Table of Contents

Dec 2009
Supplement, State of the Science 2010
  • Introduction

    This special supplement to JEMS, prepared in cooperation with the U.S. Metropolitan Municipalities EMS Medical Directors Consortium (the "Eagles" Coalition"), addresses issues important to all EMS systems. In the past five years, emergency treatment and technology have been advancing at an unprecedented pace, with prehospital systems leading the way in many regions and gaining support from their hospital systems to continue and advance the care in their emergency departments and critical care units.

  • Beyond Ventricular Fibrillation

    The utilization of post-resuscitation therapeutic hypothermia (TH)for non-neurologically intact adult patients after ventricular fibrillation (V-fib) arrest is supported by the literature and is becoming more common.[1-6] TH is less commonly used in other situations that have resulted in anoxic insult, due in large part to lack of clear evidence from clinical trials.

  • In My Own Words

    I am a paramedic who encountered the most challenging call of my career on Jan. 9, 2008—my own cardiac arrest. I was fortunate to survive because of the efforts of my colleagues, and the use of therapeutic hypothermia. This is my story.

  • Evolving AMI Care 2010

    The prehospital treatment of ST elevation acute myocardial infarction (STEMI) continues to evolve. Newer information has led to five major changes in prehospital STEMI care. In a 2009 State of the Science article, we discussed two of those changes in depth: the decreasing emphasis on morphine use in acute coronary syndromes (ACS), and the recommendation to stop utilizing IV beta blockade in initial STEMI care.[1]

  • Reducing Interruptions

    The prehospital treatment of ST elevation acute myocardial infarction (STEMI) continues to evolve. Newer information has led to five major changes in prehospital STEMI care. In a 2009 State of the Science article, we discussed two of those changes in depth: the decreasing emphasis on morphine use in acute coronary syndromes (ACS), and the recommendation to stop utilizing IV beta blockade in initial STEMI care.[1]

  • EMS and the DEA

    Case #1

  • Brief History of the DEA

    In 1973, President Richard Nixon created the Drug Enforcement Administration (DEA) through an executive order that established a centralized command structure to combat "an all-out global war on the drug menace."[1] Currently, the DEA retains a presence in the U.S. and 63 foreign countries, and has an operating budget in excess of $2.3 billion.[1] The DEA's stated mission is to "enforce the controlled substances laws and regulations of the United States."[1] This is accomplished through use of U.S.

  • Sex, Drugs and R & R (Resuscitation & Reanimation)

    What if someday, in the not too distant future,your prehospital care protocols—for cardiac arrest, post-traumatic shock, severe head injury, myocardial infarction, stroke, massive burns and a myriad of other critical illnesses and injuries—all directed you to immediately infuse the patient with an IV dose of the female sex hormone estrogen as routine prophylaxis, and that such doses should be administered as soon as possible after the onset of the critical illness or injury?

  • Lost and Found

    Learning Objectives

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