Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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It has been proved that emergency medical dispatch centers (EMDC) save lives by promoting an appropriate allocation of emergency medical service resources. Indeed, optimal dispatcher call duration is pivotal to reduce the time gap between the time a call is placed and the delivery of medical care. However, little is known about the impact of work shift configurations (i.e., work shift duration and work shift rotation throughout the day) and dispatcher call duration. Thus, the objective of our study was to assess the effect of work shift configurations on dispatcher call duration. ⋯ Our study showed that there was a statistically significant difference in dispatcher call duration over work shift rotation and duration, with longer durations seen over night shifts and shifts over 8 hours. While these differences are small and may not have clinical significance, they may have implications for EMDC efficiency.
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Diazepam and midazolam are commonly used by paramedics to treat seizures. A period of drug scarcity was used as an opportunity to compare their effectiveness in treating prehospital seizures. ⋯ For parenteral administration, midazolam demonstrated superior first-dose seizure suppression. This study demonstrates how periods of drug scarcity can be utilized to study prehospital medication effectiveness.
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To investigate the effect of ice slurry ingestion precooling on body core temperature (Tc) during exertion in wildland firefighting garments in uncompensable heat stress. ⋯ Pretreatment with ice slurry prior to exertion in wildland firefighting garments results in a modest reduction in Tc during the first 30 minutes of exercise when compared to pretreatment with control beverage but the ice slurry precooling advantage did not persist throughout the 45-minute exercise protocol.
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Since 2009, the seminal text in emergency medical services (EMS) medicine has been used to guide the academic development of the new subspecialty but direct application of the material into EMS oversight has not been previously described. The EMS/Disaster Medicine fellowship program at our institution scheduled a monthly meeting to systematically review the text and develop a study guide to assist the fellow and affiliated faculty in preparation for the board examination. In addition to the summary of chapter content, the review included an assessment of areas from each chapter subject where our EMS system did not exhibit recommended characteristics. ⋯ This collaborative environment facilitates system-based practice and practice-based learning, aligning with ACGME core competencies. Our educational model has demonstrated the success of translating the text into action items for EMS systems. This model may be useful in other systems and could contribute to the development of EMS system standards nationwide.
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This country has witnessed a steady increase in the number of active shooter incidents in recent years. The traditional emergency medical services (EMS) response to such incidents has been to stage at a safe distance until the scene has been secured by law enforcement. Such an approach may lead to unnecessary delays in medical care and potentially needless loss of life. ⋯ These included initial and ongoing training and funding sources; buy-in from risk management, labor, and the individual providers; whether only paramedics should be included in the RAMS program or if the PFD's firefighter-EMTs should be included as well; the potential for mission creep as police recognized the value of this asset and its potential application to other scenarios; and how to involve the many nonmunicipal ambulance services that are not involved in the routine operation of Philadelphia's 9-1-1 system. To date, RAMS teams have been activated on multiple occasions, but fortunately the incidents were resolved without injury or loss of life. However, the program provides another valuable tool with which the City of Philadelphia can respond should another active shooter incident occur.