Showing papers in "EMS world in 2012"

Are you under stress in EMS. Understanding the slippery slope of burnout and PTSD.

Abstract: Burnout and PTSD are closely linked and often underreported in EMS. EMS classrooms do little or nothing to prepare providers for the inherent emotional stresses of emergency response and the "thick skin" culture of EMS may make many providers apprehensive about sharing their true feelings. Burnout is triggered by many of the same stresses that lead to the symptoms of PTSD and providers experiencing burnout that doesn't resolve within a few weeks may actually be experiencing PTSD. Be mindful of yourself and your fellow coworkers, particularly after a very traumatic response. And remember traumatic responses don't need to be as dramatic as Sept. 11, New Orleans after Hurricane Katrina or the Aurora, CO shootings to bother an EMS worker. In contrast, these are the calls where providers often receive the most attention. Instead, watch for the new father who just performed CPR on an infant the same age as his own, or the provider who just watched his or her friend die following a motor vehicle collision. Pay attention to yourself and colleagues, and be responsible and honest with yourself and others about when coping strategies are enough, and when they aren't. Finally, don't ever be afraid to seek help.

Why we need to rethink C-spine immobilization: we need to reevaluate current practices and develop a saner cervical policy.

Abstract: | By Karl A. Sporer, MD, FACEP, FACP We need to reevaluate current practices and develop a saner cervical policy T he spinal immobiliza- tion of trauma patients suspected of having spinal injury has been a cornerstone of prehos- pital care for decades. Current prac- tices are based on the belief that a patient with an injured spinal column can deteriorate neurologically without immobilization. This concern has ballooned to include large numbers of patients with little or no chance of such an injury and caregivers with little appreciation for the complica- tions caused by use of the cervical collar and spinal board. Somewhere between 1 million and 5 million patients receive spinal immobiliza- tion each year in the United States. 1,2 The injury of concern is not the cervical spine fracture but the unstable cervical fracture with the potential for further neurological deficits. 3 It is clear that among severely traumatized patients admitted to hospitals, the rate of cervical spine fractures is 2%–5% and the rate of unstable cervical frac- tures is 1%–2%. 4–6 For patients with head injuries, the rate of cervical spine injuries increases substantially. 7 Among patients with known unstable cervical spine fractures, half in one study demonstrated neurological deficits upon hospital arrival. 8 Most clinicians would agree that this high-risk group would benefit from spinal immobiliza- tion, and we are truly concerned about that 0.5%–1% with unstable cervical spine fractures and intact spinal cords. It is logical that among patients with lesser mechanisms of injury, the NOVEMBER 2012 | EMSWORLD.com Trauma Types and Cervical Injury Rates Clinical Group Cervical Fractures Cervical Cord Injuries Polytrauma All blunt trauma Blunt assault Penetrating trauma

Managing unstable musculoskeletal injuries

Abstract: Musculoskeletal injuries are commonly treated by prehospital providers. The American College of Surgeons Committee on Trauma supports the early management of musculoskeletal injuries including analgesia, repositioning and splint application. Even when patients have multiple injuries, it is important to apply splints to reduce internal bleeding, pain and the potential for fatty embolisms. Strongly consider administering analgesia to any patient with a suspected musculoskeletal injury; the majority of these patients go on to receive analgesia in the hospital while their time in the ambulance is likely the most uncomfortable period of their care. When applying a splint, remember that effective splints are complete, compact and comfortable.

How obesity impacts patients health and EMS. EMS systems need to know how to handle the increase in bariatric patients.

Abstract: Obesity is a serious disease that poses many problems for EMS. Morbidly obese patients do not fit on standard EMS equipment and the need for the safe transport of obese patients is rising. In addition to posing many logistical dilemmas, obese patients are prone to many serious medical conditions that are likely to increase their exposure to EMS systems. Prepare yourself and your program for the management and transport of obese patients by designing a safe patient transport model and policy with protocols geared toward the obese patient.

Pediatric spinal cord injuries: anatomical differences bring different challenges with kids.

Abstract: Roughly 2,000 U.S. children experience spinal column injuries annually. However, thousands more present to emergency departments with mechanisms of injury that could injure their spine. When children can follow commands and understand questions, performing a careful and accurate spine assessment may eliminate the need for unnecessary spine immobilization. When a spine injury is suspected, proper pediatric immobilization requires careful control of the spine's weight centers and proper padding to ensure the spine remains in a neutral position.

Oxygen toxicity. What EMS providers need to know about possible complications from oxygen administration.

Abstract: The administration of oxygen is safe and effective for patients who are in respiratory distress or who are hypoxic. Never feel that oxygen needs to be withheld. However, keep in mind that there are real consequences to the long-term utilization of high-flow oxygen. To help prevent potential complications from oxygen administration, reach for the nasal cannula before the non-rebreather mask, and apply just enough oxygen to maintain normal saturations.

Expanding access with text-to-9-1-1.

Abstract: In spite of federal funds poured into local systems to upgrade communications and improve interoperability after 9/11, there are still holes.