Specialized Paramedicine

Trauma Care rss

TECC After-Action Video

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April 11, 2018

13 students representing seven agencies participated in SpecMed’s inaugural TECC class at Livingston County EMS on March 17-18. Some topics covered included Rescue Task Force operations and ballistic protection, TECC in fire and rescue environments, and applying tactical medical principles to more “conventional” assignments that include an element of threat. The class was presented through… Read More ›

Junctional Hemorrhage

Now that extremity tourniquets are in widespread use by the U.S. military, junctional hemorrhage is the most common cause of death from compressible hemorrhage. —Death on the Battlefield (2001-2011): Implications for the Future of Combat Casualty Care Junctional hemorrhage represents a critical area of concern in combat casualty care as improvised explosives have evolved to… Read More ›

Body Armor: Not Just for TEMS?

In September, FEMA released a guideline for EMS and fire response to active killer events, which it terms AS/MCI’s. Quoted here are the salient operational points, emphasis added: Considerations should be made for all potential first responders, including LE patrol officers, to be trained to the basic tenets of TECC. Training, equipment and protocols around… Read More ›

Hypothermia Treatment and Prevention Tools

Let’s say that you are the medic in a search party looking for someone who has been lost for several hours in upstate New York’s less-than-forgiving winter. Let’s go one step further and say that you find them, and they’re cold. What tools do you have to deal with the temperature issues? Throw a traumatic… Read More ›

Burn Care Before The Burn Center

I had a great chance to listen to an old friend talk about burn care last night. Kristen Murphy is a CCRN and coordinator at URMC’s Kessler Burn Center. With so little time spent learning about burn patients, it was nice to have a refresher. So while most of this will serve as just that,… Read More ›

Do We Need Combat Gauze?

There has been an ongoing discussion in the local tactical medicine community regarding the results of some of the research on hemostatic gauze, with the takeaway point being the position that wound packing with standard gauze is as effective as packing with combat gauze and other hemostatic agents for hemorrhage control. This position seems to… Read More ›

Needle Thoracostomy Research and Finger Thoracostomy as a Definitive Intervention

TCCC and most EMS protocols list needle thoracostomy as the intervention of choice in the management of a suspected tension pneumothorax. There is a significant amount of recent, relevant research regarding needle thoracostomy for chest decompression. Three studies examine the question of the optimal site to use for thoracostomy. A cadaver study found that the fifth… Read More ›

Fasciotomy to relieve compartment syndrome

Crush Injury, Crush Syndrome, and Compartment Syndrome

Because they are both sequelae of crush injuries, crush syndrome and compartment syndrome are often confused by prehospital providers. Crush injury Any mechanism that causes the entrapment and compression of muscle tissue is a crush injury that can eventually lead to both crush syndrome and compartment syndrome. Time under compression and the integrity of the… Read More ›

Dr. Jamie Syrett on neonatal and OB resuscitation, driver resuscitation.

Thursday evening, Newark Wayne Community Hospital welcomed EMS providers to its new emergency department, which will be opening next month. Dr. Jamie Syrett presented on two topics. The first was resuscitation of the neonate and the pregnant female. Points of interest included: Neonatal resuscitation: Transition away from APGAR scores to a classification of normal/purely cyanotic… Read More ›