Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Randomized Controlled Trial
Comparison of Two Intraosseous Devices: The NIO Versus the EZ-IO by Novice Users-A Randomized Cross Over Trial.
During resuscitation in the field, intraosseous (IO) access may be achieved using a variety of available devices, often attempted by inexperienced users. ⋯ Novice users were equally successful in establishing IO access with the NIO® in comparison to the EZ-IO® in a porcine model.
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Extracorporeal Cardiopulmonary Resuscitation (ECPR) is now considered for the treatment of refractory cardiac arrest. ⋯ Patients eligible for ECPR must be selected according to strict criteria. Further research is necessary to compare prehospital and in-hospital implementation.
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Each year, 16,000 children suffer cardiopulmonary arrest, and in one urban study, 2% of pediatric EMS calls were attributed to pediatric arrests. This indicates a need for enhanced educational options for prehospital providers that address how to communicate to families in these difficult situations. In response, our team developed a cellular phone digital application (app) designed to assist EMS providers in self-debriefing these events, thereby improving their communication skills. The goal of this study was to pilot the app using a simulation-based investigative methodology. ⋯ These results suggest that an EMS-centric app containing guiding information regarding compassionate communication skills can be effectively used by EMS providers to self-debrief after difficult events in the absence of a live facilitator, significantly altering their near-term communication patterns. Gap analysis data further imply that engaging with the app in a group context positively impacts the accuracy of each team's self-perception.
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Out-of-hospital cardiac arrests (OHCA) in high-rise buildings experience lower survival and longer delays until paramedic arrival. Use of publicly accessible automated external defibrillators (AED) can improve survival, but "vertical" placement has not been studied. We aim to determine whether elevator-based or lobby-based AED placement results in shorter vertical distance travelled ("response distance") to OHCAs in a high-rise building. ⋯ Elevator-based AEDs travel less vertical distance to OHCAs in tall buildings or those with uniform vertical risk, while lobby-based AEDs travel less vertical distance in buildings with substantial lobby, underground, and nearby street-level traffic and OHCA risk.
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Describe prehospital Emergency Medical Services (EMS) providers' beliefs regarding spinal precautions for pediatric trauma transport. ⋯ EMS providers believe that rigid cervical collars and long backboards with soft conforming surfaces provide optimal spinal precautions. There were no consensus beliefs, however, for use of particular precautions based on age and risk factors.