Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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The aging population in Canada is steadily increasing and is placing greater demand on paramedic services, especially through the growing number of non-emergent lift assist (LA) calls. A LA occurs when a person calls paramedic services and requests assistance to get up or mobilize, usually after experiencing a fall. The patient refuses transport to the emergency department for further medical attention. LA calls are time consuming and are non-reimbursable. The increase in number of this call type, specifically amongst older adults, is placing strain on paramedic services. ⋯ LAs consume the time of paramedics, preventing them from responding to more urgent emergency calls. Alternative solutions are needed to reduce the negative impact of LAs on paramedic services.
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Randomized Controlled Trial Comparative Study
Comparison of Three Junctional Tourniquets Using a Randomized Trial Design.
Hemorrhage remains a leading cause of death in both civilian and military settings. Of preventable deaths from hemorrhage, a significant portion occurs from junctional wounds that are not amenable to traditional extremity tourniquets. Junctional tourniquets (JTQs) can potentially provide hemorrhage control by compressing the arteries at the junction of the trunk and extremities. The FDA has cleared 3 JTQ products: The Combat Ready Clamp (CRoC®), the Junctional Emergency Treatment Tool (JETT™), and the SAM® Junctional Tourniquet (SJT). However, little is known regarding which of these JTQs is superior in application time, effectiveness in pulse elimination, effectiveness during transport, and user preference. ⋯ All JTQ devices performed poorly during transport. Combined, present findings highlight the potential of JTQ products for saving lives threatened by junctional wounds, but also highlight the need for specific product improvements towards fostering JTQ performance in patient transport.
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The objective of this study was to characterize key health indicators in Emergency Medical Services (EMS) personnel and identify areas for intervention in order to ensure a strong and capable emergency health workforce. ⋯ These findings suggest a high prevalence of overweight and obesity, heavy drinking, binge drinking, and high BP among NC EMS personnel. Similar to fire service personnel, these rates are higher than the general US population. As such, they suggest areas where intervention would have the greatest positive impact on the health and performance of the EMS workforce.
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In patients with traumatic brain injury (TBI), early detection and subsequent prompt treatment of elevated intracranial pressure (ICP) is a challenge in the prehospital setting, because physical examination is limited in comatose patients and invasive device placement is not possible. The aim of this study was to evaluate the quality and feasibility of optic nerve sheath diameter (ONSD) measurements obtained during the prehospital management of patients with TBI. ⋯ This study shows that it is feasible to obtain high-quality ONSD measurements in the management of patients with TBI in a prehospital setting. A randomized study evaluating the usefulness of ONSD to guide management of TBI in the prehospital phase may be of great interest.
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The purpose of the current study was to describe the injury patterns, EMS response and interventions to mass shooting (MS) and active shooter (AS) incidents. ⋯ MS and AS incidents are prevalent in the United States. Despite the fact that extremity wounds were common, documented EMS tourniquet use was uncommon. While MS events are high risk for responders, dispatch information was lacking in almost 15% of records. Responding EMS agencies were diverse, emphasizing the need to ensure all EMS providers are prepared to respond to MS incidents.