Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Paramedics and emergency medical technicians (EMTs) triage pediatric disaster victims infrequently. The objective of this study was to measure the effect of a multiple-patient, multiple-simulation curriculum on accuracy of pediatric disaster triage (PDT). ⋯ This study shows that the multiple-victim, multiple-simulation curriculum yields a durable 10% improvement in simulated triage accuracy. Future iterations of the curriculum can target greater improvements in EMT triage accuracy.
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Observational Study
Effect of Body-Worn Cameras on EMS Documentation Accuracy: A Pilot Study.
Current Emergency Medical Services (EMS) documentation practices usually occur from memory after an event is over. While this practice is fairly standard, it is unclear if it can introduce significant error. Modern technology has seen the increased use of recorded video by society to more objectively document notable events. Stationary mounted cameras, cell-phone cameras, and law enforcement officer Body-Worn Cameras (BWCs) are increasingly used by society for this purpose. Video used in this way can often clarify or contradict recall from memory. BWCs are currently not widely used by EMS. The hypothesis is that current EMS documentation practices are inaccurate and that BWCs will have a positive effect on documentation accuracy. ⋯ Current EMS documentation practices demonstrate significant inaccuracy regardless of years of experience. Use of BWC technology appears to significantly improve EMS documentation accuracy in this pilot study.
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Greater than half of Emergency Medical Services (EMS) personnel report work-related fatigue, yet there are no guidelines for the management of fatigue in EMS. A novel process has been established for evidence-based guideline (EBG) development germane to clinical EMS questions. This process has not yet been applied to operational EMS questions like fatigue risk management. The objective of this study was to develop content valid research questions in the Population, Intervention, Comparison, and Outcome (PICO) framework, and select outcomes to guide systematic reviews and development of EBGs for EMS fatigue risk management. ⋯ We describe formulating and refining research questions and selection of outcomes to guide systematic reviews germane to EMS fatigue risk management. We outline a protocol for applying the Model Process and GRADE framework to create evidence-based guidelines.
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Blunt injuries to the cervical trachea remain rare but present unique and challenging clinical scenarios for prehospital providers. These injuries depend on prehospital providers either definitively securing the injured airway or bridging the patient to a treatment facility that can mobilize the necessary resources. ⋯ Ultimately, a systematic approach to all airways will ensure that prehospital providers are best prepared for even the most challenging scenarios.
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Case Reports
CPR Induced Consciousness During Out-of-Hospital Cardiac Arrest: A Case Report on an Emerging Phenomenon.
High quality cardiopulmonary resuscitation (CPR) has produced a relatively new phenomenon of consciousness in patients with vital signs absent. Further research is necessary to produce a viable treatment strategy during and post resuscitation. ⋯ CPR induced consciousness is emerging as a new phenomenon challenging providers of high quality CPR during cardiac arrest resuscitation. Our case report describes the manifestations of CPR induced consciousness as well as the resuscitative challenges which occur during resuscitation. Further research is required to determine the true frequency of this condition as well as treatment algorithms that would allow for appropriate and safe management for both the patient and EMS providers.