Healthcare could benefit from more eyes trained specifically at looking for red flags. Conditions that may trigger high alerts and require mobilization of critical resources. Developing apprentices of patient safety moves beyond just creation of rapid response teams. It requires a dedication of those on the frontlines of healthcare to evergreen training and learning. This sort of training may require innovative modalities of rapidly deploying experience and knowledge to those on the frontlines. It may require physicians think a bit differently about the traditional physician to physician apprenticeship model. It may require us to democratize medical knowledge.
The nation's Emergency Medical System (EMS) infrastructure occupies a vital role in society where public health, public safety and individual patient needs converge. In light of concerning maternal outcomes the EMS professional can benefit from greater awareness of issues in this special population. In a prior post the rising maternal mortality trend in the USA was explored and though current campaigns at reversing this troublesome trend are not directed at pre-hospital providers there may be a missed opportunity in not doing so.
A vital tool called the Maternal Early Warning Signs (MEWS) is an evidence-based tool that has been used with success in some states to improve maternal outcomes.
Training simulations have been used by various industries including the military, entertainment, aviation, and medicine. Aviation was the leading industry of modern simulators. In 1929, Edwin Link developed the first Link Trainer, or the “Blue Box”, for aviation training. The Link Trainer had a cockpit, controls, and motions simulating that of a real airplane. In 1934 pilots used the Link Trainer for flight simulations after twelve Army Air Corp pilots were killed in fewer than 3 months trying to deliver air mail. Army Air Corp bought six Link Trainers in order for pilots to become familiar with airplane controls and flying conditions. The Link Trainers gained popularity during World War II, when more than 10,000 Trainers were sold to combatant nations. Blue Boxes trained more than 500,000 US pilots. Today, flight simulators with advanced software and computer screens have become required components in aviation pilot training in the US.
Cerebrovascular accidents, commonly known as stokes, are the fifth leading cause of death in the United States. The latest statistics from the Centers for Disease Control(CDC) put the number of stroke deaths at more than 140,000 per year. That is just the number of deaths. The number of those disabled from a stroke is much higher.
I began my medical career as a first responder within the US Army. I was a US Army Special Forces Medical Sergeant or Green Beret Medic (18D). We received the civilian NREMT Emergency Medical Technician and Paramedic Training curriculums augmented with 3rd world-centric medicine and military trauma management training. The training provided to me was thorough and detailed. We were held to a high-performance standard, and patient care mistakes or oversights were unacceptable as our next patients would be in a combat zone.
Infantile hypotonia presents significant challenges in the pre-hospital setting. As a paramedic or EMT you will likely respond to calls involving both acutely and chronically ill children. The skill of accurately and rapidly assessing a pediatric patient’s tone is essential in the first moments of an encounter. Developing an approach to handling severe abnormalities comes with training and experience. In general, preparing for these encounters both in thought and in practice is a must to do your best out there. This article will explore hypotonia and provide background on the topic, as well as a few cases, that may aide pre-hospital professionals in further improving their preparedness in this arena.
Partum and peri-partum calls don’t happen all that often, but as an EMS professional you can expect to respond to the type of case described above at least few times in your career.
In 1986 the CDC began tracking pregnancy-related deaths and since collecting this data rates have more than doubled. Although we may not realize it, the United States has the highest maternal mortality rate of any highly developed nation, according to the Alliance for Innovation on Maternal Health (AIM). Few nations beside the USA have a rising maternal mortality rate, amongst them are Afghanistan and Sudan.
The tones drop, you get to the rig, lights and siren scream out. You are on your way to a 5-month-old baby. Dispatcher says its an “unknown medical” call.
You get on scene and are met by frantic family members. You and your partner get into the house and the mother is crying. In between her sobs she’s begging you to save her baby. When you finally get to the child, you see that it is seizing. Then it stops. There is nothing. No movement and no breathing.
This is the first time you’ve ever handled a call like this.
You’ve only been an EMT for two weeks.
Training wasn’t like this. It wasn’t this real.
As we were about to deliver a PerSim system to Austin Community College the other day, I was reminded of the possibilities of how this company can transform the landscape of healthcare training. Last week while we were visiting some fire stations a voice rose from the corner of the room. I could not see his face, but his voice gently boomed across all other noises and sidebar conversations. It was immediately evident in the body language of the other firefighters in the room that this was the voice of someone respected and well regarded. The question, “So, you are going to take 15 years of experience and compress it into this medical simulator?”