Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Objective: Prehospital spinal motion restriction as a prevention technique for secondary neurological injury is a key principle in emergency medicine. Our aim was to evaluate the effectiveness of different cervical spinal cord motion restriction techniques of awake and cooperative healthy volunteers during extrication. Methods: Twenty-three healthy volunteers were asked to exit a car (unassisted) with a rigid cervical collar (CC condition) or without it (autonomous exit: AE; instructed exit: IE); they were also extricated by two rescuers after setting a rigid cervical collar and by using an extrication device (CC + XT condition). ⋯ The lowest EMG activity was observed during maneuver in CC and CC + XT; during exit a lower EMG activity was observed in CC + XT compared to CC (p < 0.001). Thus, when an extrication device is utilized (CC + XT), a lower active control of the cervical spine region is associated with faster and more brisk movements of the cervical spine compared to CC alone. Conclusions: Our findings support the idea that spinal motion restriction via rigid cervical collar of awake and cooperative trauma patients is effective in reducing cervical spine motion in the sagittal plane during vehicle extrication.
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Following an analysis of national EMS agendas, National Association of EMS Educators developed a position supporting educator degree requirements in EMS. This position provided a framework for degree requirements at varying levels of EMS education. Identified support and appreciation for interprofessional approaches as well as EMS specific education was included in the position. The need for an educational workforce capable of providing robust degree options and innovative education emerged in response to the growing academic needs and professional complexities within EMS.
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Background: EMS professionals frequently work more than a standard 40-hour work week. For some EMS professionals, working overtime or multiple jobs may be necessary to make ends meet. Our objective was to evaluate the association between job satisfaction, intention to leave EMS, and financial dependence on overtime or working multiple jobs. ⋯ Conclusion: Many EMS professionals depend on additional work to make a living. Financial dependence was associated with increased odds of workforce-reducing factors, including job satisfaction and intention of leaving. This can lead to poor individual outcomes such as stress and burnout, as well as to turnover within the workforce, thus reducing the number of individuals available to provide high quality emergency care.
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Background: After numerous recent mass casualty events, civilian hemorrhage control has taken a militaristic approach with aggressive and early use of tourniquets. While military literature has demonstrated the utility of tourniquets in preventing battlefield deaths from extremity injuries, there is limited understanding of their role in civilian penetrating trauma deaths. The purpose of this study is to review medical examiner (ME) autopsy records in a defined population to determine the incidence of preventable deaths from extremity wounds amenable to tourniquet placement. ⋯ Conclusion: Among urban ME cases, both isolated extremity cases and concurrent extremity-central injuries exist that may be amenable to life-saving tourniquet use. Extrapolating our findings nationwide suggests that many lives could be saved with early tourniquet use. Considering these findings, tourniquet availability and early placement may have a prominent role in reducing injury deaths from penetrating trauma.
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Background: Mass-casualty incidents (MCIs) are catastrophic. Whether they arise from natural or man-made disasters, the nature of such incidents and the multiple casualties involved can rapidly overwhelm response personnel. Mass-casualty triage training is traditionally taught via either didactic lectures or table top exercises. ⋯ Cost of running the VR came to AUD $712.04 (staff time), compared to the live simulations which came to AUD $9,413.71 (staff time, moulage, actors, director, prop vehicle), approximately 13 times more expensive. Conclusion: The VR simulation provided near identical simulation efficacy for paramedicine students compared to the live simulation. VR MCI training resources represent an exciting new direction for authentic and cost-effective education and training for medical professionals.