JEMS : a journal of emergency medical services
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Femoral shaft fractures can present many challenges to health-care providers from the time of injury to the time of discharge and beyond. Ongoing assessment and definitive interventions prove successful in limiting additional morbidity and mortality.
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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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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.