1. Immunizations to prevent communicable disease (such as, but not limited to,
meningitis)
• MMR (Measles, Mumps, Rubella)
• DPT (Diphtheria, Pertussis (Whooping Cough), Tetanus)
• Meningitis, Hepatitis A + B ONLY, Polio, Varicella (Chickenpox)
• VACCINE: Bacterial Meningitis = “Haemophilus” H.influenza type B
• Majority viral vaccines
• Bacterial vaccines: tetanus toxoid (causes trismus/lockjaw), meningitis, typhoid
• Influenza virus (flu; provided annually)
2. Evaluation criteria for rapid extrication
➢ 1) Unsafe scene: fuel leaking, fire, etc
➢ 2) Unstable patient condition
➢ 3) One patient blocking a more critical (airway compromised, AMS,
hypoperfusion) patient
• Maintain c-spine stabilization, prepare for move to longboard/spinal board
• Remember; environmental hazards relate to time of day, weather, temp, and
ambient lighting
• Technical Rescue: high angle, vehicle extrication, trench, ice/swiftwater,
hazardous materials
• If appear critical (bleeding to airway, AMS, hypoperfusion), apply cervical
collar, rotate patient as a unit, place backboard on seat, and remove from car
by sliding on backboard = RAPID EXTRICATION. Following removal, then
do rapid head-to-toe. IV and other skills should be performed en route to
hospital. Vest device takes too long to apply!
3. Commonly prescribed diabetic medications
• TYPE I (Insulin): Levemir, Lantus, Byetta, Humalog
• TYPE II (Enhances insulin production): Glucophage, metformin, glipizide,
glyburide, glimepiride
, • EMS: 25g of Dextrose (D50) – hypertonic, can cause tissue necrosis, IV Push
1mg Glucagon – Causes glycogen to be released from liver/muscles, IM
• Hypoglycemic patient given D50, now alert but confused; asks same question
over and over. RESPOND = Repeat the truth/tell them what happened each time.
Keeps patient aware of surroundings.
REMEMBER, patient who is hypoglycemic (ie 40 mg/dL) and denies IV/dextrose
MUST BE INFORMED of risks! Thus, explain they can go into a coma and die;
make sure they are aware of this
4. Types of extrication devices and tools
• Scoop stretcher = Great for hip/pelvic fractures; excellent support; metal frame;
NO log roll needed; SPINAL SUPPORT
, • Stokes basket/litters = Great for moving over rough terrain; use SIX people
• Folding stretcher = LESS support than scoop; better for 2nd patient to be strapped
to bench seat
• Stair chair = move patient in tight spaces, down stairs safely, good for stroke,
nausea, cardiac; NO spine support!
• Rescue = “figure eight on a bight/bite” = secure loop at the working end of a rope,
can attach to a person, fixed object, or piece of equipment. More secure than a
standard figure 8. Half hitch NOT secure. Hitch knot only to ROUND object.
5. Methods to developing EMS research
• Mean = average of the numbers
• Median = midpoint number
• Mode = Most frequent number
• Overall, research validates existing treatments/protocols, provides better patient
care, and improves EMS system
• Case Control – TWO groups; one w/ injury and other w/o or patients with same
injury & diff outcomes. Considered observational, neg = lots of variables.
Looking for causative factors of condition
• Prospective – Controlled, randomized, participants followed FORWARD in time,
high consistency
• Cohort = groups of people with common characteristics (age, living
conditions, personal habits). Ex: determining assoc. of smoking + lung
cancer. Over time, group will divide into those who smoke and those who
don’t. Determine similiarities between those groups.
• Retrospective – Occur AFTER event taken place (review of all chest pain PCRs);
however, no control over patient pop, not randomized, gathered data not designed
for specific study
• Randomized – Divided into control/study groups randomly = no bias. Impractical
due to nature of EMS. Computer program better to randomize.
• Single blind study = Patient OR provider do not know if standard therapy or
research therapy is being given
• ***Double blind study = Both patient/provider do not know if standard/research
therapy is being given. NO BIAS + PROVIDE BEST EVIDENCE