EMS Training Opportunity - Prehospital Trauma Life Support (PHTLS)

 

Colorado Cardiac CPR are offering a PHTLS at the start of March (3 & 4). This is a great opportunity for emergency medical responders, EMTs, Paramedics, Nurses, Physician Assistants and Doctors.

Description: The mission of PHTLS is to promote excellence in trauma patient management by all providers involved in the delivery of prehospital care. PHTLS is developed by NAEMT in cooperation with the American College of Surgeons' Committee on Trauma.

PHTLS is the global gold standard in prehospital trauma education and is taught in over 80 countries. 

Content: The aim of PHTLS courses is to improve the quality of trauma care and decrease patient mortality. 

The program is based on a philosophy stressing the treatment of the multi-system trauma patient as a unique entity with specific needs. 

The course covers the following topics:

• Physiology of life and death
• Scene Assessment
• Patient Assessment
• Hemorrhage Control
• Airway, Breathing, Ventilation & Oxygenation
• Circulation & Shock
• Special Populations

The course emphasizes application of trauma education through case studies, skills practice, and patient simulations.

Date: March 3 & 4, 2025 9:00 AM to 5:00 PM

Cost: $315.00

Discount: 3CPR

Location: Littleton (Broadway & Davies), Colorado

Outcome: Upon successful course completion you will be issued an NAEMT PHTLS provider card and receive 16-hours of CAPCE credits.

For more information and to register, access this link:

https://3cpr.enrollware.com/enroll?id=10735378

EMS Operations - Community Paramedicine In Kansas

The article from the Kansas Health Institute discusses the emerging model of community paramedicine in Kansas, which seeks to enhance healthcare delivery through non-traditional roles for paramedics and emergency medical services (EMS) personnel.

Community paramedicine aims to provide more comprehensive care by addressing gaps in the healthcare system, particularly in rural and underserved areas.

This model involves paramedics delivering primary care, conducting follow-up visits, managing chronic diseases, and providing preventive services in patients' homes, thus reducing hospital readmissions and emergency room visits.

Key policy considerations highlighted in the article include:

1. Regulatory and Legislative Framework: Adjustments to state regulations and legislative support are crucial for the successful implementation of community paramedicine programs.
2. This includes defining the scope of practice for paramedics and ensuring appropriate training and certification​.
3. Funding and Reimbursement: Sustainable funding models and reimbursement policies need to be developed to support community paramedicine services.
4. This might involve collaboration with Medicaid, Medicare, and private insurers to recognize and reimburse these services adequately​.
5. Integration with Healthcare Systems: Effective integration with existing healthcare systems and coordination with primary care providers, hospitals, and public health agencies are essential for the program's success.
6. This includes establishing protocols for information sharing and care coordination​.
7. Workforce Development: Ensuring that paramedics receive proper training in areas such as chronic disease management, preventive care, and patient education is vital.
8. This may require changes to current paramedic education programs and ongoing professional development opportunities​.

Conclusion

The community paramedicine model has the potential to improve health outcomes, particularly in areas with limited access to healthcare, by leveraging the skills and availability of paramedics to provide a broader range of services directly in patients' homes.

Further information can be accessed below:

https://www.khi.org/articles/community-paramedicine-in-kansas-policy-considerations-for-an-emerging-model-of-care/ 

EMS Emergencies - Pediatric Patients

EMS providers need to be well-prepared to handle pediatric emergencies as they require specialized knowledge and skills due to the unique needs of children.

Here are some key points they should know:

1. Respiratory Distress: Children commonly present with respiratory distress due to conditions such as asthma, bronchiolitis, or croup. EMS providers should be proficient in assessing respiratory status, administering oxygen, and managing airway obstructions.

2. Febrile Seizures: Febrile seizures are common in young children and are often frightening for caregivers. EMS providers should know how to assess and manage febrile seizures, including ensuring adequate ventilation and preventing injury during the seizure.

3. Trauma: Children are at risk for various types of trauma, including falls, burns, and motor vehicle accidents. EMS providers should be skilled in assessing and managing pediatric trauma, including immobilization techniques and pain management.

4. Sepsis: Sepsis can be challenging to recognize in children, as symptoms may be nonspecific. EMS providers should be vigilant for signs of sepsis, such as fever, tachycardia, and altered mental status, and be prepared to initiate early treatment.

5. Anaphylaxis: Allergic reactions, including anaphylaxis, can occur in children due to food allergies, insect stings, or medications. EMS providers should be trained in recognizing anaphylaxis and administering epinephrine as needed.

6. Dehydration: Children are at increased risk for dehydration due to factors such as vomiting, diarrhea, or fever. EMS providers should be skilled in assessing hydration status and administering fluids as needed, especially in cases of severe dehydration.

7. Seizures: Seizures can occur in children due to various causes, including epilepsy or febrile illnesses. EMS providers should know how to assess and manage seizures, including protecting the child from injury and administering appropriate medications if necessary.

8. Poisoning: Accidental poisoning is a common pediatric emergency. EMS providers should be familiar with common toxins and their effects on children, as well as appropriate decontamination and treatment measures.

9. Cardiac Arrest: While less common in children than in adults, cardiac arrest can still occur due to various causes, including congenital heart defects or respiratory failure. EMS providers should be proficient in pediatric CPR and advanced life support techniques.

10. Communication & Family Support: Effective communication with caregivers is essential in pediatric emergencies. EMS providers should be skilled in providing clear and compassionate communication, as well as offering support to families during stressful situations.

By being knowledgeable about these common pediatric emergencies and having the necessary skills to assess and manage them effectively, EMS providers can play a crucial role in providing optimal care for children in emergency situations.

Further Reading:

Alexander, M. & Belle, R. (2017) Advanced EMT: A Clinical Reasoning Approach (2nd Ed). Hoboken, New Jersey: Pearson Education

Bledsoe, B. E., Cherry, R. A. & Porter, R. S (2023) Paramedic Care: Principles and Practice (6th Ed) Boston, Massachusetts: Pearson

Mistovich, J. J. & Karren, K. J. (2014) Prehospital Emergency Care (11th Ed). Hoboken, New Jersey: Pearson Education

Peate, I. & Sawyer, S (2024) Fundamentals of Applied Pathophysiology for Paramedics. Hoboken, New Jersey:  Wiley Blackwell

EMS Particular Patient Populations - Spina Bifida

When responding to patients with spina bifida, EMS providers should be aware of the following key points:

1. Understanding Spina Bifida:

   • Spina bifida is a congenital condition characterized by incomplete closure of the spine during fetal development. It can result in varying degrees of spinal cord and nerve damage, leading to physical and neurological impairments.
   • There are different types of spina bifida, including spina bifida occulta (mild, hidden form), meningocele (meninges protruding through a spinal defect), and myelomeningocele (most severe form, with the spinal cord and nerves protruding through an open spinal defect).

2. Neurological Impairments:

   • Patients with spina bifida may experience neurological impairments such as paralysis or weakness in the lower limbs, loss of sensation, bladder and bowel dysfunction, and hydrocephalus (build-up of fluid in the brain).
   • Assess the patient's neurological status, including motor function, sensation, and reflexes, and be prepared to manage any associated complications, such as urinary retention or neurogenic shock.

3. Skin Integrity:

   • Patients with spina bifida, particularly those with myelomeningocele, are at increased risk of skin breakdown and pressure ulcers due to impaired sensation and mobility.
   • Inspect the patient's skin for signs of pressure injuries, and provide appropriate padding and positioning to prevent further skin damage during transport.

4. Bladder & Bowel Management:

   • Bladder and bowel dysfunction are common complications of spina bifida, requiring ongoing management and monitoring.
   • Be prepared to address urinary retention, urinary tract infections, and fecal incontinence, and provide appropriate interventions, such as catheterization or bowel management techniques.

5. Orthopedic Considerations:

   • Orthopedic deformities, such as scoliosis (curvature of the spine), clubfoot, or hip dislocation, may occur in patients with spina bifida and may require surgical correction or orthotic devices.
   • Be aware of any orthopedic issues that may affect the patient's mobility and positioning during transport, and provide appropriate support and accommodations as needed.

6. Hydrocephalus Management:

   • Hydrocephalus is a common complication of spina bifida, resulting from impaired cerebrospinal fluid (CSF) circulation and absorption.
   • Monitor the patient for signs and symptoms of increased intracranial pressure, such as headache, vomiting, or changes in consciousness, and provide timely interventions, such as ventricular shunting or CSF drainage, if necessary.

7. Psychosocial Support:

   • Living with spina bifida can have a significant impact on the patient's emotional well-being, as well as on their family members and caregivers.
   • Provide emotional support and reassurance to the patient and their caregivers, and connect them with appropriate community resources and support networks as needed.

8. Collaboration with Healthcare Providers:

   • Communicate with the patient's primary care provider or specialists, such as neurosurgeons, orthopedic surgeons, urologists, or rehabilitation specialists, to obtain relevant medical history and treatment information.
   • Provide a detailed report to the receiving healthcare facility to ensure that the patient's ongoing medical needs are addressed and that appropriate follow-up care is arranged.

By being knowledgeable about the unique challenges and needs of patients with spina bifida, EMS providers can deliver compassionate and effective care that supports optimal outcomes and enhances the patient's overall well-being.

Further Reading:

Alexander, M. & Belle, R. (2017) Advanced EMT: A Clinical Reasoning Approach (2nd Ed). Hoboken, New Jersey: Pearson Education

Bledsoe, B. E., Cherry, R. A. & Porter, R. S (2023) Paramedic Care: Principles and Practice (6th Ed) Boston, Massachusetts: Pearson

Mistovich, J. J. & Karren, K. J. (2014) Prehospital Emergency Care (11th Ed). Hoboken, New Jersey: Pearson Education

Peate, I. & Sawyer, S (2024) Fundamentals of Applied Pathophysiology for Paramedics. Hoboken, New Jersey:  Wiley Blackwell

EMS Particular Patient Populations - Multiple Sclerosis

EMS providers should be aware of the following key points when responding to patients with multiple sclerosis (MS):

1. Understanding Multiple Sclerosis:

   • Multiple sclerosis is a chronic autoimmune disorder that affects the central nervous system (brain and spinal cord). It is characterized by inflammation, demyelination (damage to the protective covering of nerve fibers), and neurodegeneration.
   • MS can cause a wide range of symptoms, including fatigue, muscle weakness, numbness or tingling, balance problems, vision disturbances, and cognitive impairment.
   • The course of MS can vary widely among individuals, with periods of relapse (exacerbations) followed by periods of remission. Some individuals may experience progressive disability over time.

2. Neurological Symptoms:

   • Patients with MS may present with a variety of neurological symptoms, depending on the location and severity of nerve damage. Common symptoms include weakness or paralysis of the limbs, sensory disturbances, difficulty walking or balancing, and vision problems.
   • Be alert for signs of acute exacerbations, such as sudden worsening of symptoms or new neurological deficits, which may require immediate medical attention.

3. Mobility & Functional Status:

   • MS-related mobility impairments may affect the patient's ability to move independently, transfer between positions, or navigate stairs and uneven terrain.
   • Assist the patient with mobility aids or devices as needed, and take precautions to prevent falls or injuries during the transport process.

4. Fatigue & Weakness:

   • Fatigue is a common and debilitating symptom of MS that can significantly impact the patient's ability to perform activities of daily living.
   • Be aware that patients with MS may experience sudden onset of fatigue or weakness during times of stress, exertion, or temperature changes.

5. Bladder & Bowel Dysfunction:

   • MS can affect the function of the bladder and bowel, leading to urinary urgency, frequency, or retention, as well as constipation or fecal incontinence.
   • Be prepared to address any bladder or bowel-related concerns and provide appropriate assistance and support to the patient during the transport process.

6. Cognitive & Emotional Impacts:

   • MS can affect cognitive function, including memory, attention, and processing speed. Patients may experience difficulties with concentration, problem-solving, and multitasking.
   • Be patient and supportive when communicating with patients with MS, and allow extra time for processing information and making decisions.
   • Recognize the emotional impact of living with a chronic and unpredictable condition like MS, and provide reassurance and empathy to the patient and their caregivers.

7. Medications & Treatments:

   • MS patients may be prescribed disease-modifying therapies (DMTs) to reduce disease activity and slow the progression of disability.
   • Be aware of any medications that the patient is taking for symptom management, such as corticosteroids for acute exacerbations or medications for spasticity, pain, or bladder dysfunction.

8. Collaboration with Healthcare Providers:

   • Communicate with the patient's neurologist or MS specialist to obtain relevant medical history, treatment information, and guidance on managing acute exacerbations or complications.
   • Provide a detailed report to the receiving healthcare facility to ensure that the patient's ongoing medical needs are addressed and that appropriate follow-up care is arranged.

By being knowledgeable about the unique challenges and needs of patients with multiple sclerosis, EMS providers can deliver compassionate and effective care that supports optimal outcomes and enhances the patient's overall well-being.

Further Reading:

Alexander, M. & Belle, R. (2017) Advanced EMT: A Clinical Reasoning Approach (2nd Ed). Hoboken, New Jersey: Pearson Education

Bledsoe, B. E., Cherry, R. A. & Porter, R. S (2023) Paramedic Care: Principles and Practice (6th Ed) Boston, Massachusetts: Pearson

Mistovich, J. J. & Karren, K. J. (2014) Prehospital Emergency Care (11th Ed). Hoboken, New Jersey: Pearson Education

Peate, I. & Sawyer, S (2024) Fundamentals of Applied Pathophysiology for Paramedics. Hoboken, New Jersey:  Wiley Blackwell