Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Comparative Study
Response interval comparison between urban fire departments and ambulance services.
To measure the response intervals of fire departments compared with ambulance services in three urban centers to determine whether defibrillators should be added to fire vehicles. ⋯ The shorter response interval of fire departments suggests placing defibrillators on fire response vehicles in an effort to decrease the time to defibrillation for cardiac arrest victims in this EMS system.
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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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Although death education is a standard component in most medical schools and nursing programs, few include instruction on dealing with sudden death. Typically, death education courses overlook instruction in areas germane to emergency medicine, e.g., making death notifications, interacting with survivors during the immediate grief period, and reducing professional stress innate to working with newly bereaved persons. ⋯ Topics include death perspectives and awareness, death typology, cultural and religious considerations, communicating with bereaved persons, making death notifications, and dealing with initial grief reactions. Units of instruction are outlined, including educational goals, descriptions of units, teaching strategies, and supplemental readings.
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One of the highest priorities for prehospital emergency personnel is airway management. Several rescuer positions for intubation on the ground have been published. ⋯ Using four case reports, situations in which inverse intubation may be an important tool for successful airway management are discussed. Other uses of the method are listed.
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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.