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Organizing the community for pediatric trauma
Published in David E. Wesson, Bindi Naik-Mathuria, Pediatric Trauma, 2017
Eric H. Rosenfeld, Arthur Cooper
Pediatric trauma resuscitation should begin as soon as possible after the injury occurs, ideally through pediatric-capable emergency medical dispatchers who provide prearrival instructions to lay rescuers at the scene. It continues with the arrival of prehospital professionals, including first responders, emergency medical technicians (EMTs), and paramedics. Prehospital treatment protocols utilized by these emergency medical personnel should be conservative yet permissive, emphasizing basic life support modalities such as supplemental oxygen and assisted ventilation via bag and mask, only providing advanced life support interventions such as ETI and volume resuscitation when appropriate [115]. Pediatric prehospital trauma care emphasizes aggressive support of vital functions during what has been called the “platinum half hour” of early pediatric trauma care [116].
State Requirements for Medical Directors in the United States
Published in Prehospital Emergency Care, 2023
Travis Sharkey-Toppen, Jordan D. Kurth, Osama Saadoon, Betty Yang, Emily Gibbons, Jonathan R. Powell, Ashish R. Panchal
It is surprising to note that EMS medical director expectations on the state level are not well aligned or consistently defined. This is true for duties that are considered common for EMS medical directors including EMS oversight, EMS clinician training, EMS credentialing, and quality improvement and assurance. This is particularly surprising in the face of many existing position statements providing guidance on the definition of the EMS medical director including those from the American College of Emergency Physicians (4), National Association of EMS Physicians (3), and Federal Emergency Management Agency (5). In the FEMA document, these core qualifications are itemized to include not only licensure and possible board certification in emergency medicine, but also include details of administrative and legislative processes in EMS, understanding of emergency medical dispatch, education of prehospital clinicians, involvement in quality improvement, and knowledge of mass casualty and disaster plans. Based on this knowledge, in our data, it is surprising to note that the requirement for medical directors to engage in educational activities is not present in 15 states, and quality assurance is missing in 18 states. The inconsistencies in state rules, regulations, and legislation regarding the qualifications and duties of EMS medical directors have the potential to affect the quality of medical direction in communities, as well as the availability of medical directors to support EMS educational programs.
Emergency Call Characteristics and EMS Dispatcher Protocol Adherence for Possible Anaphylaxis
Published in Prehospital Emergency Care, 2019
Kathleen Grisanti, Lisa Martorano, Margaret Redmond, Rebecca Scherzer, Kasey Strothman, Lauren Malthaner, James Davis, Songzhu Zhao, David Kline, Julie C. Leonard
We included all patient calls to one Franklin County, Ohio emergency dispatch center for which Columbus Division of Fire EMS responded. Columbus Division of Fire, a Committee on Fire Accreditation International accredited organization and transport agency, encounters over 164,000 patients annually. All Columbus Division of Fire dispatchers are required to be at least an Emergency Medical Technician, and be Emergency Medical Dispatch and Emergency Fire Dispatch certified. Columbus Division of Fire uses ProQA Dispatch Software, and all dispatchers are certified in this software, with recertification every 2 years. From these calls, we limited our analysis to those with a clinical impression of an “allergic reaction” or “difficulty breathing related to a suspected allergic reaction” as determined by the EMS dispatcher. We limited to these 2 clinical impressions because by definition, they are appropriate to triage by the Allergies/Envenomations or Breathing Problems protocols. We excluded calls if there was not a direct interaction between the EMS dispatcher and the caller. For example, calls between medical personnel or calls that were transferred prior to information exchange were excluded.
Joint Statement on Lights & Siren Vehicle Operations on Emergency Medical Services Responses
Published in Prehospital Emergency Care, 2022
Douglas F. Kupas, Matt Zavadsky, Brooke Burton, Shawn Baird, Jeff J. Clawson, Chip Decker, Peter I. Dworsky, Bruce Evans, David Finger, Jeffrey M. Goodloe, Brian LaCroix, Gary G. Ludwig, Michael McEvoy, David K. Tan, Kyle L. Thornton, Kevin Smith, Bryan R. Wilson
Emergency medical dispatch (EMD) protocols have been proven to safely and effectively categorize requests for medical response by types of call and level of medical acuity and urgency. Emergency response agencies have successfully used these EMD categorizations to prioritize the calls that justify a L&S response. Physician medical oversight, formal quality improvement programs, and collaboration with responding emergency services agencies to understand outcomes is essential to effective, safe, consistent, and high-quality EMD.