EMS support of executive protection and counter-terrorism operations
Jan de Boer, Marcel Dubouloz in Handbook of Disaster Medicine, 2020
The decision to provide medical training to individual team members versus recruiting or contracting with a physician, an EMT (emergency medical technician) or Paramedic to provide support is complex. Selecting a physician for these types of ‘special operations’ is often centred around items such as specialty training, cost, and availability. In reality, participation in these types of activities involves ‘hours of boredom, and seconds of terror’. It thus is sometimes difficult to select a single individual who would be able to provide all of the essential skill levels and capabilities. During routine activities, a family practitioner, internal medicine specialist or even someone with a preventative medicine background is often more useful. However, during the time of threat exposure, specialists in trauma/EMS (i.e. anaesthesiologists, surgeons, etc.) have proven value.
The management of major injuries
Ashley W. Blom, David Warwick, Michael R. Whitehouse in Apley and Solomon’s System of Orthopaedics and Trauma, 2017
Provision of a pre-hospital EMS depends on economic resources and varies from no provision in rural, low-income countries to sophisticated services linked to hospital care in developed economies. The EMS in most countries is based on ambulances crewed by emergency medical technicians (EMTs) or paramedics with support from pre-hospital emergency medicine doctors varying between countries. The most integrated system is probably the French Services de l’Aide Medical Urgente (SAMU): all emergencies are triaged by a control room team, which includes a doctor, and an appropriate response is mounted. For major cases, intervention is provided by Services Mobile d’Urgence et de Reanimation (SMUR) teams — hospital-based medical teams with sophisticated equipment and access to a range of transport including helicopters. SMUR teams can deliver an advanced level of care on scene with rapid transfer to an appropriate hospital and European experience is that a doctor-led pre-hospital service leads to a 2.8-fold improvement in mortality for seriously injured patents. However, the service is very expensive and demands a high number of experienced medical staff. In the UK, medical support in the pre-hospital environment comes primarily from Helicopter Emergency Medical Service (HEMS) doctors working with charitably funded air ambulances.
A Brief Review of Cancer
C.S. Sureka, C. Armpilia in Radiation Biology for Medical Physicists, 2017
Generally, EMT has been categorized into three types. They are types I, II, and III transitions. Type I transition is responsible for the development of many tissues and organs during embryogenesis. Type II transition is responsible for fibrosis and wound healing. Type III transition induces cancer due to change in the gene expression of the stem cells. The normal gene expression can be changed due to growth factor–mediated crosslinking between signaling pathways, transcription factor–mediated depression, down-regulation or silencing of E-cadherin, change in the expression of microRNAs, etc.
Developing a Cancer Care and Community Paramedicine Partnership
Published in Oncology Issues, 2022
Michele Goodman, Scott A. Kasper
Paramedics or emergency medical technicians (EMTs) are traditionally trained to deal with acute medical emergencies. When these professionals arrive on scene, they take charge, quickly develop a plan of care, implement and execute that plan, and then move on to the next patient. This is in contrast to the world of mobile integrated health, in which clinical practice is more akin to nursing than to traditional paramedicine. However, because the Albuquerque Ambulance Service’s Mobile Integrated Health EMTs are among the senior-most staff, their ability to adapt to a different modality of care was quickly demonstrated. In addition, the Mobile Integrated Health team easily understood the value that their expertise offered the healthcare system and patients. Therefore, the staff’s support for the program and their comfort level performing the required skills was high.
Death by Suicide—The EMS Profession Compared to the General Public
Published in Prehospital Emergency Care, 2019
Neil H. Vigil, Andrew R. Grant, Octavio Perez, Robyn N. Blust, Vatsal Chikani, Tyler F. Vadeboncoeur, Daniel W. Spaite, Bentley J. Bobrow
Occupation on death records are recorded in a free text field. All AZ-EDR records during the study period were categorized into 2 groups: EMTs and non-EMTs. EMTs consisted of any occupation providing emergency medical care that required an EMT certification. All occupations including firefighter, fireman, emergency medical technician, EMT, and paramedic were included in the EMT cohort (Appendix 1, see online supplement). Additionally, all occupation free text fields from our population were manually reviewed for occupations involving emergency medical care. Any occupations that were uncertain for needing EMT certification were adjudicated by the investigators. If EMT certification could not be determined from the listed occupation or text, the subject was categorized as non-EMT. All other occupations were included in the non-EMT cohort. Additionally, records with a blank occupation field were included in the non-EMT cohort.
Demography of the National Emergency Medical Services Workforce: A Description of Those Providing Patient Care in the Prehospital Setting
Published in Prehospital Emergency Care, 2021
Madison K. Rivard, Rebecca E. Cash, Christopher B. Mercer, Kirsten Chrzan, Ashish R. Panchal
This was a cross-sectional evaluation of nationally certified EMS professionals in the United States who recertified their National EMS Certification between October 1st, 2017 to March 31, 2018 or October 1, 2018 to March 31st, 2019. There are four levels of National EMS Certification, provided by the National Registry of Emergency Medical Technicians, that comprise the workforce: emergency medical responder (EMR), emergency medical technician (EMT), advanced EMT (AEMT) and paramedic (6). National certification is required for initial licensure at one or more certification level for more than 46 states, territories, and federal agencies (7). Continuous certification, including biennial recertification, is voluntary; however, ten states require National EMS Certification to maintain state EMS licensure at one or more certification levels. These “recertification states” include Alabama, Louisiana, Massachusetts, Minnesota, New Hampshire, North Dakota, South Carolina, Vermont, West Virginia, and Utah. The National EMS Certification database contains a list of essentially all EMS professionals within these states who are certified and licensed.
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