Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Immobilizing a child presents a unique challenge for emergency medical services (EMS) personnel in addition to those challenges faced when immobilizing an adult. Most equipment commonly carried by EMS personnel is sized for adult use and as a result does not routinely provide adequate static or dynamic immobilization of a child. ⋯ An ideal pediatric immobilization device would be one that uses an existing piece of equipment, is of limited additional cost, is routinely used by EMS providers, could be easily modified to immobilize a child, could easily be taught to EMS providers, and provides excellent static and dynamic immobilization. The Kendrick extrication device (KED) used as the authors describe meets these goals of an ideal pediatric immobilization device.
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To determine whether paramedics can safely use a spinal clearance algorithm to reduce unnecessary spinal immobilization (SI) in the out-of-hospital setting. ⋯ An out-of-hospital spinal clearance algorithm administered by paramedics can reduce SI by one-third. Any application of a spinal clearance algorithm should be accompanied by rigorous medical supervision.
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The United States Pharmacopoeia (USP) recommends that medication storage temperatures should be maintained between 15 degrees C and 30 degrees C (59 degrees F to 86 degrees F). Concerns have been raised that storage temperatures in EMS may deviate from this optimal range, predisposing drugs to degradation. This study was conducted to determine whether temperatures inside the drug box carried by paramedics aboard a helicopter remained within the range. ⋯ Medications stored aboard an EMS helicopter are exposed to extremes of temperature, even inside a drug bag. Measures are needed to attenuate storage temperature fluctuations aboard aeromedical helicopters.
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To examine the practice of clinically "clearing" the cervical spine (c-spine) of trauma patients brought to the ED by EMS with cervical immobilization in place, and to examine developing trends in prehospital c-spine clearance. ⋯ There is tremendous variation in the ED practice of clinically clearing cervical spines. This, and a lack of support from many ED directors, may hinder attempts at development of research and standardized protocols for pre-hospital c-spine clearance.