Administration and Leadership, Commentary, News

Closing Out the Year and Looking to the Future

As 2018 ends and 2019 approaches, I wanted to first thank all our readers, authors, columnists, photographers and editorial board members for following and contributing to our work throughout 2018. It was a year of change for JEMS, moving to an all-electronic platform and working to enhance our electronic delivery systems and methods.

Change takes time, so we thank you for your patience and promise you that more great innovations are on the way to make your receipt and use of important articles and information easier to read, print out and share on all your devices.

We appreciate our audience and do not take your trust in us lightly. You count on us to continue to seek out and present the most important, innovative and clinically sound information to you to allow you to do what you love to do—save lives, provide comfort to your patients, and remain energized and excited about EMS and all that it entails.

We also want you to know that your safety and physical and emotional health is paramount to our staff, and we pledge to continue to “have your backs” in more ways than one. Stress and suicide in EMS continue to affect way to may providers and we, and many others, are working hard to help you get over these hurdles.

In early 2019, JEMS and Clarion UX Fire & Rescue Group will publish a comprehensive textbook on EMS resiliency that’s being released through our Fire Engineering Books & Videos division titled, A Community of One: Building Social Resilience. The text will expand on the multi-step approach to resilience presented in our Medic-CE course, Beyond The Call: Resiliency for First Responders, which allows providers to enroll and participate anonymously.

We will also be presenting an innovative new JEMS article delivery method in early January that will present what many believe to be a much safer and easier way to lift, move and carry patients under most circumstances. The “Side-by-Side Lift and Carry” article will be presented to you in a narrated article that you can share, as well as a downloadable slide show and a printable PDF you can share. We hope you will like this new JEMS innovation. Three ways to learn and share, all for the same price: FREE!

Last December, we published epic work on patient resuscitation underway by many EMS systems in multiple countries. By dramatically changing their approach, focus and culture of care, systems in Minnesota, Rialto, Alameda County (Calif.), and Lincoln (Neb.) have had skyrocketing improvement in the return of spontaneous circulation (ROSC), some approaching 60%.

They have all adopted what Take Heart America calls the “Optimal Bundle of Care” approach, focusing on top-quality, uninterrupted compressions, use of mechanical chest compression devices and/or the ResQCPR ITDs, head-up CPR and transport directly to a cath lab or facility that can institute ECMO (ECPR) within 30 minutes.

The proposed optimal bundle was developed for pediatric and adult patients and is divided into four parts: 1) community response; 2) first responder and BLS; 3) ALS; and 4) hospital-based resuscitation center care.

We will present much more on this to you in early 2019 in a special compilation of results presented at the “State of the Future of Resuscitation Conference” held in Oakland, Calif., in September 2018.

The new International Resuscitation Collaborative involved with this information-packed conference identified six broad areas within an optimal bundle of care where innovations are needed, and have recently become available, to improve the likelihood of survival with favorable neurological function. 

These six areas are:

  1. Enhanced community response or “citizen activation,” so that CPR and defibrillation are provided more rapidly by lay rescuers following cardiac arrest;
  2. Enhanced hemodynamics during CPR using technologies that provide significantly greater cerebral and coronary blood flow, and that help lower intracranial pressure compared to traditional manual CPR;
  3. Technologies that provide greater circulation and hemodynamic stability in patients with refractory ventricular fibrillation, allowing time for more definitive treatments;
  4. Improved methods to reduce reperfusion injury;
  5. Improved diagnostic and therapeutic means of neuro-monitoring and neuro-prognostication to help guide, optimize, and individualize post-resuscitation care; and
  6. Predictive analytics to enhance in-hospital triage and prevent occurrence of in-hospital cardiac arrest.

It’s exciting, cutting-edge medicine that will change the way we care for many patients in the future—and allow you to save up to 50% more patients in your EMS system.

We will also publish an article on the first mobile emergency department in the United States, which is set to be on the road by mid-year in the Minneapolis/St. Paul region. It’s a program that will bring an ECMO team to suburban and rural hospitals that need it, as well as rendezvous with ALS units en route to the University of Minneapolis.

All this, and more, will be discussed at EMS Today: The JEMS Conference, which will be held February 20–22, 2019, in National Harbor, Maryland, just across the Potomac River from Washington, DC. Join us there for the most cutting-edge clinical and operational topics in the EMS industry. And don’t forget to sign up to receive JEMS NOW, our fresh and innovative twice-weekly email newsletter that features new editorial content in each issue, as well as our two new monthly email newsletters: EMS Today Leadership Focus and the Cardiac and Resuscitation Report.

Best wishes for a safe, happy and prosperous holiday season and Happy New Year!