Showing papers in "EMS world in 2013"

Hyperglycemia and what to do about it

Abstract: Diabetes mellitus is on incredibly complex disease and impacts millions of Americans. The pancreas and insulin are both key to normal glucose metabolism and glucose control.Nearly any body stressor that alters a patient's metabolism can impair normal insulin function and trigger hyperglycemia. It is prudent to check blood sugar in all patients with suspected serious illness, whether or not they have diabetic histories. Hyperglycemia can affect any patient and is a predictor of increased mortality if not treated early. Diabetic ketoacidosis has a more rapid onset than a hyperosmolar hyperglycemic state and often presents with a comparatively lower blood sugar and the presence of acidosis. HHS does not present with profound acidosis and has a slower onset, yet more profound dehydration and a higher blood sugar. Do not underestimate the need for early prehospital intervention with hyperglycemia. Early and aggressive IV fluid administration can improve patient outcomes and speed recovery.

Umbilical vein catheterization in the critical newborn: a review of anatomy and technique.

Abstract: Why attempt a UVC line when intraosseous access is often available and the literature has demonstrated its ease of placement and effectiveness even in neonates? This article is not intended to suggest giving up IO vascular access if you currently have it in your toolbox. The intent was to discuss an alternative to IO vascular access when it fails--for example, when a tibia is fractured during an IO attempt or is not an option for other reasons. The Fast-Cath UVC is another tool in the advance EMS clinician's arsenal that can be easily learned and utilized. It is an effective option for vascular access in the distressed newborn when other options have failed or are not available.

What's in your all-hazards plan? In Boston they were prepared. Are you?

Abstract: The best EMS major incident response program comes from excellent day-to-day delivery of care, combinbed with common sense preparedness and an excellent relationship with hospitals, law enforcement and regional public health officials. Expansion of a few physical assets, understanding the regional resources that can be utilized for major incidents, and routine use of an incident management system will lay the necessary groundwork for a major terrorist incident response. System leaders must consider the adaptation of triage efforts and response, with security and responder safety issues becoming an immediate consideration.

FInding a new seat at the healthcare table.

Abstract: Editor’s note: Some of EMS’s most influential leaders believe the concept of mobile integrated healthcare practice has the potential to change not just what EMS calls itself, but how emergency care is delivered and reimbursed It’s so important that we’re presenting a special in-depth report on the topic here Next month we’ll hear more from Eric Beck, OD, medical director for the City of Chicago EMS System and Chicago Fire Department and one of the leading advocates for this emerging concept — Keith Griffiths