Category Archives: Fire Prevention & Education

EMS Week 2015 Challenge

In 1974, President Gerald Ford declared the first “National Emergency Medical Services Week? as an annual observance to recognize the critical component that emergency prehospital medicine began to play in the public health safety net. That year was a time of many other significant events. Richard Nixon had become the first president to resign in office. The newly formed OPEC consortium successfully constrained production causing a worldwide oil shortage that skyrocketed the cost of a gallon of gasoline to 55 cents. A national speed limit of 55 MPH was imposed to conserve fuel and save lives. The Sears tower in Chicago was opened as the world’s tallest building. It was also the same year that a 1973 Ward LaFrance P80 replaced the original 1965 Crown Firecoach as “Engine 51” in the popular television show “Emergency!” then in just its third season.

In the 41 years since that time there has also been a great deal of change. Pneumatic Anti-Shock Garments such as the Medical Anti-Shock Trousers (MAST) have come and gone while Nitrous Oxide had gone away and may be coming back. Spinal immobilization is being completely re-examined as long back boards are being sidelined and may soon be joined by the hard cervical collar. CPR guidelines are being extended as we work patients longer on scene and the A&E series “Nightwatch” has been signed for a second season.

It is all too easy to say that we do not have any impact on what is happening in the world around us, that things are just happening and it is out of our control. For those who accept they are powerless, it is true. The future always belongs to those who are willing to shape it. Every fact I quoted above only happened because some individual was inspired to make something happen. This year you have the unique opportunity to stand up and be counted. You can choose to be a part of the solution and make your community a better, safer place for everyone. It all starts by you just trying something new. 

Look for 2015 EMS Week activity ideas by downloading the Planning Guide PDF from www.emsstrong.org.

“We gain strength, and courage, and confidence by each experience in which we really stop to look fear in the face… we must do that which we think we cannot.” – Eleanor Roosevelt

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A Short Take on Long Boards

The National Association of EMS Physicians and the American College of Surgeons Committee on Trauma have made their Position Statementon spinal immobilization for EMS publicly available. So, now what?

It is hard to argue with their findings:

  • Long backboards are commonly used to attempt to provide rigid spinal immobilization among emergency medical services (EMS) trauma patients. However, the benefit of long backboards is largely unproven.
  • The long backboard can induce pain, patient agitation, and respiratory compromise. Further, the long backboard can decrease tissue perfusion at pressure points, leading to the development of pressure ulcers.
  • Utilization of backboards for spinal immobilization during transport should be judicious, so that the potential benefits outweigh the risks.

I know that I have been torn in my own mind while strapping an octogenarian to a rigid long backboard when the only indication for such treatment was that she slipped on the floor of a rest home. Neurologically she may appear completely intact with a normal level of consciousness (GCS of 15), no complaints of numbness, lacking any spinal deformation or distraction injury. However, our protocols say she must be strapped to a rigid device without padding and subjected not only to the jolts of our handling, but every bump of a threshold as the stretcher is wheeled outside and then she continues to suffer the uneven pavement between theEmeritus Senior Living facility and the hospital. If she wasn’t sore due to the fall, she will definitely feel it by the time she is seen by a physician. I know I am protecting myself from any potential injury lawsuit, but am I really protecting my patient?

The Prehospital Emergency Care statement suggests criteria where use of a long backboard would not be indicated. Part of that definition includes the following recommendation: Continue reading

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