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Last WordEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
MedStar EMS in Fort Worth, Texas, has started a house call pilot program to cut down on “habitual clients” like the 21 patients responsible for 812 transports in 2008. One patient took 127 trips to the emergency department in one year. (Source: JEMS: Journal of Emergency Medical Services)
Source: JEMS: Journal of Emergency Medical Services - November 1, 2009 Category: Emergency Medicine Tags: Last Word Source Type: journals

Holiday AlgorithmicsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I doubt anyone can argue that EMS medical procedures are more complex today than they used to be. We no longer lump all our patient care into the one simple (but fun) formula of driving all those we encounter on scene to the hospital in an insanely fast manner. EMS care has also become more sophisticated in its patient billing collection process. No, wait … I mean, it's become more of a scientific art form. (Source: JEMS: Journal of Emergency Medical Services)
Source: JEMS: Journal of Emergency Medical Services - November 1, 2009 Category: Emergency Medicine Authors: Steve Berry Tags: The Lighter Side Source Type: journals

Rapid Sequence Intubation & Rapid Sequence Airway: An Airway 911 GuideEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
By the author's own admission, this isn't a comprehensive airway management text but is instead designed as an adjunct to a rapid sequence intubation (RSI) course. The text is written in a very relaxed, conversational tone and presents the fundamental elements of RSI and rapid sequence airway (RSA) management. RSA differs from RSI in that it deals with the placement of non-visualized airways, such as the Combitube and King airway, instead of the endotracheal tube. (Source: JEMS: Journal of Emergency Medical Services)
Source: JEMS: Journal of Emergency Medical Services - November 1, 2009 Category: Emergency Medicine Authors: Keith Wesley Tags: Hands On Source Type: journals

Resuscitate! How Your Community Can Improve Survival from Sudden Cardiac ArrestEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We've all heard the old adage that in sudden cardiac arrest, “Time is muscle,” and we've looked for ways to improve our systems of care, especially in regard to cardiac arrest. In Resuscitate!, Dr. Eisenberg provides us with 25 steps we can take to improve cardiac arrest survival in our communities. He answers two main questions: 1) Why do some communities have excellent survival rates, while others don't? and 2) What can be done to improve the chances of survival? Although this book is geared for EMS administrators and medical directors, every reader will take something away. (Source: JEMS: Journal of Emergency Medical Services)
Source: JEMS: Journal of Emergency Medical Services - November 1, 2009 Category: Emergency Medicine Authors: Mark Meredith Tags: Hands On Source Type: journals

ET Passing Made EasyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The inherent difficulty with laryngoscopy is that you have to look around a natural curve. Knowing the endotracheal tube is correctly placed in the trachea requires that you watch the tube pass through the vocal cords. Studies have also shown that paramedics are not as proficient with intubation of children and infants. The pediatric and infant-sized AIRTRAQ from King Systems is an optical, periscope-type device that allows you to look around the corner of the airway. It's color-coded, easy to use and designed to fit ETT sizes from 2.5–3.5 and 4.0–5.5. You simply select the proper size AIRTRAQ and ETT, load the ETT int...
Source: JEMS: Journal of Emergency Medical Services - November 1, 2009 Category: Emergency Medicine Tags: Hands On Source Type: journals

Know Who Has WhatEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Who has pager number XYZ123? Which staff members have outdated safety gear? Why didn't I start that database program we talked about? An electronic database to manage all the EMS equipment in your department can make tracking, upgrading and budgeting of issued equipment much easier. The Equipment Inventory Module from eSchedule not only allows you to track equipment items assigned to each member or employee, but also contains versatile reporting features that allow you to manage inventory and track budget controls. (Source: JEMS: Journal of Emergency Medical Services)
Source: JEMS: Journal of Emergency Medical Services - November 1, 2009 Category: Emergency Medicine Tags: Hands On Source Type: journals

Save Their BacksEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I know a number of former EMTs and paramedics who had their “last straw” back injury while stooping to remove equipment from an ambulance compartment. Installing Emergency Vehicle Cargo Trays from R-O-M Corporation may have prevented these injuries. These cargo trays allow personnel to slide the equipment out from the compartment and use better lifting techniques. The trays have a handle along their entire width'which provides single-handed access'and heavy-duty, v-groove sealed bearings ensure smooth operation. The Cargo Tray requires minimal maintenance: Simply keep the track clean and lubricated, and you'll have lif...
Source: JEMS: Journal of Emergency Medical Services - November 1, 2009 Category: Emergency Medicine Tags: Hands On Source Type: journals

Emesis ControlEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Emesis Management Specialist'many of my “civilian” friends think that's what EMS stands for. Face it, if you can't handle puke, EMS may not be for you. The new Barf Bib gives you one more item in your toolbox for handling one of the most serious indicators of a bad shift. The new Barf Bib has many features that can make mincemeat out of emesis. It has a tear-resistant Pellan outer shell, so a combative patient can't tear the bag off, and a plastic inner shell provides a leak-resistant barrier. The elastic neck opening provides a quick, secure and comfortable fit for the patient while a flip-up splash guard offers added...
Source: JEMS: Journal of Emergency Medical Services - November 1, 2009 Category: Emergency Medicine Tags: Hands On Source Type: journals

Dell Goes BallisticEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Mobile data computers used in EMS must hold up under the toughest conditions: the temperature extremes of baking in the direct desert sun, the freezing cold of sub-arctic winters, the constant vibrations of a diesel engine, and the spill risks of a crew eating lunch while responding Code 3. Each of these things can wreak havoc on almost any motherboard. However, the Dell Latitude E6400 XFR has a QuadCool Thermal Management System that keeps the processor running cool and fast. The exclusive Ballistic Armor Protection System meets or exceeds real-world and military standards (MIL-STD-810F), and its PrimoSeal technology has ...
Source: JEMS: Journal of Emergency Medical Services - November 1, 2009 Category: Emergency Medicine Tags: Hands On Source Type: journals

Wound WellnessEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
When you think of wound treatment, you likely consider irrigation, a sterile dressing and a bandage as the norm. But EMTs and paramedics working in remote locations and extended deployments, such as mid-ocean oil rigs and combat zones, often have to manage a patient's wound through the entire healing process. Prontosan from B. Braun is an FDA 510(k) approved wound irrigation solution that speeds healing. Prontosan contains polyhexanide and betaine. Polyhexanide is a preservative that prevents bacterial growth, ensuring the solution remains sterile for up to eight weeks. Betaine is a surface active solution that penetrates ...
Source: JEMS: Journal of Emergency Medical Services - November 1, 2009 Category: Emergency Medicine Tags: Hands On Source Type: journals

Cotton ComfortEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
When it comes to uniform pants, we usually have to pick between good looks and comfort. Polyester looks good but is hot in the summer and cold in the winter. Cotton is comfortable but can wrinkle and fade. The upgraded Station Pants and Station Cargo Pants from 5.11 Tactical solve both of these problems. They're made of fade-, shrink- and wrinkle-resistant 8.25-oz. and 100% cotton twill, and they're now vat dyed for improved color retention. They also include the superior 5.11 functionality you've come to expect. The flat-front Station Pant has a hidden thigh-seam pocket for notepads, pens, gloves or a cell phone. The Stat...
Source: JEMS: Journal of Emergency Medical Services - November 1, 2009 Category: Emergency Medicine Tags: Hands On Source Type: journals

2010 Buyer's GuideEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
5.11 Tactical Series® creates innovative products that enhance the safety, speed and performance of fire/EMS, law enforcement and military professionals. Built on a foundation of durability, quality and value, 5.11 leads the industry in delivering functionally innovative gear. Learn more about 5.11—s best-selling station wear, outerwear, footwear and accessories at www.511tactical.com. (Source: JEMS: Journal of Emergency Medical Services)
Source: JEMS: Journal of Emergency Medical Services - November 1, 2009 Category: Emergency Medicine Source Type: journals

A Better Benchmark: Savvy EMS agencies use data to identify, communicate & advocate for their patients' needsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Successful EMS systems don't happen by chance or accident. They exist within their community to serve an important need. This need may be a reliable, timely emergency response to any given location in the community; a dependable, well-trained EMS professional to care for the acutely ill or injured; or a local resource for the mitigation of a natural or manmade disaster. Each of these EMS system components requires ongoing resources, knowledge, expertise and, most importantly, funding. (Source: JEMS: Journal of Emergency Medical Services)
Source: JEMS: Journal of Emergency Medical Services - November 1, 2009 Category: Emergency Medicine Authors: EMS Performance Improvement Center Source Type: journals

Sentimental Journeys: Granting hospice patients one last wishEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The journey began as a standard transfer call with a hospice patient. For the crew, it was an uneventful transport until the patient began struggling to look out the ambulance window. The man said he just wanted to see the fall colors of the Colorado aspens one last time. When the driver heard his request, she immediately turned down a small country road. In an open field, surrounded by vibrant red and yellow aspens, the paramedics opened the doors of their unit and rolled the man out into the sunlight. (Source: JEMS: Journal of Emergency Medical Services)
Source: JEMS: Journal of Emergency Medical Services - November 1, 2009 Category: Emergency Medicine Authors: Teresa Mccallion Source Type: journals

Surviving Cardiac Arrest: ITDs provide optimal blood flow at a critical timeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: JEMS: Journal of Emergency Medical Services)
Source: JEMS: Journal of Emergency Medical Services - November 1, 2009 Category: Emergency Medicine Authors: Kenneth Navarro Tags: CE Article Source Type: journals

Research ReviewEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
MOVEMENT DURING INTUBATION Turner CR, Block J, Shanks A, et al: “Motion of a cadaver model of cervical injury during endotracheal intubation with a Bullard laryngoscope or a Macintosh blade with and without in-line stabilization.” Journal of Trauma. 67(1):61–66, 2009. (Source: JEMS: Journal of Emergency Medical Services)
Source: JEMS: Journal of Emergency Medical Services - November 1, 2009 Category: Emergency Medicine Authors: Elizabeth A. Criss Tags: Research Review Source Type: journals

Stimulus Overload: ‘Video game epilepsy’ causes seizures in young and oldEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Late one evening, Ambulance 463 was dispatched for a 24-year-old patient with a reported change in responsiveness. While en route to the scene, dispatch advised 463 to “step it up” because the family had called back and reported the patient's condition had worsened. (Source: JEMS: Journal of Emergency Medical Services)
Source: JEMS: Journal of Emergency Medical Services - November 1, 2009 Category: Emergency Medicine Authors: Joshua Cox, Eric T. Richardson Tags: Case of the Month Source Type: journals

Trucker Tricks: Tips from long-haul truckersEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Between me and Mike Smith, we've been bangin' away at this column for more than 30 years now. I remember in 1980 it paid for my first typewriter'a used Underwood Five I bought from a college bookstore for $75. (Source: JEMS: Journal of Emergency Medical Services)
Source: JEMS: Journal of Emergency Medical Services - November 1, 2009 Category: Emergency Medicine Authors: Thom Dick Tags: Tricks of the Trade Source Type: journals

Generation Y: Why you can't connectEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Beloit College recently released its “mindset list” for the class of 2013. This list serves as a reminder to educators and other professionals who work with young adults that this age group has a different mentality than others before it, due to the events its members have (and have not) experienced. (Source: JEMS: Journal of Emergency Medical Services)
Source: JEMS: Journal of Emergency Medical Services - November 1, 2009 Category: Emergency Medicine Authors: Gary Ludwig Tags: Leadership Sector Source Type: journals

> Half MAST: Will merger with fire service destroy high-performing EMS system?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In a move described as an attempt to streamline operations and save money, the Kansas City (Mo.) Council has voted to merge Metropolitan Ambulance Services Trust (MAST) directly into the city's fire department. (Source: JEMS: Journal of Emergency Medical Services)
Source: JEMS: Journal of Emergency Medical Services - November 1, 2009 Category: Emergency Medicine Tags: Priority Traffic Source Type: journals

Campaign on WheelsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
[Ambulance signage] is a hot button topic at the moment here in the U.K. The government is introducing foundation trust status to our services, under which services can accept funding from other sources, including corporate advertising on the side of ambulances. At the moment, our ambulances display issues related to EMS, such as violence against ambulance staff. These I am happy to display, but the thought of six-foot billboard on an ambulance sponsored by Pepsi is a difficult one. I feel the question to be answered is, does it lower our professional image? (Source: JEMS: Journal of Emergency Medical Services)
Source: JEMS: Journal of Emergency Medical Services - November 1, 2009 Category: Emergency Medicine Authors: Neil White Tags: Letters Source Type: journals

Campaign on WheelsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I sympathize with these people who cannot strike. If you're right in what you stand for, then stand for it, to the end, no matter what. If you're fighting for what's right, don't compromise values; stay right and suffer the consequences. In the end, you may suffer for it, but you will not have sacrificed yourself in the process. (Source: JEMS: Journal of Emergency Medical Services)
Source: JEMS: Journal of Emergency Medical Services - November 1, 2009 Category: Emergency Medicine Authors: blair4630 Tags: Letters Source Type: journals

Campaign on WheelsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I agree [with JEMS]! Keep politics off of and out of the ambulance. One of the objectives of a strike is to garner public support. There's a fine line between getting the message out and getting public support. Sometimes they go hand in hand, and other times, getting the message out turns the public away, or worse, the message turns people against the profession. Picket lines for example, which are intended to inform the public, sometimes piss them off with overzealous union members harassing drivers and pedestrians. (Source: JEMS: Journal of Emergency Medical Services)
Source: JEMS: Journal of Emergency Medical Services - November 1, 2009 Category: Emergency Medicine Authors: Rob Theriault Tags: Letters Source Type: journals

Campaign on WheelsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: JEMS: Journal of Emergency Medical Services)
Source: JEMS: Journal of Emergency Medical Services - November 1, 2009 Category: Emergency Medicine Authors: asysin2leads Tags: Letters Source Type: journals

He Gave Us All a Lift: Remembering EMS pioneer Richard FerneauEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Dick Ferneau and El Bourgraf were not only partners in the stretcher manufacturing business'they were also best friends. This combination of a work partnership and friendship kept the two innovating around the clock, in and out of the office. One day in 1958, the young founders of the Ferno Manufacturing Co. were invited to their secretary/receptionist/bookkeeper's house for a cold beer as a well-deserved break from their long day at the office. (Source: JEMS: Journal of Emergency Medical Services)
Source: JEMS: Journal of Emergency Medical Services - November 1, 2009 Category: Emergency Medicine Authors: A.J. Heightman Tags: From the Editor Source Type: journals

Rescue on Black FridayEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Volunteer paramedics and firefighters with Orchard Farm (Mo.) Fire Protection District along with Rivers Point (Mo.) Fire Protection District work to extricate a woman who became trapped in her vehicle after it collided with a tree at high speed. The patient, who was semi-conscious during the extrication, suffered internal injuries and fractures, including an obvious femur fracture. St. Charles County (Mo.) Ambulance District Paramedic Supervisor Craig Boschert maintained C-spine immobilization from within the car and placed the patient on O2 via a non-rebreather. After she was extricated, the patient was trauma packaged a...
Source: JEMS: Journal of Emergency Medical Services - November 1, 2009 Category: Emergency Medicine Tags: Call to Action Source Type: journals

JEMS.comEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: JEMS: Journal of Emergency Medical Services)
Source: JEMS: Journal of Emergency Medical Services - November 1, 2009 Category: Emergency Medicine Tags: Load & Go Source Type: journals

Last WordEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Having a diverse EMS workforce fosters patient-provider communication and ultimately better care. However, many EMS organizations are not representative of their local populations, and many in underrepresented groups still can't afford to forgo work to get the necessary training. That all may start to change in St. Paul, Minn., where the fire chief dreamed up an idea to address a lack of diversity and the mayor got on board. (Source: JEMS: Journal of Emergency Medical Services)
Source: JEMS: Journal of Emergency Medical Services - September 30, 2009 Category: Emergency Medicine Tags: Last Word Source Type: journals

Acoustic CoolnessEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Ah, the stethoscope. It's the iconic symbol of power for those working in the health-care industry. It not only transmits the internal sounds of any species with a pulse, but it communicates merit and reverence to its possessor. When slung around the neck in a resting position, it brings instant respect to the bearer of its weight. (Source: JEMS: Journal of Emergency Medical Services)
Source: JEMS: Journal of Emergency Medical Services - September 30, 2009 Category: Emergency Medicine Authors: Steve Berry Tags: The Lighter Side Source Type: journals

Management of EMSEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Whether you're an EMS manager or an aspiring future leader in need of a mentor, Management of EMS is a must-have book. Seasoned EMS professionals Bruce Evans and Jeff Dyar have taken a no-holds-barred approach to this popular topic. The authors go step by step, creating an easy-to-read style. The book explains how to deal with numerous EMS issues as a manager, and more importantly, it will help you further define your own leadership principles. (Source: JEMS: Journal of Emergency Medical Services)
Source: JEMS: Journal of Emergency Medical Services - September 30, 2009 Category: Emergency Medicine Authors: Cameron Bucek Tags: Hands On Source Type: journals

The Real ThingEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Learning how to intubate is hard, and successfully translating the skill from a manikin to a human is even harder. The RespiTrainer Advance from IngMar Medical offers a high level of fidelity to make the human transition easier. The anatomically correct head offers realism in landmarks, skin and airway. The uniquely constructed airway is anatomically correct and has many visually accurate internal features. The “real-feel” skin covering makes for a more realistic bag-mask ventilation training experience, while the neck design allows for accurate articulation. And “mean” instructors can inflate the tongue to make fo...
Source: JEMS: Journal of Emergency Medical Services - September 30, 2009 Category: Emergency Medicine Tags: Hands On Source Type: journals

Under Less PressureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A comfortable patient usually makes for a more enjoyable ride in the back of the ambulance. The WAFFLE Pediatric Cushion from EHOB Inc. provides an easy way to manage pressure sores during transport. The cushion's low-profile air chamber evenly redistributes the patient's weight. By maintaining that air cushion, the WAFFLE keeps the patient stable and comfortable while preventing pressure ulcers. Other recommended usages include protecting the occiput, heel, ear or elbow or between the knees for contracted patients. Also, the cushion's holes naturally circulate air, allowing the patient's skin to breathe. (Source: JEMS: Jo...
Source: JEMS: Journal of Emergency Medical Services - September 30, 2009 Category: Emergency Medicine Tags: Hands On Source Type: journals

For the BoomersEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
As the baby boomer generation continues to age, the numbers of Alzheimer's patients is bound to increase. And, 9-1-1 response to Alzheimer's can lead to many unique situations. Is the fall patient really “disoriented” and in need of a trauma center? Does someone in good physical health who's found wandering the neighborhood unaware of their address need to be transported? The Approaching Alzheimer's Training Program from the Alzheimer's Association will provide first responders with tools to quickly and appropriately respond to people with the disease. Subjects covered include wandering, unsafe driving, use of guns, ab...
Source: JEMS: Journal of Emergency Medical Services - September 30, 2009 Category: Emergency Medicine Tags: Hands On Source Type: journals

Against the WindEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Dealing with any type of wind-chill factor can make for a miserable shift, especially if you end up on a scene that affords no protection from the elements. Elevated highways and waterfronts are a few favorites. The Station Windbreaker from 5.11 Tactical will stop the chill from cutting through your core in classic 5.11 style. Raglan sleeves and full-length underarm gussets allow for a comfortable range of motion. Pen pockets on the left sleeve and ergonomic hand-entry pockets make the windbreaker easy to work in. Lightweight “peached microfiber” blocks the wind and a spandex-enhanced V-neck, cuff and waist help the ri...
Source: JEMS: Journal of Emergency Medical Services - September 30, 2009 Category: Emergency Medicine Tags: Hands On Source Type: journals

Point A to BEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Moving a patient down stairs and through narrow hallways makes for some interesting challenges, which are compounded when the patient is large or needs to be moved quickly. The MegaMover Transport Chair from Graham Medical is made of strong, non-woven material and is designed to support patients up to 350 lbs. Its eight handles allow for ergonomically safe lifting. Easily stored in a kit or an oxygen duffle, the transport chair can be rapidly deployed in circumstances in which an emergent move wouldn't be anticipated. Economically priced for single use, a disposable chair eliminates cleaning and cross-contamination concern...
Source: JEMS: Journal of Emergency Medical Services - September 30, 2009 Category: Emergency Medicine Tags: Hands On Source Type: journals

Cool MagicEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Hyperthermia is one of the major concerns during medical surveillance for hazmat and warm weather fire-ground operations. The cooling process after these operations often leaves providers soaking wet from ice water and towels. The Cool Cloth from Heyltex offers an easy way to cool off without the mess. Simply wet and wring out the reusable cloth, then snap it to activate the mechanism that makes the cloth 32° cooler. The magic of this cooling is even more evident when you use near-scalding hot water to wet the cloth and see that in a snap, it begins to cool and continues to cool for more than an hour. The fabric can also ...
Source: JEMS: Journal of Emergency Medical Services - September 30, 2009 Category: Emergency Medicine Tags: Hands On Source Type: journals

See the VeinsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
When paramedic students are taught how to achieve IV access, they're told to look for a large vein fairly close to the surface of the skin. Seasoned paramedics have learned to “look” with their finger tips, knowing that many patients do not have easily visible large veins. The AccuVein AV300 eliminates the need for either of these techniques. The easy-to-use handheld device operates on the principle that hemoglobin has a different infrared signature than the surrounding tissues. This difference is sensed, illuminating the positions of the veins on the skin's surface directly above the veins, allowing you to “see” t...
Source: JEMS: Journal of Emergency Medical Services - September 30, 2009 Category: Emergency Medicine Tags: Hands On Source Type: journals

Smoke Signals: > Recognition and Treatment of Combustion-Induced Cyanide ToxicityEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The inhalation of combustion products, such as smoke from fires, is the leading cause of death from fire in the U.S. According to the National Fire Protection Agency (NFPA), there were more than 3,430 civilian fire-related deaths and 17,675 civilian fire-related injuries in 2007, with 50–80% attributed solely to the inhalation of smoke's imbedded toxic chemicals. The danger of smoke inhalation is well demonstrated by several of this country's large catastrophic fires. For instance, Boston's Cocoanut Grove nightclub fire killed 491 people in 1942. Firefighters who entered the structure reportedly found bodies stacked near...
Source: JEMS: Journal of Emergency Medical Services - September 30, 2009 Category: Emergency Medicine Authors: John P. Benner, David Lawrence, William Brady Source Type: journals

Pediatric Airway Maintenance: Choosing Between the Home Ventilator & Manual VentilationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: JEMS: Journal of Emergency Medical Services)
Source: JEMS: Journal of Emergency Medical Services - September 30, 2009 Category: Emergency Medicine Authors: James F. Goss, Allen Patee, Sarah Green, Diane Schoendienst, Cynthia Navis Source Type: journals

Down Economy Year 1—is Your Belt Tight, Too? JEMS 2009 Salary & Workplace SurveyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: JEMS: Journal of Emergency Medical Services)
Source: JEMS: Journal of Emergency Medical Services - September 30, 2009 Category: Emergency Medicine Authors: David M. Williams Source Type: journals

Attacking Asthma: Five steps to treat pediatric status asthmaticusEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
EMS is called to the house of a 12-year-old male patient in severe respiratory distress. He has a history of asthma and is on multiple controller medicines, including Flovent, Singulair and albuterol sulfate. On arrival to the house, you find the patient seated in a tripod position. He's tachypneic and in severe distress. His mother states he developed cold symptoms yesterday and has used his albuterol inhaler multiple times today without improvement. (Source: JEMS: Journal of Emergency Medical Services)
Source: JEMS: Journal of Emergency Medical Services - September 30, 2009 Category: Emergency Medicine Authors: Mark Meredith, Jeremy Brywczynski, Corey Slovis Tags: Case of the Month Source Type: journals

Girth Hitch: A little horse sense for yaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Any school kid with a few horseback-riding lessons can tell you, some horses are real smart. As Bugs Bunny's pal Elmer Fudd used to say, they're “twickstas.” If a horse doesn't feel like totin' you all over the countryside, one of his twicks is to fill his lungs as he's being saddled. Watch out especially on hot days or when it's about hay time. (You have legs. You can walk.) (Source: JEMS: Journal of Emergency Medical Services)
Source: JEMS: Journal of Emergency Medical Services - September 30, 2009 Category: Emergency Medicine Authors: Thom Dick Tags: Twicks of the Twade Source Type: journals

Follow the Law: Philosophies we should borrow from law enforcementEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Sometimes you have to step outside a problem to see the solution. Many EMS systems fail to do this when implementing their quality improvement (QI) programs. Often, these programs simply ensure everybody is doing what they're supposed to. There's no attempt to make system improvements or help employees become better at what they do. We need to look at the bigger picture. (Source: JEMS: Journal of Emergency Medical Services)
Source: JEMS: Journal of Emergency Medical Services - September 30, 2009 Category: Emergency Medicine Authors: Gary Ludwig Tags: Leadership Sector Source Type: journals

> Always Open: Study finds no adverse effects from stopping ambulance diversionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Ambulance diversion is a frustrating fact of life for most EMS providers, but that may not always be the case. In 2006, emergency physician Franklin Friedman, MD, of Tufts Medical Center, led a team of researchers that looked at what happened when a group of Boston teaching hospitals stopped diverting ambulances for two weeks. (Source: JEMS: Journal of Emergency Medical Services)
Source: JEMS: Journal of Emergency Medical Services - September 30, 2009 Category: Emergency Medicine Tags: Priority Traffic Source Type: journals

CorrectionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
On p. 67 in the conclusion to the September article “Of EMS, By EMS, For EMS,” the author did not intend to state anything in particular about his agency but rather was commenting on changes that have come to pass in EMS in general. (Source: JEMS: Journal of Emergency Medical Services)
Source: JEMS: Journal of Emergency Medical Services - September 30, 2009 Category: Emergency Medicine Tags: Letters Source Type: journals

Delegation HesitationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I'm doing my field time with AMR for paramedic school, and my preceptor had me read “Pass it On” [August JEMS]. After reading Raphael Barishansky's article, I know my delegation skills will improve during my field time and throughout my career. I plan on sharing this with my classmates. (Source: JEMS: Journal of Emergency Medical Services)
Source: JEMS: Journal of Emergency Medical Services - September 30, 2009 Category: Emergency Medicine Authors: Dan Nuñez Tags: Letters Source Type: journals

Where Safety StartsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
It seems deeply ingrained in our psyche to shun any safety improvements we feel may interfere with “our way” of patient care. [“The Hazards to Providing Care in an Ambulance,” JEMS.com]. Our attitudes about safety need to change from the time we're in our initial EMT class. If individual providers would not only cooperate with safety initiatives but demand them, we'd get a lot further, a lot faster. (Source: JEMS: Journal of Emergency Medical Services)
Source: JEMS: Journal of Emergency Medical Services - September 30, 2009 Category: Emergency Medicine Authors: Raymond J. Barth Tags: Letters Source Type: journals

False ProofEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I agree providers must be very careful and deliberate in their assessment of these patients. However, can't one argue that placing the patient on the cardiac monitor necessitates an aggressive resuscitation per ACLS? We have an algorithm to treat asystole, yet we should fail to employ it? I would rather err on documenting “injuries incompatible with sustaining life” and forgo the ECG. (Source: JEMS: Journal of Emergency Medical Services)
Source: JEMS: Journal of Emergency Medical Services - September 30, 2009 Category: Emergency Medicine Authors: Jon Kavanagh Tags: Letters Source Type: journals

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Declaration of death continues to be a controversial topic in EMS. In our July article, “Proof of Life,” author David Erdman, EMT-P, recommends taking every measure to identify life—even when there appears to be none. Judging by some letters we received, it's clear this won't be the final word. (Source: JEMS: Journal of Emergency Medical Services)
Source: JEMS: Journal of Emergency Medical Services - September 30, 2009 Category: Emergency Medicine Authors: Richard Blanchet Tags: Letters Source Type: journals

Protect Your Rear: Putting your best lights forwardEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
My son is a California Highway Patrol motorcycle officer welltrained in accident investigation. He's better trained than me (and most EMS and fire responders) at controlling, stopping and diverting traffic at collision scenes on multi-lane highways. He recently responded to a crash that, although located on a straight section of highway, was visible only after fast-moving vehicles rounded a blind curve. Another officer had arrived on scene first and positioned his cruiser to divert traffic away from the vehicles near the right shoulder. (Source: JEMS: Journal of Emergency Medical Services)
Source: JEMS: Journal of Emergency Medical Services - September 30, 2009 Category: Emergency Medicine Authors: A.J. Heightman Tags: From the Editor Source Type: journals