Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Each year, 16,000 children suffer cardiopulmonary arrest, and in one urban study, 2% of pediatric EMS calls were attributed to pediatric arrests. This indicates a need for enhanced educational options for prehospital providers that address how to communicate to families in these difficult situations. In response, our team developed a cellular phone digital application (app) designed to assist EMS providers in self-debriefing these events, thereby improving their communication skills. The goal of this study was to pilot the app using a simulation-based investigative methodology. ⋯ These results suggest that an EMS-centric app containing guiding information regarding compassionate communication skills can be effectively used by EMS providers to self-debrief after difficult events in the absence of a live facilitator, significantly altering their near-term communication patterns. Gap analysis data further imply that engaging with the app in a group context positively impacts the accuracy of each team's self-perception.
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Extracorporeal Cardiopulmonary Resuscitation (ECPR) is now considered for the treatment of refractory cardiac arrest. ⋯ Patients eligible for ECPR must be selected according to strict criteria. Further research is necessary to compare prehospital and in-hospital implementation.
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Describe prehospital Emergency Medical Services (EMS) providers' beliefs regarding spinal precautions for pediatric trauma transport. ⋯ EMS providers believe that rigid cervical collars and long backboards with soft conforming surfaces provide optimal spinal precautions. There were no consensus beliefs, however, for use of particular precautions based on age and risk factors.
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National Park Service (NPS) Parkmedics provide medical care in austere environments. The objective of this study was to evaluate the stability of specific medications used by Parkmedics at extremes of temperatures likely to be faced in the field. ⋯ We recommend that EMS providers replace atropine, naloxone, diphenhydramine, fentanyl, and midazolam frequently if they are practicing in low call volume or high-temperature environments. Further studies will be needed to determine if re-dosing midazolam, naloxone, and atropine is the appropriate clinical strategy in this setting if adequate clinical effect is not reached with a single dose.
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Cardiopulmonary resuscitation (CPR) after a drowning episode is performed under fatigue conditions. However, the characterization of CPR in this context is still unknown. Our purpose was to investigate the effect of a 100-m simulated in-water rescue on CPR and physiological parameters in trained certified lifeguards. ⋯ Fatigue induced by the 100-m simulated in-water rescue had a strong physiological expression but a minimal impact on CPR performance. Key words: CPR; fatigue; lifeguards; VO2.