Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Injuries from assaults on paramedics and firefighters in an urban emergency medical services system.
To determine the nature and frequency of injuries resulting from assaults on paramedics and firefighters in a large, fire department-based emergency medical services (EMS) system. ⋯ In this EMS system, injuries resulting from assaults were uncommon. However, due to their potential impact on the victims and the EMS system as a whole, policies and procedures should be developed to minimize these incidents.
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This ten-year longitudinal study examines various attributes and demographic characteristics of emergency medical technicians (EMTs) and paramedics to identify factors that influence their careers, to identify trends in emergency medical services (EMS), and to provide data on why individuals report leaving the EMS career field. ⋯ The initial EMT and paramedic attribute and demographic data have been collected, analyzed, and reported. The longitudinal nature of this study requires further data collection and analysis to accurately present trends in EMS, as well as correlations and associations between identified attributes and other factors that influence the careers of EMTs and paramedics. Further reports of the findings will be necessary.
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To evaluate the effect of a new protocol allowing paramedics to administer morphine without a physician order to patients with extremity trauma with respect to time of morphine administration, scene time, morphine amount and number of doses per patient, and proportion of patients receiving morphine. ⋯ A change in protocol that permits trained paramedics to administer morphine without physician approval reduces time to analgesia administration without influencing the amount of morphine delivered per patient or the rate of prehospital morphine use. Further study should measure the effect on base hospital physician interruptions and patient outcome.
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The standard of care for patients following blunt trauma includes midline palpation of vertebrae to rule out fractures. Previous studies have demonstrated that spinal immobilization does cause discomfort. ⋯ This study shows that over time, standard immobilization causes a false-positive exam for midline vertebral tenderness. In order to reduce this high false-positive rate for midline vertebral tenderness, the authors recommend that, initially on arrival to the emergency department, immediate evaluation occur of all immobilized patients. Furthermore, backboards should be modified to reduce patient discomfort to prevent the iatrogenically induced midline vertebral tenderness, thereby reducing subsequent false-positive examinations.