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JEMS Volume 33 Issue 7
Changing a protocol requires significant time and energy. The reason for the change must be clear and"ževidence-based, and there must be measurable benefits. The 2005 AHA guidelines are an example of the amount of evidence that must be reviewed before a major protocol can be altered. (1) For a grassroots effort to change one protocol, we must review precedent, abstract medical literature and consider practice patterns across similar systems."ž
EMTs and paramedics from the Oklahoma City Fire Department (OCFD) and Emergency Medical Services Authority (EMSA) treat a fall victim at a construction site. The worker was laying metal roofing when a gust of wind blew him and the roofing off the structure. He fell 25 feet to the ground and sustained a significant closed head injury and bilateral tension pneumothorax. The EMSA and OCFD crews worked together to render BLS/ALS care to the patient and carefully immobilize him before transport.
"Treatment guidelines [lead] to four-fold increase in survival rate for cardiac arrest" declared a recent press release from the Society for Academic Emergency Medicine (SAEM).
At approximately 10:15 a.m. on Dec. 7, 2007, multiple calls came into the New York City 9-1-1 system reporting a scaffolding collapse in Manhattan. According to civilian callers, a window washing scaffolding platform had fallen from the roof of a 47-story high-rise building with possibly two victims on the apparatus.
The paramedics arriving on scene found the 79-year-old man acting nervous but alert and oriented. The patient identified himself and said he had called 9-1-1 after his implanted defibrillator had fired 11 times. He denied having any chest pain, dizziness or shortness of breath before the ICD had begun firing. His lungs were clear, vital signs were within normal limits, and the cardiac monitor showed a 100% paced rhythm. A 12-lead ECG was performed with no unusual findings.
On Aug. 17, 2007, the Federal Emergency Management Agency (FEMA) activated their contract with American Medical Response (AMR), requesting them to send at least 300 ambulances, 25 air ambulances and enough paratransit vehicles to move 3,500 ambulatory patients throughout"žTexas in anticipation of Hurricane Dean. Expecting the storm to hit as a Category 5 hurricane, all of these resources had to be in"žSan Antonio within 24 hours.