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EMS Research

For everyone involved in EMS research projects

Members: 107
Latest Activity: Feb 28

EMS Discussion Forum

Fire Rehab policy?

Started by Kay Vonderschmidt Dec 25, 2009.

Kampala Trauma Score (KTS) for PreHospital Care Providers

Started by Kay Vonderschmidt Nov 8, 2009.

RAMPART Study 13 Replies

Last reply by Kay Vonderschmidt Oct 16, 2009.

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Comment by Kay Vonderschmidt on October 24, 2012 at 9:18am

PEC is looking for research abstracts.....deadline is Oct 31

http://www.pcrf.mednet.ucla.edu/pcrf/index.shtml

Comment by Kay Vonderschmidt on July 12, 2012 at 3:16pm

What new research is your department involved with?

Resuscitation outcomes?

Hypothermia?

Systems - Quality Assurance?

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Comment by Kay Vonderschmidt on July 31, 2010 at 5:50pm
Hey guys/gals.....

85 members and we aren't talking much. anyone going to EMS Expo?
Comment by Kay Vonderschmidt on June 27, 2010 at 3:00pm
Has anyone done any research on sepsis and EMS protocols? If so, did you do lactate measurements in the field?
Comment by Kay Vonderschmidt on December 17, 2009 at 11:10am
We are starting a Fire Rehab study....we will be doing baseline vitals include CO, vitals when active such as workout/treadmill (that is what NFPA based their recommendations on), vitals including CO at live fire training drills and vitals including CO at rehab on fire scenes...
What is your dept rehab policy? We have seen none to a card file with everyone's baseline vitals not including CO.
Comment by Rob Theriault on July 27, 2009 at 10:39pm
You're not wrong...."Survival" is defined as an ROSC with neuro function on par with the patient's neuro function pre-arrest. That usually means no neurological damage. I believe Utsteain uses the cerebral categories score with a score of 1 considere as "survival".

What I am suggesting is there is also an increase in the number of patients with an ROSC who have sustained serious is not catastrophic neurological damage as a result of the improvements in CPR standards and ITDs, etc. I suspect we'll have to collectively tackle this issue soon, or at least soon after the ROC trial.

The best place for information on the ROC Trial is at the Prehospital Care and Transport Medicine site.

cheers
Comment by Kay Vonderschmidt on July 23, 2009 at 4:28pm
Wow - i thought that the increase in survival also had good neuro outcomes...what level are they debilitated? (fetal position and to the NH) or home with some help?

can you give an overview of the ROC trial and what outcomes are they looking for
Comment by Rob Theriault on July 3, 2009 at 10:22pm
Is anyone else participating in the ROC Trial? Three things (maybe more) seem to be happening that are of interest:

1. we are getting a great deal more ROSC

2. survival seems to be increasing

3. ETCO2 readings seem to be higher with the new faster-deeper compressions with fewer and lower TV ventilations

Some interesting questions will, I predict, arise from these improvements (we'll wait for the final results of the research of course to draw any conclusions):

1. In addition to there being an increase in survival, as there appears to be so far, there also seems to be a significant increase in ROSCs with significant neurological damage. These patients inevitably end up in the ICU and become a significant drain on the health care system. Is it ethical to apply CPR and ALS resuscitation for all cardiac arrests (barring the usual gross rigor, decomposition, etc). And should EMS systems that don't have a good termination of resuscitation policy be encouraged to adopt one so that not all cardiac arrests are given the bells and whistles in terms of effort and technology?

2. ETCO2 readings of 10mmHg in a cardiac arrest used to be a good predictor of an ROSC and if the ETCO2 was 14 or greater the chances of an ROSC and survival (neorologically intact) was very good. Now, and this has just been my own experience, unwitnessed cardiac arrest are producing ETCO2 levels routinely above 20-30 with the new CPR standards. Add the impedence threshold device (ITD) and the readings seem to be even higher. This begs the questions: Do we need to reevaluate ETCO2 readings as a predictor of survival from cardiac arrest?

What are your thoughts?

Rob Theriault
my blog
Comment by Kay Vonderschmidt on July 1, 2009 at 9:16am
What other research projects are your depts working on? They can be clinical or system related? Do you use research data when making a decision on staffing? Has anyone been to the EMS six sigma classes?
 

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