Rhode Island medical journal (2013)
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Emergency medical services (EMS) bring the practice of emergency medicine directly to the homes of patients. Physician guidance of system development and provider practice can enhance the quality of care. This article provides an overview of issues in the development of EMS system oversight in the United States in general, and in Rhode Island.
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Critical care transport (CCT) is the segment of the Emergency Medical Services (EMS) system that transports patients who are critically ill or injured. Nearly 1,000 medical helicopters affiliated with over 300 transport programs, hundreds of fixed-wing aircraft, and many, many ground ambulances assisting adult, pediatric and neonatal CCT teams are operating in the United States.1 This article reviews the history of and indications for CCT, team qualifications, vehicle options, safety, CCT system design, and physician involvement in CCT. It concludes with a brief review of CCT services in Rhode Island.
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Emergency Medical Services (EMS) and Emergency Medicine staff are often described as life-saving providers, but there is no generally accepted objective definition of a life saved by these providers. Therefore, a proposed definition is described. Development of this definition began with conceptual rules, followed by a survey of physician EMS medical directors, and then by the development of a tool to implement the definition, and measure its validity and reliability through a review of 100 critical care transport EMS patient charts.
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Emergency Medical Services (EMS) training and education are vital and vibrant aspects of a young and evolving profession. This article provides a perspective on this effort in the United States and reviews current activity in Rhode Island.
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Prescription drug abuse/misuse in Rhode Island and the US is an epidemic. Chronic pain is often treated with prescription opiates which offer some relief, yet present risks to the patient of dependence, addiction and overdose. Physicians find themselves at times at odds with their patients regarding the management of pain and may feel bullied or pressured regarding prescribing. The Rhode Island Board of Medical Licensure and Discipline recognizes the value of established parameters for responsible and safe prescribing.