as well as recognition that there may be individual differences between paramedics.
-
Abstract Introduction. Prehospital personnel frequently encounter agitated, combative, and intoxicated patients in the field. In recent years, ketamine has been described as an effective sedative agent to treat such patients; however, a paucity of research exists describing the use of prehospital ketamine. ⋯ Conclusion. We found that in a cohort of patients administered ketamine, paramedics reported a subjective improvement in patient condition. Endotracheal intubation was performed in 8 patients.
-
Abstract Objective. Although ketamine has recently been demonstrated to provide a morphine-sparing effect, no previous study reports the effect of continuous infusion of ketamine for analgesia in out-of-hospital environments. The aim of this study was to compare the effect of a continuous infusion of ketamine (IK group) vs. a continuous infusion of saline (IS group) on morphine requirements in out-of-hospital trauma patients suffering from severe acute pain. ⋯ Analgesia was as efficient without any significant difference in VAS at Tf between groups (3.1 ± 2.3 (IK group) vs. 3.7 ± 2.7 (IS group), p = 0.5). Conclusions. Continuous ketamine infusion did not reduce morphine requirements in severe acute pain trauma patients in the out-of-hospital emergency settings.
-
Case Reports
Double Sequential Defibrillation for Refractory Ventricular Fibrillation: A Case Report.
A 40-year-old male struck his chest against a pole during a basketball game and had sudden out-of-hospital cardiac arrest. After bystander cardiopulmonary resuscitation, fire and emergency medical services personnel provided six defibrillation attempts prior to emergency department arrival. ⋯ The double sequential defibrillation was successful and the patient had return of spontaneous circulation at the next pulse check. He recovered in the intensive care unit, was discharged home 1 month later, and continues to follow up in clinic over 1 year later with a Cerebral Performance Category score of 1 (short-term memory deficits).