Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Immobilizing a child presents a unique challenge for emergency medical services (EMS) personnel in addition to those challenges faced when immobilizing an adult. Most equipment commonly carried by EMS personnel is sized for adult use and as a result does not routinely provide adequate static or dynamic immobilization of a child. ⋯ An ideal pediatric immobilization device would be one that uses an existing piece of equipment, is of limited additional cost, is routinely used by EMS providers, could be easily modified to immobilize a child, could easily be taught to EMS providers, and provides excellent static and dynamic immobilization. The Kendrick extrication device (KED) used as the authors describe meets these goals of an ideal pediatric immobilization device.
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The need for valid and reliable emergency medical services (EMS) data has long been recognized. EMS data are useful for monitoring resources and operations, documenting patient care and outcome, and evaluating injury prevention strategies. The goal of this project was to develop a computerized data set with the capability to generate a patient care record (PCR) to overcome some of the current EMS data limitations. ⋯ This computerized approach overcomes many limitations inherent with using paper-based systems for research. Linked with emergency department, hospital discharge, and mortality data, EMS data can be used in systems analyses related to patient outcome.
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To examine the practice of clinically "clearing" the cervical spine (c-spine) of trauma patients brought to the ED by EMS with cervical immobilization in place, and to examine developing trends in prehospital c-spine clearance. ⋯ There is tremendous variation in the ED practice of clinically clearing cervical spines. This, and a lack of support from many ED directors, may hinder attempts at development of research and standardized protocols for pre-hospital c-spine clearance.
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The authors have successfully implemented automated external defibrillation (AED) training in police departments that function as first responders. The initial elements are to think the project through, and to develop clear policies and procedures for the police as they relate to dispatching so there is timeliness of notification, because response time is such a critical element. ⋯ A system to evaluate training, compliance with protocol, and efficacy must be developed and closely monitored. While this is a tremendous amount of work and a large time investment, the result can be a dramatic increase in patient survival.
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The therapeutic window for intervention in acute cerebral ischemia is brief. Prehospital identification of acute stroke patients and paramedic administration of neuroprotective agents may soon become critical components of successful acute stroke treatment. This preliminary study sought to demonstrate that a new prehospital screening instrument, the Los Angeles Prehospital Stroke Screen (LAPSS), sensitively identifies acute stroke patients. Further, the study evaluated the potential time savings that could be achieved by paramedic administration of neuroprotective agents in the field. ⋯ The LAPSS sensitively identifies ambulance-arriving acute stroke patients, and a substantial time savings will potentially occur if neuroprotective agents are administered by paramedics in the field. The LAPSS is a promising tool that may enable paramedic recognition of stroke with a high degree of sensitivity and simplicity in a short period of time.