JEMS : a journal of emergency medical services
-
Case Reports
The new ABCs of AV block. A revised classification to remove the mental block from recognizing AV block.
This revised classification system is designed to etch the indicators of a block into your memory. You only have to remember that the degree is the number of atrial beats getting through to the ventricles (all, some or none) and the type is where the block occurs (AV node or septum). Once you learn this system, simply practice interpreting block rhythms (see "AV Block Case Studies," p. 33). ⋯ This is a patient in sinus tachycardia who has received adenosine. Notice how the patient goes from sinus tachycardia to first-degree, type 1 to second-degree, type 1 to second-degree, type 2 and back again. It's a very rare strip that you can use to test your ability--and the ability of your crews--to interpret block rhythms.
-
When it comes to deployment, one size (approach) doesn't fit all. Progressive public safety and EMS systems will recognize that a successful plan can thoughtfully balance system performance and human needs. ⋯ Providing optimum system coverage, improved response times and quality care for patients fits the same mold. Sophisticated and accountable EMS systems readily accept this as part of their mandate.
-
200 city survey. JEMS 2001 annual report on EMS operational & clinical trends in large, urban areas.
This year's survey offered examples of evolving partnerships between the public and EMS providers with a growing number of systems implementing PAD programs. The apparent influence of a communication center's managing agency on prioritization strategies is concerning. However, further study is needed. ⋯ In light of the events of Sept. 11 and events yet to occur, EMS managers and providers face significant operational challenges. Overcoming these challenges will require leadership, a willingness to question and change tradition and the ability to cope with the discomfort of changing demands and uncertainty. Maintaining the hard-fought successes of EMS will increasingly require more imagination and the willingness of current and future practitioners to study, develop and implement innovative approaches to addressing future requirements.