Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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We present a case of failed prehospital treatment of fentanyl induced apnea with intranasal (IN) naloxone. While IN administration of naloxone is becoming more common in both lay and pre-hospital settings, older EMS protocols utilized intravenous (IV) administration. ⋯ In order to contribute to our understanding of the strengths and limitations of IN administration of naloxone, we present a case where it failed to restore ventilation. We also describe peer reviewed literature that supports the use of IV naloxone following heroin overdose and explore possible limitations of generalizing this literature to opioids other than heroin and to IN routes of administration.
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Studies from Australia, Sweden, the United States, and elsewhere have found that paramedics experience violence in the emergency medical services (EMS) workplace. The objective of this study was to describe and explore violence experienced by paramedics in the ground ambulance setting, including types of violence experienced, by whom the violence was perpetrated, actions taken by paramedics, and effects of these episodes. ⋯ The majority of Canadian paramedics surveyed experience violence in the workplace, which can lead to serious personal and professional sequellae. Strategies should be devised and studied to reduce violent events toward paramedics and to mitigate the impact such events have on the wellbeing of paramedics.
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Observational Study
Paramedics Accurately Apply the Pediatric Assessment Triangle to Drive Management.
To provide an evaluation of the Pediatric Assessment Triangle (PAT) as an assessment tool for use by paramedic providers in the prehospital care of pediatric patients. ⋯ The PAT is a rapid assessment tool that can be readily and reliably used by paramedics in the prehospital setting. The PAT should be used in conjunction with other assessments but can safely drive initial field management.
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Comparative Study
A Comparative Assessment of Adverse Event Classification in the Out-of-hospital Setting.
We sought to test reliability of two approaches to classify adverse events (AEs) associated with helicopter EMS (HEMS) transport. ⋯ We identified a higher level of agreement/reliability in AE decisions utilizing a consensus-based approach for review rather than independent reviews.