scholarly journals Trauma Ultrasound in Civilian Tactical Medicine

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Lori Whelan ◽  
William Justice ◽  
Jeffrey M. Goodloe ◽  
Jeff D. Dixon ◽  
Stephen H. Thomas
Keyword(s):  
Decision Making ◽  
Law Enforcement ◽  
Emergency Medical Services ◽  
Hospital Setting ◽  
Clinical Applications ◽  
Medical Services ◽  
Medical Support ◽  
Emergency Medical ◽  
Tactical Medicine ◽  
Potential Use

The term “tactical medicine” can be defined in more than one way, but in the nonmilitary setting the term tactical emergency medical services (TEMS) is often used to denote medical support operations for law enforcement. In supporting operations involving groups such as special weapons and tactics (SWAT) teams, TEMS entail executing triage, diagnosis, stabilization, and evacuation decision-making in challenging settings. Ultrasound, now well entrenched as a part of trauma evaluation in the hospital setting, has been investigated in the prehospital arena and may have utility in TEMS. This paper addresses potential use of US in the tactical environment, with emphasis on the lessons of recent years’ literature. Possible uses of US are discussed, in terms of both specific clinical applications and also with respect to informing triage and related decision making.

scholarly journals WSPÓŁCZESNE ZAGROŻENIA DLA SŁUŻB RATOWNICTWA MEDYCZNEGO W KONTEKŚCIE KONFLIKTÓW ASYMETRYCZNYCH

2019 ◽  
Author(s):  
Michał Czerwiński
Keyword(s):  
Law Enforcement ◽  
Emergency Medical Services ◽  
Service System ◽  
Medical Services ◽  
Special Forces ◽  
Asymmetric Warfare ◽  
Emergency Medical ◽  
European Union Countries ◽  
Tactical Medicine ◽  
Health Service System

Abstrakt: Współczesne zagrożenia bezpieczeństwa, a w szczególności konflikty asymetryczne (włączając działania terrorystyczne) i prowadzenie wojen hybrydowych, dotyczą również służb ratownictwa medycznego oraz systemu służby zdrowia. Autor w swojej pracy skupia się na potrzebie wykonania studium możliwości obecnie dostępnych rozwiązań w realiach ratownictwa medycznego w Polsce, jak i wybranych krajach Unii Europejskiej. Przeprowadza ogólną analizę zagrożeń oraz opisuje w jaki sposób ratownictwo medyczne przeniknęło do służb odpowiedzialnych za utrzymanie porządku publicznego i wojska (w tym jednostek specjalnych i wojsk obrony terytorialnej) oraz zespołów ratownictwa medycznego. Abstract: Modern safety threats - in particular with regard to asymmetric warfare (including terrorism activities) and hybrid wars - are related also to emergency medical services and health service system with all their facilities. Author at this study, focused on a need to implement a dissertation of available capabilities for emergency medical services accessible in Poland and selected European Union countries. Implement general threat’s analysis and describe how „tactical medicine” penetrated Law Enforcement, Military (including Special Forces and Territorial Army) and Emergency Medical Services.

Naturalistic Decision-Making in Emergency Medical Services

2017 ◽  
pp. 41-52
Author(s):  
Michael A. Rosen ◽  
Ian Coffman ◽  
Aaron Dietz ◽  
P. Daniel Patterson ◽  
Julius Cuong-Pham
Keyword(s):  
Decision Making ◽  
Emergency Medical Services ◽  
Medical Services ◽  
Naturalistic Decision Making ◽  
Emergency Medical

Emergency Medical Services Experience With Barb Removal After Taser Use By Law Enforcement: A Descriptive National Study

2018 ◽  
Vol 34 (1) ◽  
pp. 38-45
Author(s):  
Mazen El Sayed ◽  
Chady El Tawil ◽  
Hani Tamim ◽  
Aurelie Mailhac ◽  
N. Clay Mann
Keyword(s):  
Law Enforcement ◽  
Emergency Medical Services ◽  
Life Support ◽  
Salt Lake ◽  
Traumatic Injury ◽  
Medical Services ◽  
National Study ◽  
Publication Type ◽  
Excessive Heat ◽  
Emergency Medical

AbstractBackgroundConducted electrical weapons (CEWs), including Thomas A. Swift Electric Rifles (TASERs), are increasingly used by law enforcement officers (LEOs) in the US and world-wide. Little is known about the experience of Emergency Medical Service (EMS) providers with these incidents.ObjectivesThis study describes EMS encounters with documented TASER use and barb removal, characteristics of resulting injuries, and treatment provided.MethodsThis retrospective study used five combined, consecutive National Emergency Medical Services Information System (NEMSIS; Salt Lake City, Utah USA) public-release datasets (2011-2015). All EMS activations with documented TASER barb removal were included. Descriptive analyses were carried out.ResultsThe study included 648 EMS activations with documented TASER barb removal, yielding a prevalence rate of 4.55 per 1,000,000 EMS activations. Patients had a mean age of 35.9 years (SD=18.2). The majority were males (80.2%) and mainly white (71.3%). Included EMS activations were mostly in urban or suburban areas (78.3%). Over one-half received Advanced Life Support (ALS)-level of service (58.2%). The most common chief complaint reported by dispatch were burns (29.9%), followed by traumatic injury (16.1%). Patients had pain (45.6%) or wound (17.2%) as a primary symptom, with most having possible injury (77.8%). Reported causes of injury were mainly fire and flames (29.8%) or excessive heat (16.7%). The provider’s primary impressions were traumatic injury (66.3%) and behavioral/psychiatric disorder (16.8%). Only one cardiac arrest (0.2%) was reported. Over one-half of activations resulted in patient transports (56.3%), mainly to a hospital (91.2%). These encounters required routine EMS care (procedures and medications). An increase in the prevalence of EMS activations with documented TASER barb removal over the study period was not significant (P=.27).ConclusionAt present, EMS activations with documented TASER barb removal are rare. Routine care by EMS is expected, and life-threatening emergencies are not common. All EMS providers should be familiar with local policies and procedures related to TASER use and barb removal.El SayedM, El TawilC, TamimH, MailhacA, MannNC. Emergency Medical Services experience with barb removal after TASER use by law enforcement: a descriptive national study. Prehosp Disaster Med. 2019;34(1):38–45.

Emergency Medical Services Response to Active Shooter Incidents: Provider Comfort Level and Attitudes Before and After Participation in a Focused Response Training Program

2014 ◽  
Vol 29 (4) ◽  
pp. 350-357 ◽  
Author(s):  
Jerrilyn Jones ◽  
Ricky Kue ◽  
Patricia Mitchell ◽  
Sgt. Gary Eblan ◽  
K. Sophia Dyer
Keyword(s):  
Law Enforcement ◽  
Medical Care ◽  
Emergency Medical Services ◽  
Training Program ◽  
Comfort Level ◽  
Medical Services ◽  
Active Shooter ◽  
Response Training ◽  
Emergency Medical ◽  
Before And After

AbstractIntroductionEmergency Medical Services (EMS) routinely stage in a secure area in response to active shooter incidents until the scene is declared safe by law enforcement. Due to the time-sensitive nature of injuries at these incidents, some EMS systems have adopted response tactics utilizing law enforcement protection to expedite life-saving medical care.ObjectiveDescribe EMS provider perceptions of preparedness, adequacy of training, and general attitudes toward active shooter incident response after completing a tactical awareness training program.MethodsAn unmatched, anonymous, closed-format survey utilizing a five-point Likert scale was distributed to participating EMS providers before and after a focused training session on joint EMS/police active shooter rescue team response. Descriptive statistics were used to compare survey results. Secondary analysis of responses based on prior military or tactical medicine training was performed using a chi-squared analysis.ResultsTwo hundred fifty-six providers participated with 88% (225/256) pretraining and 88% (224/256) post-training surveys completed. Post-training, provider agreement that they felt adequately prepared to respond to an active shooter incident changed from 41% (92/225) to 89% (199/224), while agreement they felt adequately trained to provide medical care during an active shooter incident changed from 36% (82/225) to 87% (194/224). Post-training provider agreement that they should never enter a building with an active shooter changed from 73% (165/225) to 61% (137/224). Among the pretraining surveys, significantly more providers without prior military or tactical experience agreed they should never enter a building with an active shooter until the scene was declared safe (78% vs 50%, P = .002), while significantly more providers with prior experience felt both adequately trained to provide medical care in an active shooter environment (56% vs 31%, P = .007) and comfortable working jointly with law enforcement within a building if a shooter were still inside (76% vs 56%, P = .014). There was no difference in response to these questions in the post-training survey.ConclusionsAttitudes and perceptions regarding EMS active shooter incident response appear to change among providers after participation in a focused active shooter response training program. Further studies are needed to determine if these changes are significant and whether early EMS response during an active shooter incident improves patient outcomes.JonesJ, KueR, MitchellP, EblanG, DyerKS. Emergency Medical Services response to active shooter incidents: provider comfort level and attitudes before and after participation in a focused response training program. Prehosp Disaster Med. 2014;29(4):1-7.

scholarly journals Contemporary evidence-based practice in Canadian emergency medical services: a vision for integrating evidence into clinical and policy decision-making

CJEM ◽  
2016 ◽  
Vol 19 (3) ◽  
pp. 220-229
Author(s):  
Jan L. Jensen ◽  
Andrew H. Travers
Keyword(s):  
Decision Making ◽  
Emergency Medical Services ◽  
Evidence Based Practice ◽  
Systems Of Care ◽  
National Level ◽  
Policy Decision ◽  
Medical Services ◽  
Evidence Based ◽  
Emergency Medical ◽  
Patient Health

AbstractNationally, emphasis on the importance of evidence-based practice (EBP) in emergency medicine and emergency medical services (EMS) has continuously increased. However, meaningful incorporation of effective and sustainable EBP into clinical and administrative decision-making remains a challenge. We propose a vision for EBP in EMS: Canadian EMS clinicians and leaders will understand and use the best available evidence for clinical and administrative decision-making, to improve patient health outcomes, the capability and quality of EMS systems of care, and safety of patients and EMS professionals. This vision can be implemented with the use of a structure, process, system, and outcome taxonomy to identify current barriers to true EBP, to recognize the opportunities that exist, and propose corresponding recommended strategies for local EMS agencies and at the national level. Framing local and national discussions with this approach will be useful for developing a cohesive and collaborative Canadian EBP strategy.

Health and Medical Preparedness and Response to the 2008 Republican National Convention

2009 ◽  
Vol 3 (4) ◽  
pp. 224-232 ◽  
Author(s):  
John L. Hick ◽  
Ralph J. Frascone ◽  
Katherine Grimm ◽  
Merle Hillman ◽  
Jayne Griffith ◽  
...  
Keyword(s):  
Law Enforcement ◽  
National Security ◽  
Emergency Medical Services ◽  
Metropolitan Area ◽  
The United States ◽  
Medical Services ◽  
Special Events ◽  
Emergency Medical ◽  
National Convention ◽  
Riot Control

ABSTRACTObjective: National security special events occur yearly in the United States. These events require comprehensive advance planning for health and medical contingencies in addition to law enforcement concerns. The planning for and impact of the Republican National Convention (RNC) on the City of St Paul and the Minneapolis–St Paul metropolitan area is described.Methods: Descriptive analysis of events was provided by the authors based on their planning and operational experiences. Daily data were gathered from area hospitals, emergency medical services agencies, the National Weather Service, federal medical teams, and the Minnesota Department of Health to capture the impact of the RNC on emergency department activity, nonemergency surgery, emergency medical services run volumes, patient visits to onsite and offsite medical clinics, and general hospital occupancy in the metropolitan area.Results: There were no epidemiological signal events. Weather was not extreme. Confrontations between protestors and law enforcement resulted in frequent use of riot-control agents. Protestors sought medical care from “street medics” and their affiliated free clinics in preference to usual medical facilities. Emergency departments close to the event venue reported decreased patient volumes. Hospitals close to the venue reported significantly decreased nonemergency surgical case volumes. Local hospitals implemented access controls and in 1 case, shut down ventilation systems due to riot-control agent deployment in the streets outside. Emergency medical services volumes were near average, with the exception of St Paul Fire Department on the day of a major protest march.Conclusions: Planning and operational response for the RNC consumed large amounts of time and resources. The RNC had minimal patient impact on the health care system and in fact caused significant volume decreases at hospitals proximate to the venue. Although contingencies available for a mass casualty event were not needed, they must continue to be available for all such events. Health and medical preparedness and funding is not adequately detailed in the planning framework for national security special events, and this should be a focus for future events. (Disaster Med Public Health Preparedness. 2009;3:224–232)

Prehospital Research

1993 ◽  
Vol 8 (S1) ◽  
pp. S5-S10 ◽  
Author(s):  
Donald M. Yealy
Keyword(s):  
Emergency Medical Services ◽  
Knowledge Base ◽  
Research Design ◽  
Prehospital Care ◽  
Hospital Setting ◽  
Medical Services ◽  
Professional Advancement ◽  
Emergency Medical ◽  
Potential Benefits ◽  
Basic Features

Prehospital care experienced a “honeymoon” from the early 1970s until recently. Treatments usually were extrapolated directly from the hospital setting, even though the prehospital environment is markedly different. That honeymoon is over and emergency medical services (EMS) providers must prove what is beneficial. Additionally, academic prehospital care physicians interested in professional advancement, must show the same ability as do the more traditional medical academicians to expand the knowledge base of their chosen field.This manuscript will highlight the basic features and identify the potential benefits and pitfalls of prehospital research. This chapter is not a cookbook for EMS research, nor will it obviate the need for accessing other sources on research design. Other manuscripts within this series will focus on more specific topics; yet, it will be obvious that many of the points made here will be re-emphasized in the following papers. That simply is a reflection of the importance of these commonly overlooked perils and pitfalls.

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