Articles: emergency-medicine.
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Editorial Comment Review
Computerized simulation technology for clinical teaching and testing.
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To assess regulatory trends in EMS medical direction by examining state EMS legislation and regulations, and legal qualifications for medical direction. ⋯ There is tremendous variation in regulatory requirements for physician participation in EMS medical direction activities at the ALS level. Few states have specific training or background requirements for the provision of OLMC, and a requirement for board certification in emergency medicine is the exception, not the rule.
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Randomized Controlled Trial Clinical Trial
Optimization of glottic exposure during intubation of a patient lying supine on the ground.
Two methods of endotracheal intubation of patients lying on the ground were compared for ease and speed of intubation and minimization of complications in a crossover study of prehospital-oriented emergency physicians. Intubation of a mannequin was attempted by the physicians in either a left lateral decubitus (LLD) position or a kneeling (K) position, followed by the alternate position. ⋯ Intubation times were 10.5 versus 14.6 seconds in the LLD and K positions, respectively (P < .001). The LLD position is a more effective position (in a mannequin model) than the K position for intubation of patients found lying on the ground, a frequent situation in prehospital care.