Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Very little is known about prehospital providers' knowledge regarding anaphylaxis care. ⋯ Whereas a large percentage of the paramedics recognized classic anaphylaxis, a very small percentage recognized atypical anaphylaxis. Less than half chose epinephrine as the initial drug of choice, and most respondents were unable to identify the correct route/location of administration. This survey identifies a number of areas for improved education.
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To identify and investigate the barriers and enablers perceived by paramedics regarding the administration of analgesia to pediatric emergency medical services (EMS) patients. ⋯ We have identified a number of previously unrecognized barriers to and enablers for prehospital pediatric analgesia. The majority of these factors lead to an overall preference of paramedics to defer administration of analgesic agents. A number of educational and EMS system changes could be made to address these barriers and increase the frequency of appropriate pediatric prehospital analgesia.
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Comparative Study
Potential adverse effects of spinal immobilization in children.
The purpose of our study was to describe potential adverse effects associated with spinal immobilization following trauma among children. ⋯ Despite presenting with comparable PTSs and GCSs, children who underwent spinal immobilization following trauma had a higher degree of self-reported pain, and were much more likely to undergo radiographic cervical spine clearance and be admitted to the hospital than those who were not immobilized. Future studies are warranted to determine whether these differences are related to spinal immobilization or differences in the mechanisms of injury, injury patterns, or other variables.
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Burning Man is a large weeklong outdoor arts festival held annually in the rugged and austere Black Rock Desert in northern Nevada. The 2011 event presented several unusual challenges in terms of emergency medical services (EMS) and medical care provision. ⋯ We describe the preparation and medical care for a large outdoor mass-gathering event held in a remote and austere environment. We met the stated goals of providing needed medical care while minimizing the need to transport attendees offsite for additional care. Our experience with Burning Man 2011 may aid planners with similar events.
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Practice Guideline
Termination of resuscitation for adult traumatic cardiopulmonary arrest.
The National Association of EMS Physicians (NAEMSP) and the American College of Surgeons Committee on Trauma (ACS-COT) believe that emergency medical services (EMS) systems should have protocols that allow EMS providers to terminate resuscitative efforts for certain adult patients in traumatic cardiopulmonary arrest. This document is the official position of the NAEMSP and ACS-COT.