JEMS : a journal of emergency medical services
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Brain injury, specifically TBI, is a common occurrence in our society, with devastating physical, emotional, social and economic costs. Injury not only occurs on initial impact, but also develops slowly over ensuing hours or days. ⋯ Serial assessment, particularly of the GCS and pupillary changes, is vital in continuing to monitor patient status. All treatment associated with the TBI patient is aimed at restoring CPP and allowing oxygenated blood to reach injured brain tissues.
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Humans are warm-blooded mammals and must maintain a constant internal temperature. Body temperature is controlled by the hypothalamus in the brain, with input from sensory receptors throughout the body. At any given time, body temperature is a function of heat production and heat loss. ⋯ EMTs and paramedics must be familiar with the physiological and pathophysiological processes resulting from these disorders. By close observation of the patient, it should be fairly easy to determine which underlying processes are causing the observed signs and symptoms. With this knowledge, you can provide competent, compassionate prehospital care.
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Every EMT, paramedic, supervisor and EMS medical director must stress that our job is to treat every patient the way we'd like to be treated or the way we'd want one of our family members treated. Those charged with supervision must ensure that EMTs and paramedics receive the support and training necessary to allow adherence to the 10 objectives outlined in this article. Quality-assurance reviews, quality-improvement programs, provider comments and complaints from the public must all be used to improve the care we deliver. Prehospital care should be constantly improving the delivery of excellent, life-saving care.
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Decisions must be made rapidly in the field when assessing trauma patients. Acronyms, such as ESCAPE, can help you remember important facts and aid your assessment. ⋯ But don't play guessing games with trauma victims. Use a systematic approach to quickly assess your trauma patients and determine the need to transport them to a trauma center.