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Tactical paramedic

Alan James Hawk
BACKGROUND: Just over 200 years ago, surgeons were puzzled that the use of the tourniquet to control hemorrhage as common sense during surgery was a relatively recent development. Within the last 20 years, much progress has been made to controlling hemorrhage in the prehospital context. Then, as now, it was surprising that progress on something that appeared obvious had occurred only recently, begging the question how controlling blood loss was common sense in a surgical context, but not for emergency treatment...
February 27, 2018: Journal of Trauma and Acute Care Surgery
Juan A March, Theresa E Tassey, Noel B Resurreccion, Roberto C Portela, Stephen E Taylor
BACKGROUND: When working in a tactical environment there are several different airway management options that exist. One published manuscript suggests that when compared to endotracheal intubation, the King LT laryngotracheal airway (KA) device minimizes time to successful tube placement and minimizes exposure in a tactical environment. However, comparison of two different blind insertion supraglottic airway devices in a tactical environment has not been performed. This study compared the I-Gel airway (IGA) to the KA in a simulated tactical environment, to determine if one device is superior in minimizing exposure and minimizing time to successful tube placement...
January 24, 2018: Prehospital Emergency Care
Sedat Bilge, Attila Aydin, Meltem Bilge, Cemile Aydin, Erdem Cevik, Mehmet Eryilmaz
OBJECTIVE: Strict blackout discipline is extremely important for all military units. To be able to effectively determine wound characteristics and perform the necessary interventions at nighttime, vision and light restrictions can be mitigated through the use of tactical night vision goggles (NVGs). The lamp of the classical laryngoscope (CL) can be seen with the naked eye; infrared light, on the other hand, cannot be perceived without the use of NVGs. The aim of the study is to evaluate the safety of endotracheal intubation (ETI) procedures in the dark under tactically safe conditions with modified laryngoscope (ML) model...
July 2017: Military Medicine
Emily M Ayub, Esther M Sampayo, Manish I Shah, Cara B Doughty
BACKGROUND: A gap exists in understanding a provider's approach to delivering care that is mutually beneficial to patients, families, and other providers in the prehospital setting. The purpose of this study was to identify attitudes, beliefs, and perceived barriers to providing patient and family centered care (PFCC) in the prehospital setting and to describe potential solutions for improving PFCC during critical pediatric events. METHODS: We conducted a qualitative, cross-sectional study of a purposive sample of Emergency Medical Technicians (EMTs) and paramedics from an urban, municipal, fire-based EMS system, who participated in the Pediatric Simulation Training for Emergency Prehospital Providers (PediSTEPPS) course...
March 2017: Prehospital Emergency Care
Teija Norri-Sederholm, Heikki Paakkonen, Jouni Kurola, Kaija Saranto
BACKGROUND: In prehospital emergency medical services, one of the key factors in the successful delivery of appropriate care is the efficient management and supervision of the area's emergency medical services units. Paramedic field supervisors have an important role in this task. One of the key factors in the daily work of paramedic field supervisors is ensuring that they have enough of the right type of information when co-operating with other authorities and making decisions. However, a gap in information sharing still exists especially due to information overload...
2015: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Sean M Caffrey, John R Clark, Scott Bourn, Jim Cole, John S Cole, Maria Mandt, Jimm Murray, Harry Sibold, David Stuhlmiller, Eric R Swanson
Demographic, economic, and political forces are driving significant change in the US health care system. Paramedics are a health profession currently providing advanced emergency care and medical transportation throughout the United States. As the health care system demands more team-based care in nonacute, community, interfacility, and tactical response settings, specialized paramedic practitioners could be a valuable and well-positioned resource to meet these needs. Currently, there is limited support for specialty certifications that demand appropriate education, training, or experience standards before specialized practice by paramedics...
November 2014: Air Medical Journal
Matthew J Levy, Rebecca Smith, Kevin B Gerold, Donald W Alves, Nelson Tang
INTRODUCTION: The Maryland State Police (MSP) Tactical Medical Unit (TMU) provides tactical emergency medical support (TEMS) through the deployment of specially trained state trooper tactical paramedics. The MSP TMU maintains an operational database of all mission related medical activity. This information constitutes a robust dataset derived from real world operational medicine experiences. METHODS: A retrospective analysis of de-identified entries from the MSP TMU operational response database was performed for the 5-year period of 2007?2013...
2014: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Brian J Yun, Calvin A Brown, Christopher J Grazioso, Charles N Pozner, Ali S Raja
OBJECTIVES: While optical and video laryngoscopy have been studied in the emergency department, the operating room, and the routine prehospital setting, their efficacy in the tactical environment--in which operator safety is as important as intubation success--has not been evaluated. This study compared direct laryngoscopes to optical (AirTraq) and video (King Vision) laryngoscopes in a simulated tactical setting. METHODS: This prospective institutional review board-approved simulation study evaluated each of the laryngoscopes in the hands of seven experienced tactical paramedics...
July 2014: Prehospital Emergency Care
D Q McArdle, D Rasumoff, J Kolman
The emphasis of training for paramedics that function in the civilian sector in the United States has focused on the management of blunt trauma. The personal risks they face generally are the result of accidents or public health threats. The management of penetrating trauma under the threat of intentional personal harm is a different matter.Law enforcement agencies have responded to the threat of apprehending heavily armed felons by forming special units highly trained in military-style, small-unit tactics...
September 1992: Prehospital and Disaster Medicine
John R Clark
No abstract text is available yet for this article.
2013: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Amy Apodaca, Chris M Olson, Jeffrey Bailey, Frank Butler, Brian J Eastridge, Eric Kuncir
BACKGROUND: The following three helicopter-based medical evacuation platforms operate in Southern Afghanistan: the US Army emergency medical technician (basic)-led DUSTOFF, US Air Force paramedic-led PEDRO, and UK physician-led medical emergency response team (MERT). Nearly 90% of battlefield deaths occur in the prehospital phase, comparative outcomes for these en route care platforms are unknown. The objective of this investigation was to characterize the nature of injuries in patients transported by three evacuation platforms...
August 2013: Journal of Trauma and Acute Care Surgery
Daniel Cohen, Nick Sevdalis, Vishal Patel, Michael Taylor, Henry Lee, Mick Vokes, Mick Heys, David Taylor, Nicola Batrick, Ara Darzi
OBJECTIVES: To determine feasibility and reliability of skills assessment in a multi-agency, triple-site major incident response exercise carried out in a virtual world environment. METHODS: Skills assessment was carried out across three scenarios. The pre-hospital scenario required paramedics to triage and treat casualties at the site of an explosion. Technical skills assessment forms were developed using training syllabus competencies and national guidelines identified by pre-hospital response experts...
July 2013: Resuscitation
Christian Hohenstein, Dorothea Hempel, Kerstin Schultheis, Oliver Lotter, Thomas Fleischmann
BACKGROUND: Medical errors frequently contribute to morbidity and mortality. Prehospital emergency medicine is prone to incidents that can lead to immediate deadly consequences. Critical incident reporting can identify typical problems and be the basis for structured risk management in order to reduce and mitigate these incidents. METHODS: We set up a free access internet website for German-speaking countries, with an anonymous reporting system for emergency medical services personnel...
May 2014: Emergency Medicine Journal: EMJ
Lewis J Kaplan, Mark D Siegel, Alexander L Eastman, Lisa M Flynn, Stanley H Rosenbaum, David C Cone, David P Blake, Jonathan Mulhern
Tactical emergency medical services (TEMS) bring immediate medical support to the inner perimeter of special weapons and tactics team activations. While initially envisioned as a role for an individual dually trained as a police officer and paramedic, TEMS is increasingly undertaken by physicians and paramedics who are not police officers. This report explores the ethical underpinnings of embedding a surgeon within a military or civilian tactical team with regard to identity, ethically acceptable actions, triage, responsibility set, training, certification, and potential future refinements of the role of the tactical police surgeon...
December 2012: Prehospital and Disaster Medicine
A Rump
War wounds usually show abundant devitalized tissue and often contain foreign material (environmental matter, shrapnels, and bullets). Thus, they are particularly prone to infection. Moreover, evacuation to a medical treatment facility and surgical debridement are often delayed due to tactical constraints. Thus, the early administration of an antibiotic on the ground in a prehospital setting seems justified to slow bacterial growth and the development of early infection. However, antibiotics are never a substitute for surgical treatment...
March 2012: Annales Françaises D'anesthèsie et de Rèanimation
A Donat, F Petitjeans, P Précloux, M Puidupin, J Escarment
OBJECTIVES: To detail current data in cricothyrotomy and imperatives of airway management in combat casualty care. METHODS: Review of the literature in Medline database over the past 40 years. RESULTS: Modern armed conflicts, including guerrilla and terrorism, have changed the approach of tactical combat casualty care. The first medical support must be as close as possible to the battlefield, reducing casualties thanks to a quick intervention...
February 2012: Annales Françaises D'anesthèsie et de Rèanimation
Daniel Kollek, Michelle Welsford, Karen Wanger
Providing prehospital care poses unique risks. Paramedics are essentially the only medical personnel who are routinely at the scene of violent episodes, and they are more likely to be assaulted than are other prehospital personnel. In addition to individual acts of violence, emergency medical services (EMS) providers now need to cope with tactical violence, defined as the deployment of extreme violence in a non-random fashion to achieve tactical or strategic goals. This study reviewed two topics; the readiness of EMS crews for violence in their environment and the impact of violence on the EMS crew member...
March 2010: Prehospital and Disaster Medicine
Joseph J Valadez, Jerald Hage, William Vargas
Few studies of community interventions examine independent effects of investments in: (1) capital (i.e., physical, human and social capital), and (2) management systems (e.g., monitoring and evaluation systems (M&E)) on maternal and child health behavior change. This paper does this in the context of an inter-organizational network. In Nicaragua, international non-governmental organizations (NGOs) and local NGOs formed the NicaSalud Federation. Using Lot Quality Assurance Sampling (LQAS), 14 member organizations took baselines measures of maternal safe motherhood and child health behavior indicators during November 1999 and August 2000, respectively, and final evaluation measures in December 2001...
September 2005: Social Science & Medicine
Michael M Krausz
Medical training in the Israel Defense Forces (IDF) is currently based on the principles of the Advanced Trauma Life Support course of the American College of Surgeons termed Military Trauma Life Support. The Advanced Trauma Life Support guidelines provide a systematic standardized approach to the treatment of trauma casualties that has been very successful in civilian trauma. On the battlefield, however, these guidelines have been modified according to the combat environment. The factors that influence these changes are tactical considerations, availability and level of training of medical personal, direct enemy fire, medical equipment limitations, means of transportation of casualties, and the variable transportation time from the front line to the first medical echelon...
May 2003: Journal of Trauma
R F Lavery, M D Adis, J V Doran, M A Corrice, B J Tortella, D H Livingston
The potential need for rapid medical intervention and access to a trauma center after major injury is crucial to the safety and success of SWAT team operations. This manuscript describes the genesis and development of a unique model for which advanced medical care is rendered by trained health care professionals within a regional trauma system in the support of a SWAT team. The model was developed jointly by the Newark, New Jersey, Division of the Federal Bureau of Investigation and The New Jersey Trauma Center-University Hospital, an academic, urban Level I trauma center...
January 2000: Journal of Trauma
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