Articles: emergency-medical-services.
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Pediatric emergency care · Oct 2024
Highlights From the 2023 Revision of Pediatric Tactical Emergency Casualty Care Guidelines.
In 2023 the Committee for Tactical Emergency Casualty Care (C-TECC) issued updated Pediatric Tactical Emergency Casualty Care (TECC) Guidelines (Guidelines) that focus on the delivery of stabilizing care of children who are the victims of high-threat incidents such as an active shooter event. The Guidelines provide evidence-based and best practice recommendations to those individuals and departments that specifically provide operational medical support to law enforcement agencies caring for children in this uniquely dangerous environment where traditional resources may not be available. This article highlights key takeaway points from the Guidelines, including several updates since the first version was released in 2013. ⋯ The high-threat environment is dynamic and there is competing safety, tactical/operational, and patient care priorities for responders when infants and children are injured. The Guidelines provide recommendations on the type of medical and psychological care that should be considered under each phase of threat and establishes the context for how and why to deliver (or potentially defer) certain interventions under some circumstances in order the maximize the opportunity for a good outcome for an injured pediatric patient. The Guidelines also emphasize the importance of synergizing hospital-based pediatric trauma care with those law enforcement and fire/emergency medical services that may provide field care to children under high-threat circumstances.
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Scand J Trauma Resus · Oct 2024
Frequent callers contacting the Norwegian national emergency medical number 113: a retrospective study.
Calling for help is the first link in the chain of survival; however, few studies have investigated the challenges faced by frequent callers (FCs) to emergency medical communication centres (EMCCs). This study aimed to explore the characteristics of FCs and the nature of their calls to the Bergen EMCC, Norway. ⋯ FCs were common, and more often men. The EMCC dispatched ambulances or admitted patients to hospitals less frequently following these calls. Many of these situations could be handled in other parts of the healthcare system, reducing the burden on EMCCs, and providing more suitable services for FCs. Thus, EMCCs should identify and adjust patient management to match their actual needs.
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Previous investigations comparing intraosseous (IO) and intravenous (IV) epinephrine delivery in out-of-hospital cardiac arrest (OHCA) suggest that epinephrine is oftentimes more expeditiously administered via the IO route, but this temporal benefit doesn't always translate to clinical benefit. However, very few studies adequately controlled for indication and resuscitation time biases, making the influence of first epinephrine route on OHCA outcomes unclear. To determine the association between first epinephrine route and return of spontaneous circulation (ROSC) while controlling for resuscitation time bias and other potential confounders. ⋯ This retrospective analysis of a national EMS database revealed that IO epinephrine was negatively associated with ROSC. Additionally, there appears to be a finite time window during which intravenous epinephrine remains superior to the intraosseous route even if there are brief initial delays in IV drug delivery.