RESUMEN
In continued support of establishing and maintaining a foundation for standards of care, our organizations remain committed to periodic review and revision of this position statement. This latest revision was created based on a structured review of the National Model EMS Clinical Guidelines Version 2.2 in order to identify the equipment items necessary to deliver the care defined by those guidelines. In addition, in order to ensure congruity with national definitions of provider scope of practice, the list is differentiated into BLS and ALS levels of service utilizing the National Scope of Practice-defined levels of Emergency Medical Responder (EMR) and Emergency Medical Technician (EMT) as BLS, and Advanced EMT (AEMT) and Paramedic as ALS. Equipment items listed within each category were cross-checked against recommended scopes of practice for each level in order to ensure they were appropriately dichotomized to BLS or ALS levels of care. Some items may be considered optional at the local level as determined by agency-defined scope of practice and applicable clinical guidelines. In addition to the items included in this position statement our organizations agree that all EMS service programs should carry equipment and supplies in quantities as determined by the medical director and appropriate to the agency's level of care and available certified EMS personnel and as established in the agency's approved protocols.
Asunto(s)
Servicios Médicos de Urgencia , Auxiliares de Urgencia , Técnicos Medios en Salud , Ambulancias , Certificación , HumanosRESUMEN
Survey response is higher when the request comes from a familiar entity compared to an unknown sender. Little is known about how sender influences response to surveys of organizations. We assessed whether familiarity of the sender influences response outcomes in a survey of emergency medical services agencies. Emergency medical services agencies in one U.S. state were randomly assigned to receive survey emails from either a familiar or unfamiliar sender. Both deployment approaches were subsequently used nationwide, with each state selecting one of the two contact methods. Experimental results showed that requests from the familiar sender achieved higher survey response (54.3%) compared to requests from the unfamiliar sender (36.9%; OR: 2.03; 95% CI: 1.23, 3.33). Similar results were observed in the subsequent nationwide survey; in states where the familiar sender deployed the survey, 62.0% of agencies responded, compared to 51.0% when the survey was sent by the unfamiliar sender (OR: 1.57; 95% CI: 1.47, 1.67). The response difference resulted in nearly 60 additional hours of staff time needed to perform telephone follow-up to nonrespondents. When surveying healthcare organizations, surveyors should recognize that it is more challenging to obtain responses without a pre-established relationship with the organizations.
Asunto(s)
Servicios Médicos de Urgencia , Humanos , Encuestas y CuestionariosRESUMEN
Airway management is as easy as your ABCs: Assess the airway for adequacy, blockages and sixth-sense concerns; use basic skills to position, utilize adjuncts and suction the airway; and control the airway with endotracheal intubation, alternative airways, or, when all else fails, invasive and surgical airways. It is the responsibility of every provider, regardless of certification level, to manage a patient's airway in the most effective way possible. When it's done in an organized manner, quickly, properly and effectively, considering all options of care, both patient and provider will be able to take a deep breath of relief.
Asunto(s)
Servicios Médicos de Urgencia , Intubación Intratraqueal/métodos , Educación Continua , Humanos , Intubación Intratraqueal/instrumentación , Triaje , Estados UnidosRESUMEN
Prehospital providers who are trained to access and utilize existing CVADs, including Groshong, Hickman, Broviac, PICC lines and implanted ports, will be able to establish rapid i.v.s. The CVADs, which should be used in critical scenarios like shock, cardiac arrest and critical medical conditions, will allow EMS to administer medications and fluids to patients in whom i.v. access may otherwise be impossible. Providers should review with their medical directors the feasibility and practical application of using these devices, ensuring they have the correct training and equipment to use these potentially lifesaving devices.