A survey of 536 AMT personnel, including 136 paramedics, 12 EMTs, 52 respiratory therapists and 288 RNs, reveals most are willing to participate in EMS-related research (87 percent) and AMT-related research (92 percent). But Jolene Fox, A.D., R.N., and colleagues at Intermountain Medical Center in Murray, Utah, also found few with actual research experience.
Overall, 519 respondents shared their association; of the 135 university-based, only about 7, 10 and 12 percent, respectively, had obtained a research grant, presented at industry meetings or had research published. Corresponding figures for the 384 non-university-based respondents were even lower: less than 2, 9 and 10 percent, respectively.
“Given the high levels of interest in research,” Fox told Research Monitor, “providing opportunities for staff participation is a worthy goal.” She suggests staff education on the relevance of quality prehospital- and AMT-focused research—for example, how 1980s-era MAST were contraindicated for hypovolemic trauma, how hyperventilation was found to be detrimental for traumatic brain injury and how research is changing CPR methodology. EMS and AMT managers should also facilitate the training, time and resources their staff need to participate in research, she adds. — Air Medical Journal 29(4):178–187, July/August 2010.
Various cooling methods seem to mitigate the increased core body temperatures and heart rates firefighters experience while working in TPC, suggest study findings from the University of Pittsburgh. David Hostler, Ph.D., and colleagues compared cooling by a fan, forearm immersion in water, hand cooling and a water-infused cooling vest as alternatives to either a saline infusion at 4 degrees C (39.2 degrees F) or passive cooling in ambient air at 24 degrees C (about 75 degrees F).
On each of six days (one week between test days), 13 firefighters and five similarly fit university affiliates, all between 18 and 45 years old, wore TPC while exercising for 50 minutes on a treadmill. After removing their TPC, they cooled for 20 minutes via one of the six methods and re-donned TPC for a second treadmill bout. The rest period was not sufficient for participants to fully recover their pre-exercise core temperature. Participants were also not able to exercise as long during the second vs. the first treadmill period, regardless of the cooling method used. Hostler’s team found no clear advantage over passive cooling for any of the other cooling methods tested. — Prehospital Emergency Care 14(3):300–309, July/September 2010.
By 2030, 49 percent of all EMS transports in North Carolina may be for patients 65 years and older, estimate Timothy F. Platts-Mills, M.D., and colleagues at the University of North Carolina at Chapel Hill. They looked at complete records of more than 2.7 million ED visits in 2007—just over 38 percent of all EMS transports involved patients 65 years and older—and estimated corresponding figures for year 2030 using state demographic projections from the U.S. Census Bureau. Year 2030 projections suggest total EMS to ED transports will increase by 47 percent and patients 65 years and older will account for 70 percent of the increase. These figures likely exemplify national trends, the researchers note, and emphasize the need for increased geriatric training for EMS providers. — Prehospital Emergency Care 14(3):329–333, July/September 2010.
Average Kansas City, Mo., response intervals—time of call to time on-scene—increase about 4.5 minutes when ambulances must stage until law enforcement secures the scene, report Matthew Gratton, M.D., and colleagues at the city’s Truman Medical Center. They reviewed 62,157 EMS calls from 2006; of these, 4,414 (7.1 percent) were staged—about 21 percent each for assault/rape or overdose, nearly 17 percent for psychiatric/suicide attempts, and about 9 percent each for gunshot/stab wounds or unknown cause/man down dispatches.
Response intervals for staged calls averaged 10:55 minutes; non-staged averaged 6:16 minutes. Interestingly, there were similar percentages of transports, 70 and 72 percent, for staged and non-staged calls. Of these transports, 7.2 and 6.7 percent, respectively, involved red lights and sirens from the scene to ED. Red light and siren use, Gratton’s team notes, can serve as a proxy indicator of more serious patient status. — Prehospital Emergency Care 14(3):340–344, July/September 2010.
There’s no cause for shift workers to stop using caffeine to increase alertness, report London School of Hygiene and Tropical Medicine researchers. In fact, when Katherine Ker, BSc, MSc, and her United Kingdom-based colleagues combined results from 13 research studies (about 330 shift workers in total), they found evidence that caffeine may reduce errors and sharpen thinking skills. The caveat: The studies involved mostly young workers under simulated conditions. Therefore, additional research must confirm these findings. — Cochrane Database of Systematic Reviews, 2010, Issue 5, DOI: 10.1002/14651858.CD008508, May 12, 2010.
